What Is a Laryngectomy?

Start with the word itself: a laryngectomy is surgery to remove the larynx — your voice box. Rather than describing it as one big event, it helps to follow it as a sequence of steps, because each step answers a different worry. The short video at the top of this page, "Laryngectomy" (about two minutes and twenty seconds), outlines the core idea plainly: the larynx is removed and the airway is separated from the mouth, nose and food pipe. Here's how that plays out in practice, step by step.

Step 1: The decision — part or all of the voice box

The first step happens long before any operating theatre. Your team looks at why surgery is being considered — most often a growth in the larynx that cannot be dealt with safely in a smaller way, and occasionally severe damage or a voice box that no longer protects the airway. If only part of the larynx needs to go, that's a partial laryngectomy, and some natural voice may be preserved. If the whole voice box must be removed, that's a total laryngectomy, and it changes breathing and speaking permanently — which is why the decision is never rushed. Scans, a camera examination of the throat and a biopsy usually feed into it, and you'll normally meet a speech and language therapist before surgery, not after, so the communication options are familiar in advance.

Step 2: Preparing for a different way of breathing

Here's the part people find hardest to picture. After a total laryngectomy you no longer breathe through your nose and mouth. Instead, the windpipe is brought out to a small, permanent opening at the front of the neck, called a stoma, and all your breathing happens through it. That is different from the temporary or sometimes long-term neck opening described in our guide to tracheotomy, where the voice box itself stays in place and air can still pass up through it. With a laryngectomy stoma there is no connection left between the windpipe and the mouth — which also means food and drink can no longer slip into the airway. Before surgery, nurses usually show you stoma covers and simple humidifying filters, because air that bypasses the nose arrives drier than your lungs are used to.

Step 3: The operation itself

You'll be asleep under a general anaesthetic for this step. Working through an incision in the neck, the surgeon removes the part of the larynx agreed in Step 1 — or the whole voice box in a total laryngectomy — and, where needed, nearby lymph nodes in the neck as well. In a total laryngectomy the top of the windpipe is stitched to the skin of the neck to form the stoma, and the food pipe is closed and repaired so swallowing has its own separate route. It's major surgery, and it takes several hours. When you wake up you'll have the stoma at the front of your neck, usually with a soft tube or cover over it at first, plus drains and a drip that are removed over the following days. Unlike the much smaller throat operation in our tonsillectomy guide, this isn't a go-home-the-same-day procedure — expect a hospital stay measured in days, often around a week or more.

Step 4: Healing, eating and the first quiet days

For the first stretch afterwards, most people are fed through a tube while the repaired food pipe heals, and swallowing is reintroduced gradually, sometimes after a check that nothing is leaking. Your voice, though, is the absence you'll notice most. After a total laryngectomy you cannot speak the usual way at first, so writing boards, gestures and messaging apps do the talking while you heal. That quiet period is planned for, not a setback. The stoma also needs daily care — gentle cleaning, humidified air, and a cover when you go out — and the nursing team will practise it with you until it feels routine. Call your team promptly if the stoma narrows, bleeds, or breathing through it becomes noisy or difficult.

Step 5: Finding a voice again

The final step is rehabilitation, and for many people it's the most hopeful one. A speech and language therapist will talk you through the main routes: a voice prosthesis — a small silicone valve fitted between the windpipe and food pipe that lets you produce voice by covering the stoma and speaking as you breathe out; an electrolarynx, a handheld device held to the neck that creates a buzz you shape into words; and oesophageal speech, a learned technique using swallowed air. The second video on this page, "Voice Prothesis" (about a minute and a half), explains how that small silicone prosthesis helps people who've had their voice box removed to speak again. None of these restores your old voice exactly, but with practice many people hold conversations, use the phone, and get back to work. Give it time, and take the follow-up therapy appointments seriously — they're part of the operation's success, not an optional extra.

References & further reading

• MedlinePlus — Laryngectomy: https://medlineplus.gov/ency/article/007398.htm
• MedlinePlus — Throat Cancer: https://medlineplus.gov/throatcancer.html
• National Cancer Institute — Laryngeal Cancer Treatment: https://www.cancer.gov/types/head-and-neck/patient/adult/laryngeal-treatment-pdq
• NHS — Laryngeal (larynx) Cancer: https://www.nhs.uk/conditions/laryngeal-cancer/

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Will I be able to talk after a total laryngectomy? Not with your natural voice, because the vocal cords are removed with the larynx. Most people do learn to communicate out loud again using a voice prosthesis, an electrolarynx, or oesophageal speech, with help from a speech and language therapist. It takes practice, and your team will discuss the options before surgery.

Is a laryngectomy stoma the same as a tracheotomy? No. A tracheotomy is an opening into the windpipe while the voice box remains in place, and it can be temporary. After a total laryngectomy the stoma is permanent, the voice box is gone, and the airway is completely separated from the mouth and nose.

Can I eat and drink normally afterwards? Usually, yes — once the food pipe has healed. Most people are tube-fed at first, then return to drinking and eating in stages under the team's guidance. Because the airway is separated, food going down the wrong way is far less of a risk than before.

Can I shower or swim with a stoma? Showering is fine with care and a stoma cover to keep water out. Swimming and bathing in deep water are risky because water can enter the windpipe directly through the stoma, so most people are advised against them unless their team suggests specialised equipment and training.

How long is recovery? The hospital stay is often around a week or more, and energy and neck movement return gradually over the following weeks. Voice rehabilitation continues for longer. Your own timeline depends on whether the surgery was partial or total and on any other treatment you need.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/14/26

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. If you have difficulty breathing through a stoma, bleeding from the neck, or sudden swelling, seek urgent medical care.