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Vocal cord stripping may be used to treat very early cancers of the vocal cords. The doctor removes the top layer of tissue from the vocal cord where abnormal cells are located.

TLM can be used to treat some early-stage cancers of the larynx and hypopharynx. A microscope and a focused laser beam are used to see and remove the tumor very precisely while limiting damage to nearby tissues.

Small robotic instruments controlled by the surgeon are used to remove the tumor with very precise movements. TORS is sometimes used for certain cancers of the larynx or hypopharynx.

Smaller cancers of the larynx can sometimes be treated by removing only part of the voice box. The goal of this surgery is to remove all the cancer while leaving as much of the larynx as possible so speech and swallowing can still work.

Supraglottic laryngectomy

Only the part of the larynx above the vocal cords is removed in this surgery. It may be used to treat some supraglottic cancers. Because the vocal cords are left in place, most people are still able to speak afterward.

Hemilaryngectomy

For some small cancers of the vocal cords, the surgeon may remove only one side of the larynx, including one vocal cord. The other side is left in place. Most people keep some ability to speak after this surgery.

This surgery removes the entire larynx. The trachea (windpipe) is attached to a hole (stoma) made in the skin on the front of the neck. You breathe and cough through this hole instead of through your mouth and nose. It is called a tracheostomy or trach.

If your entire larynx is removed, you will no longer be able to speak as you did before the surgery. But you can learn other ways of speaking through various rehabilitation options after this surgery. See Living as a Laryngeal or Hypopharyngeal Cancer Survivor to learn more.

The connection between the throat and the esophagus (swallowing tube) is usually not affected. You should be able to swallow food and liquids just as you did before the surgery.

A tracheostomy is a stoma (hole) made through the skin in the front of the neck and attached to the trachea (windpipe). It is done to help a person breathe.

Short-term tracheostomy

Your doctor may create a short-term tracheostomy if they expect a lot of swelling in your airway after your cancer is removed. This is done by using a small plastic tube to help you breathe more easily until the swelling goes down. It stays in place for a short time and is then removed (reversed) when it's no longer needed.

A short-term tracheostomy may be needed after a partial laryngectomy or pharyngectomy.

Permanent tracheostomy

You may need a permanent tracheostomy if the cancer is blocking your throat and is too big to remove completely. This is a permanent opening to connect a lower part of your windpipe to a stoma (hole) in the front of your neck. It bypasses the tumor and allows you to breathe more comfortably.

A permanent tracheostomy is needed after a total laryngectomy.

Cancer in the larynx or hypopharynx may keep you from swallowing enough food to stay well nourished. This can make you weak and make it harder to complete treatment. Sometimes the treatment itself can make it hard to eat enough. A few different types of feeding tubes might be used in these situations.

Gastrostomy tube (G-tube)

A gastrostomy tube, or G-tube, is a feeding tube put through the skin and muscle of your abdomen (belly) and right into your stomach. Sometimes this tube is placed during a surgery, but often it's put in place through endoscopy.  

When the feeding tube is put in place through endoscopy, it's called a percutaneous endoscopic gastrostomy, or PEG tube.

The tube is placed while you are sedated, using medicine to put you in a deep sleep. The doctor inserts an endoscope down your throat. This is a long, thin and flexible tube with a camera on the end so the doctor can see inside your stomach. The feeding tube is then guided through the endoscope and to the outside of your body.

Once in place, the feeding tube can be used to put liquid nutrition right into your stomach. As long as you can still swallow normally, you can also eat regular food while you have this type of tube.

PEGs can be used for as long as needed. Sometimes these tubes are used for a short time to help keep you healthy and fed during treatment. They can be removed when you are able to eat normally.

Nasogastric feeding tube (NG tube)

If the swallowing problem is likely to be only short-term, another option is a nasogastric feeding tube (NG tube). This tube goes in through your nose, down your esophagus, and into your stomach. Special liquid nutrients are put in through the tube. Some people dislike having a tube coming out of their nose and prefer a PEG tube.

No matter which type of feeding tube you have, you and your caregivers will be taught how to use it. After you leave the hospital, home health nurses may visit to make sure you are comfortable with tube feedings.

If radiation is part of your treatment plan, you must have a dental evaluation before you begin. Depending on the radiation plan and condition of your teeth, some or even all of your teeth may need to be removed before radiation can start.

The teeth may be removed by a head and neck surgeon or an oral surgeon. If broken or infected (abscessed) teeth are left in and exposed to radiation, these teeth are very likely to cause problems such as infections and areas of bone death (necrosis) in the jaw.

Laryngectomy, the surgery that removes the voice box, leaves you without the usual means of speech. The voice can be restored in several ways. See After Treatment for Laryngeal and Hypopharyngeal Cancer to learn more about voice restoration.

After a laryngectomy, you breathe through a tracheostomy. This is a hole (stoma) placed in the front of your neck that connects to your trachea (windpipe).

The air you breathe in and out no longer passes through your nose or mouth. This normally helps moisten, warm, and filter the air, removing dust and other particles. The air reaching your lungs will be dryer and cooler. This can irritate the lining of the tracheostomy and can cause thick or crusty mucus to build up.

It's important to learn how to take care of your stoma.

You will need to use a humidifier over the stoma as much as possible, especially right after the surgery, until your airway lining has a chance to adjust to the drier air now reaching it.

You will also need to learn how to suction out and clean your stoma to help keep your airway open. Your healthcare team can teach you how to care for and protect your stoma. This includes keeping small particles out of your windpipe and making sure water does not enter it when you shower or bathe.

It is sometimes hard to swallow well after throat surgery. This can affect how you eat. If it’s severe, you might need a permanent feeding tube.

Pharyngectomy can also lead to the development of a fistula. This is an abnormal opening between 2 areas that are not normally connected. If this happens, you may need surgery to fix it.

A very rare but serious complication of neck surgery is rupture of a carotid artery. This is the large artery on either side of the neck.