Management of Total Laryngectomy: Pre- and Postoperative Care
Presented by Kelly Salmon
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Nonfinancial: Kelly Salmon is a member of the American Speech-Language-Hearing Association, the Dysphagia Research Society, and the Pennsylvania Speech and Hearing Association. She is a Professional Development Manager (PDM) for ASHA Special Interest Group 13. She is also a member of the Pennsylvania Academy of Otolaryngology – Head and Neck Surgery and the Lymphology Association of North America. Kelly Salmon has no competing nonfinancial interests or relationships with regard to the content presented in this course.
Laryngeal cancer accounts for approximately 1% of all new cancer diagnoses worldwide. For some individuals with advanced stages of laryngeal cancer, failure of targeted organ preservation therapies, or a dysfunctional larynx, surgical intervention may be recommended in the form of a total laryngectomy (TL). Management of individuals undergoing TL requires a specific set of knowledge and skills to ensure successful outcomes postoperatively.
This course is recommended for speech-language pathologists, physical therapists, registered nurses, occupational therapists, and social workers practicing in hospital, outpatient, skilled nursing, home care, private practice, or outpatient settings who are interested in learning more about the care of individuals undergoing total laryngectomy during the preoperative and immediate postoperative phases. This course will provide the participant with a foundation upon which to develop the skills necessary to care for individuals for whom total laryngectomy has been recommended. Participants will gain insight into the role of the speech-language pathologist (SLP) in the preoperative evaluation and counseling process. In addition, care of the individual in the acute postoperative phase will be addressed, including the roles of the SLP and the interprofessional team in ensuring that the individual post TL is able to: (a) complete self-care activities related to postsurgical anatomic changes, (b) communicate effectively, and (c) establish expectations related to breathing, communication, and swallowing function.
Meet your instructor
Kelly Salmon
Kelly is a speech-language pathologist specializing in the treatment of adults with communication and swallowing disorders across the continuum of care. She has been a Board Certified Specialist in Swallowing and Swallowing Disorders (BCS-S) since 2011 and earned designation in 2014 as a Lymphology Association of North…
Chapters & learning objectives
1. Introduction to Total Laryngectomy
This chapter explains what a total laryngectomy is and what is involved in the surgical procedure (in general terms). In addition, the indications for total laryngectomy and the role of the SLP during the preoperative phase are discussed. Finally, the members of multidisciplinary team and their roles are identified.
2. Preoperative Assessment
This chapter discusses in detail what is included as part of a preoperative assessment and counseling session. The types of resources and materials that are typically used for patient education preoperatively are identified and demonstrated. Finally, an explanation of the key changes to the processes of respiration, communication, and swallowing that result from TL is given.
3. Patient Perspective: Preoperative Experience
This chapter includes a brief discussion with an individual who has been a long-term HNC survivor post TL. The guest provides responses to questions related to his experience during the preoperative phase.
4. Acute Postoperative Care
This chapter identifies the role of the SLP in the immediate postoperative phase within the acute care setting. Priorities in caring for the individual post TL during the typically limited time in the inpatient setting, and typical protocols for establishing a reliable means of communication in the immediate postoperative phase are discussed. In addition, the role of the speech-language pathologist within the multidisciplinary team in patient education, training, and preparation for discharge from the acute setting is highlighted.
5. Postsurgical Supply and Equipment Needs
This chapter Identifies necessary supplies for alaryngeal communication postoperatively, including options for stoma protection. The importance and benefits of early application and consistent use of heat–moisture exchange (HME) filter systems is discussed. Other miscellaneous items that are typically necessary when transitioning from acute inpatient care to inpatient acute or subacute rehabilitation or home are described.
