Anaesthetic Management of Total Laryngectomy Patients

Abstract

Laryngeal carcinoma is one of the common malignancies of the head and neck. Incidence is higher in males than females, and it is more affecting patients in 60 to 70 years old. More than 90% of laryngeal cancer is squamous cell carcinoma (SCC), and is directly linked to smoking and excessive alcohol use. Total laryngectomy continues to play a major role in the treatment of advanced laryngeal cancer or for recurrent/persistent disease after failed organ preservation attempts. Laryngeal cancer patients are a great challenge and they need meticulous evaluation preoperative and special measures intraoperative and of course close observation and management postoperative. The general condition of the patients is one of the most important points during the management. Those patients mostly are elderly smokers with many associated comorbidities such as ischemic heart diseases, chronic obstructive pulmonary diseases, diabetes mellitus, impairment of renal and hepatic functions, nutritional and psychological problems and notably their preoperative treatment by radiotherapy and chemotherapy with their associated undesired side effects. All of this demands special consideration and perioperative management.