This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 3, 2022.
Surgery is usually the main treatment for throat cancers diagnosed in the early stages. For later-stage disease, surgery may be combined with other therapies, such as chemotherapy and radiation therapy, as part of a comprehensive throat cancer treatment plan.
Following are the surgical procedures that may be recommended for patients with throat cancer.
With this technique, a long surgical instrument is used to remove the outer layers of tissue on the vocal cords. This approach may be used for a biopsy, or to treat some stage 0 throat cancers confined to the vocal cords. Vocal cord stripping rarely impacts speech after the operation.
In laser surgery, an endoscope with a high-intensity laser on the tip is inserted down the throat. The tumor can then be vaporized or cut out using the laser.
In a cordectomy, part or all of the vocal cords are removed. This approach may be used to treat glottic cancer that is very small or located only on the surface tissues. Patients who receive a cordectomy may experience changes in speech. Removing part of a vocal cord may lead to a hoarse voice. If both vocal cords are removed, speech is no longer possible.
A laryngectomy is an operation in which part or all of the larynx is removed.
For small laryngeal cancers, it may be possible to remove only the portion of the voice box where the cancer exists, leaving the rest of the larynx intact. A partial laryngectomy may be used to remove the portion of the larynx above the vocal cords (supraglottic laryngectomy), or only one of the two vocal cords (hemilaryngectomy).
For more extensive laryngeal cancers, sometimes a total laryngectomy may be the recommended treatment. With this procedure, the entire voice box is removed. Then, in a process known as a tracheostomy, the windpipe is surgically moved toward a hole in the neck for breathing. For patients who follow this treatment option, normal speech is no longer possible, but other forms of speech can be learned. Foods and liquids can be swallowed normally, just as they were before the procedure.
An operation in which part or all of the throat is removed, which may be recommended for patients with hypopharyngeal cancers. In some instances, the surgeon may remove the patient's larynx along with the hypopharynx. Reconstructie surgery may be needed following a pharyngectomy to rebuild the patients throat so they can improve swallowing ability.
A possible option for patients who undergo a laryngectomy, a tracheoesophageal puncture, or TEP, involves a head and neck surgeon placing a small, one-way valve between the trachea and the esophagus, allowing air to reach the lungs while blocking food, saliva and liquids. The valve also produces a vibration that the patient may use for voicing.
Cancer of the throat sometimes spreads to the lymph nodes in the neck. If such spreading seems likely, then removing the lymph nodes during a lymphadenectomy might be recommended. This operation is also called a neck dissection, and is usually done at the same time as surgery to remove an already existing tumor. The exact amount of tissue that needs to be removed depends on the throat cancer stage. With the most invasive procedure, some nerves and muscles that control neck and shoulder movement may be removed with the lymph nodes. However, many times surgery of this kind does not need to involve as much of the healthy tissue, preserving the normal function of the shoulders and neck.
A tracheotomy is done to create an alternate pathway for breathing by creating a hole, or stoma, in the trachea, or windpipe. There are different situations when a tracheotomy may be needed. After a total laryngectomy, the opening in the windpipe is connected with an opening in the front of the neck to provide a new route for breathing. This permanent procedure is known as a tracheostomy.
A gastrostomy tube is a feeding tube that can be inserted directly into the stomach. This approach may be recommended if a cancer in the pharynx prevents swallowing. A gastrostomy tube can ensure that an individual is getting adequate nutrition.
A feeding tube may also be placed in the stomach through the mouth. With this process, known as a percutaneous endoscopic gastrostomy, or PEG, a camera is attached to the end of a long, thin tube, allowing the care team to see directly into the stomach. Special liquid nutrients can be provided through the tube.
These tubes may be inserted on a short-term or long-term basis. They are designed to help keep patients healthy and fed during treatment, and may be left in after treatment, if necessary. The tube can be easily removed as soon as normal eating is possible.
Following extensive surgery to remove throat cancer, reconstructive operations can help restore both the structure and the function of the affected areas.
The throat is reconstructed using muscle and skin from a nearby area that is rotated toward the throat.
Using “microvascular surgery,” in which small blood vessels are sewn together under a microscope, it may be possible to reconstruct the throat using tissues from other areas of the body, such as the intestines or arm muscle.
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