Authors: Jerzy Rottermund, Agnieszka Hamerlińska, Andrzej Knapik
Published online: 16 July 2020
Abstract: Total laryngectomy is a surgical procedure that consists in the removal of the larynx used in patients with advanced laryngeal cancer. A tracheostomy is also required, which means that after the procedure, breathing will be done while bypassing the mouth, nose, and throat. After the procedure, patients are unable to speak, their swallowing and taste are impaired, the appearance of the face changes, the patient’s body posture is disturbed, whereas postoperative scars limit the range of motion within the neck and shoulder girdle. In addition to surgery, radiation, and chemotherapy, modern standards of cancer treatment include physiotherapy, which has become an indispensable element of comprehensive rehabilitation at every stage of medical management. The paper presents the basic health problems of patients following the surgeries that occur in the motor, respiratory, circulatory, digestive, and sensory systems as well as communication difficulties. The main goal of physiotherapy in patients with laryngeal cancer is to prevent complications and functional disorders. The paper presents a tabular summary of the physiotherapy used in patients after total laryngectomy divided into preoperative, postoperative hospital, postoperative inpatient, and late postoperative periods. Therapeutic recommendations and goals that can be achieved in individual periods were defined. The need to individualize physiotherapeutic procedures and the importance of physiotherapists in the psychoeducation process were also indicated.
Properly conducted physiotherapy helps reduce pain and sensory disturbances, improves the performance of the musculoskeletal system and reduces anxiety. The above-mentioned elements of therapy have an impact on the achievement of the main goal of the treatment of patients following total laryngectomy, which is to achieve the fullest possible psychomotor performance and speech re-education.