Total Laryngectomy for the Hospital Medicine Provider.

Total laryngectomy (TL) is a common surgical procedure that is performed for patients with advanced laryngeal cancer, recurrent laryngeal cancer, or laryngeal dysfunction after radiation. TL entails the removal of the entirety of a patient's larynx and reconstruction by creating a tracheal stoma in the anterior neck, permanently separating a patient's gastrointestinal and respiratory tracts. In the immediate postoperative setting, care must be taken to ensure the stoma is not occluded by crusting or thick secretions. Various airway prostheses, including heat moisture exchangers, can be used to prevent dehydration of a laryngectomy patient's lower respiratory tract.