[Laryngectomy-still state of the art?].

Total laryngectomy provides a curative approach for patients with advanced laryngeal and hypopharyngeal cancer without distant metastasis. Especially in stage cT4a disease, laryngectomy is superior to primary radio(chemo)therapy in retrospective studies. Further relevant indications for the procedure are tumor-related laryngeal dysfunction such as dysphagia and aspiration, as well as cancer recurrence after primary radio(chemo)therapy. The surgical procedure is highly standardized, with an appropriate safety profile. The subsequent loss of voice must be compensated by voice rehabilitation (voice prosthesis, ructus). The current overview provides information about indications for laryngectomy, preoperative clinical diagnostics, the surgical procedure, complications, alternative treatment, rehabilitation, and prognosis. Total laryngectomy remains a standard procedure in modern head and neck oncology.