GLOSSARY OF TERMS

Your laryngectomee journey will introduce you to medical terms and words you may not know, or fully understand. Below are some of the common words and terminology that crop up in conversation, before and after laryngectomy surgery.

Achalasia

Achalasia is a health condition that prevents the nerves that control the muscles of the oesophagus and the sphincter from working properly. Normally, food is pushed down the oesophagus by a series of muscle contractions. It enters the stomach through a valve called the lower oesophageal sphincter.

When someone has achalasia, their sphincter does not relax and so food can’t pass through. Instead of passing into the stomach, the food can get stuck in the oesophagus or come back up into the mouth. (Health Direct)

Although rare, Achalasia like symptoms may affect patients after Laryngectomy surgery. The cause is unknown, but may be owing to the disruption of the nerves during surgery.

Artificial Larynx (AL)

An Artificial Larynx works by electronically or pneumatically producing a tone that substitutes for the vocal chords. The Artificial Larynx produces a voice that would not otherwise be there. There are a large number of electronic Artificial Larynges but a more restricted range of pneumatic ones.

Biopsy

Taking a sample of tissue for examination to determine whether cancer cells are present.

Calcium

Calcium is not only essential for healthy bones but also aids muscle contraction, heart action, vitamin B-12 absorption and blood clotting. Hypoglycemia (low calcium) can affect the nervous system and cause spasms, muscle cramps, abdominal cramps etc.

Calcium deficiency can lead to poor mineralisation of bones, osteoporosis etc. Foods containing calcium include dairy products, broccoli, spinach, salmon, oysters, tofu etc.

The ideal daily intake of calcium is 1,000 to 1,300 milligrams. Over 2,500 milligrams per day can lead to hyperglycaemia and associated problems.

cancerresearchuk.org/about-cancer/coping-with-cancer/coping-physically/calcium

Cancer

A group of different and distinctive diseases. Cancer refers to cells which grow abnormally in an uncontrolled fashion. Any tissue in the body can be involved and there can be many different forms of cancer in each area of the body.

Candida

Variety of thrush that colonises voice prostheses causing them to leak. Controlled by soaking prosthesis in hydrogen peroxide or Milton, coating flange of fresh prosthesis with Nystatin gel, gargling with Nystatin drops, using slippery elm powder, Fungilin (on prescription) and eating acidophilus yogurt. Avoid consuming yeasty food and drinks.

altmedicine.about.com/od/popularhealthdiets/a/candidadiet.htm

Chemotherapy

Anticancer drugs can be given into a vein, muscle or orally. Chemotherapy is usually given in cycles i.e. a period of treatment followed by a period of recovery. Side effects can include loss of appetite, vomiting, hair loss and mouth sores. The side effects tend to go away after treatment stops. In younger people, chemotherapy can result in a loss of fertility.

medicinenet.com/chemotherapy/article.htm

Depression

Depression often goes undiagnosed and untreated. Emotional reactions including depression are experienced by most people who are diagnosed with cancer. Depression is readily treatable with medications, counseling, or a combination of both. See your family doctor, psychiatrist or psychologist for diagnosis, referral, and/or treatment.

www.healthyplace.com/communities/depression/nimh/co_occurence_depression_cancer.htm

Dry Mouth
Dysphagia

Dysphagia is the medical term for difficulty in swallowing. Laryngectomees may experience difficulty in swallowing caused by muscle problems of the face or neck, oesophageal spasms, or structural changes to the mouth and throat after surgery. Speech pathologists can help by suggesting swallowing exercises or arrange tests to investigate the problem further.

Fistula

A fistula is an abnormal connection or passageway that forms between two organs or vessels that do not normally connect. In the context of a laryngectomy, a fistula can develop between the trachea and the esophagus or another nearby structure. This can cause complications such as leakage of food or fluids, infections, and difficulty swallowing. Treatment may involve medical management or surgical repair, depending on the severity and location of the fistula.

 

Granulation

Is the part of the healing process where rough pink tissue, which contains new connective tissue and capillaries, form around the edge of a wound. Granulation is normal and desirable.

Grief

Psychiatrist Elizabeth Kubler-Ross describes a five stage grieving process, and becoming a laryngectomee represents one or more losses we have to work through. The five stages are: Shock and Denial, Anger, Bargaining, Depression and Acceptance. When you reach acceptance you are ready to get on with your life.

HME – Heat and Moisture Exchanger

An HMS is a device used by individuals who have undergone a laryngectomy. It attaches to the stoma (the opening in the neck) and helps to warm and humidify the air being breathed in. This mimics the natural functions of the nose and mouth, helping to prevent dryness and irritation in the airway, and can improve breathing comfort and reduce the risk of respiratory infections.

Laryngectomee

A person with a permanent stoma resulting from a laryngectomy operation.

Laryngectomy

This is the surgery to remove all or part of the larynx or voice box with a stoma being created in the front of the neck. A partial laryngectomy preserves the voice as only part of the voice box is removed and the stoma is only temporary.

With a total laryngectomy the whole of the voice box is removed and the stoma is permanent.

Larynx

This is the voice box, located between the pharynx and trachea and is used in speech, breathing and swallowing.

www.medicinenet.com/larynx_cancer/article.htm

Lymph Glands

Small, bean shaped organs in the lymphatic system which contain cells that can trap cancer cells and bacteria being transported in the lymph fluid.

www.cancerhelp.org.uk/about-cancer/what-is-cancer/body/the-lymphatic-system

Nebuliser

A medical device used to turn liquid medication into a fine mist, which can be inhaled directly into the lungs. It helps treat respiratory conditions like asthma and COPD by delivering medication quickly and effectively. The mist is inhaled through a mouthpiece or mask, making it easier to breathe for those with breathing difficulties.

Oncology

Is the field of medicine concerning cancer. Medical oncology is the treatment of cancer with chemotherapy. Surgical oncology covers biopsy, staging and the resection of tumours.

Radiation oncology is the treatment of cancers with radiotherapy.

P.O.E.M

The per-oral endoscopic myotomy, or POEM, is a minimally invasive surgical procedure for the treatment of achalasia wherein the inner circular muscle layer of the lower esophageal sphincter is divided through a submucosal tunnel. This enables food and liquids to pass into the stomach, a process that is impaired in achalasia. The tunnel is created, and the myotomy performed, using a flexible endoscope, meaning the entire procedure can be done without external incisions. (Wikipedia).

Prosthesis

A prosthesis is any artificial replacement of a body part and can be temporary or permanent.

In laryngectomees we usually refer to a voice prosthesis, which is a one-way valve connecting the airway to the oesophagus which supplies air for producing a voice.

Radiotherapy

Use of high-energy rays to destroy cancer cells, stopping them from growing and dividing. Radiotherapy can be by machine or by implants of radioactive material in or near the tumour.

Side effects include tiredness, skin reactions, loss of appetite etc. Most laryngectomees receive radiotherapy around the neck area after surgery.

www.cancer.gov/cancertopics/factsheet/Therapy/radiation

Reflux

Gastro-oesophageal reflux disease (GORD) { or Gastroesophageal reflux disease (GERD) US } is where acid from the stomach is regurgitated back up the oesophagus, sometimes reaching the throat.

This causes coughing attacks from the burning sensation that is created, damage can occur to the lining of the oesophagus. There are many proprietary medicines to combat GORD, slippery elm powder can also be effective.

http://www.heartburn.com.au/

Stent

A stent is a tube that is used to keep a passageway in the body open, for example in keeping the fistula between the airway and oesophagus open when there is no prosthesis in place.

Stoma

Any opening into the body from outside that is created by a surgeon. In our case it is the entry for the direct airway to the lungs.

Sweet Spot

Refers to the one or two locations on the neck or cheek that most effectively transfers the speech signal of an electronic artificial larynx into the pharynx and mouth for speech.

TEP – Trans Oesophageal Puncture

A surgical procedure often performed at the time of laryngectomy or as a secondary procedure. It involves creating a small hole between the trachea (windpipe) and the esophagus (food pipe). A voice prosthesis is inserted into this puncture, allowing air from the lungs to pass into the esophagus and produce sound, enabling speech. This method is a common and effective way for laryngectomees to regain the ability to speak.

en.wikipedia.org/wiki/Tracheo-oesophageal_puncture

Thyroid

Often removed in total laryngectomy, the thyroid is located around the trachea below the larynx. Hormones that regulate growth and metabolism are made and stored in the thyroid, controlling heart rate, blood pressure, body temperature and the rate food is converted to energy.

The correct dosage of thyroid hormone replacement tablets must be taken each day after thyroidectomy.

www.thyroid.org.au

Tracheostomy

This is the surgical operation that creates the stoma in your windpipe when the larynx is removed. They are also performed to create a temporary airway in an emergency.

www.medicinenet.com/tracheostomy/article.htm

Trismus

A condition characterised by the restricted ability to open the mouth fully, often occurring as a late side effect of radiation therapy for head and neck cancers. It results from fibrosis and stiffening of the jaw muscles and connective tissues. Symptoms include limited mouth opening, jaw pain, and difficulty chewing and speaking. Management typically involves physical therapy, jaw exercises, and sometimes medication or surgical intervention.

Vapourisers

A vapouriser is useful in helping to keep your stoma and airway from drying out, particularly in winter.

Radiators and heaters can make for a dry environment, a bowl of water placed near the heater can maintain humidity.

Vitamin C

An essential nutrient found in fruits and vegetables that must be replenished daily. Vitamin C or Ascorbic Acid helps produce collagen, a protein needed to develop and maintain healthy teeth, bones, gums, cartilage, vertebrate discs, joint linings, skin and blood vessels.

It also promotes healing of wounds, fights infection, dilates blood vessels, regulates cholesterol levels, aids iron absorption among numerous other things that keep you healthy.

Vitamin E

An antioxidant vitamin that binds oxygen free radicals which cause tissue damage. Vitamin E deficiency can cause anaemia.

Research is being conducted into the role of Vitamin E in preventing heart disease and cancer of the lung and prostate.

Xerostomia

From the Greek meaning ‘dry mouth’. Associated with hypothyroidism and radiation, xerostomia results from inadequate function of the salivary glands and can lead to increased tooth decay and thrush.

There are a number of proprietary products that combat xerostomia.

www.medterms.com/script/main/art.asp?articlekey=6041