Bechara Y. Ghorayeb, MD, PA
Otolaryngology-Head & Neck Surgery                                                              Phone: 713 464 2614
8830 Long Point, Suite 806
Houston, TX 77055                   www.ghorayeb.com


Laryngectomy
Informed Consent
Total or partial laryngectomy has been a highly successful method to remove cancer of the larynx (voice box). The choice of surgery over other forms of treatment such as radiation or chemotherapy is determined by the tumor size, although patient preference and social factors may influence that decision. If it is quite likely that there has been spread of the tumor to the neck, a lymph node dissection may also be recommended.

Two common, but temporary, complications of laryngectomy are wound infection and fistula (an opening from the throat allowing saliva to leak out through the neck incision). Breathing or swallowing difficulties sometimes occur and require treatment. Alteration of voice is not a complication, as it always occurs with total or partial laryngectomy. Post operative rehabilitation is usually successful in helping the patient recover a voice that can be understood. After a total laryngectomy, there may be some loss of lifting strength. Some patients also experience some difficulty in straining to have a bowel movement. Alteration in the sense of smell can be expected after total laryngectomy, because the patient is no longer able to breathe through the nose. Patients with tracheostomies must avoid water sports for risk of drowning.



I/We have been given an opportunity to ask questions about my condition, alternative forms of treatment, risks of nontreatment, the procedures to be used, and the risks and hazards involved, and I/we have sufficient information to give this informed consent. I/We certify this form has been fully explained to me/us, and I/we understand its contents. I/We understand every effort will be made to provide a positive outcome, but there are no guarantees.


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Patient / Legal Guardian
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Witness

Date:___________________________          Time:___________________________


  www.ghorayeb.com