Laryngopharyngectomy With Plastic Reconstruction, Abroad

Laryngopharyngectomy With Plastic Reconstruction cost:
{the cost covers all destination medical & logistics costs}
International Destinations: India, Jordan, Mexico, South Korea, Turkey

Laryngopharyngectomy is a surgical procedure which is used for the management of early carcinomas of the hypopharynx (i.e. the part of the upper aero-digestive tract). The procedure of Laryngopharyngectomy involves the complete removal of the larynx (i.e. the voice box along with the vocal folds) with partial or complete removal of the pharynx. After the removal of the larynx, several reconstructive options are available, which could help the patients in retaining their ability to talk. The pharynx is reconstructed using a flap of skin from the forearm, intestine or any other part of the body. Subsequent to the procedure, patients would require to be specially trained by speech pathologists, to reduce difficulty during swallowing and regain their ability to talk. The procedure is conducted at several hospitals across international medical tourism destinations. The most preferred locations for conducting complex cancer surgeries of the head and neck are South Korea, India, Jordan and Turkey in Asia and Mexico in North America.

The need for Laryngopharyngectomy with plastic reconstruction:

Laryngopharyngectomy is one of the many surgical procedures which are used for the management of laryngeal and hyppharyngeal cancers. The common risk factors/ predisposing factors for the development of cancer of the throat are:

• Smokers are at a very high risk of developing throat cancer. As per available clinical and epidemiological data, throat cancer is closely associated with cancers of the mouth, lung and esophagus.
• Alcohol consumption with smoking is considered to potentially increase the risk of hypopharyngeal cancers.
• Deficiencies of Vitamin A and Vitamin E are known to increase the risk of developing hypopharyngeal cancers. Plummer- Vinson Syndrome, a condition with iron deficiency and difficulty in swallowing has also been associated with hypopharyngeal cancers.
• Certain types of Human Pailloma Virus (HPV) infections are also associated with one- third increase in the risk of developing laryngeal cancers. HPV is transmitted through sexual intercourse
• Exposure to certain chemicals, wood dust, paint fumes, and asbestos, substantially increase the danger of developing laryngeal and hypopharyngeal cancer.
• Other predisposing factors include age ( above 55 years), sex ( males are five times more predisposed) and race ( blacks are more prone than whites to develop laryngeal and hypopharyngeal cancers)

Plastic reconstruction may be done with skin flap from the forearm or intestinal tissue with a Transesophageal puncture, which allows communication between the trachea and the esophagus. This is done to help restore normal ability of the patient to speak after the complete removal of the larynx and the vocal flaps.

Survival rates after Laryngopharyngectomy with plastic reconstruction:

Unfortunately, the diagnosis of hypopharyngeal carcinomas occurs late after their onset, invariably, when the disease has advanced into metastasis. This considerably reduces the post Laryngopharyngectomy five year survival rate to as low as 30%. The cure rate increases with administration of post operative radiation therapy. Plastic reconstruction is accomplished immediately after the procedure which reduces the morbidity associated with the procedure.

Preoperative Care for Laryngopharyngectomy with plastic reconstruction:

• A preliminary physical examination of the patient is conducted which includes examination of the neck, mouth, pharynx and larynx. This is invariably accompanied with a neurological examination.
• Radiological investigations are conducted to locate the tumor mass and assess its size and other morphological considerations. These investigations include X ray examination (i.e. a barium swallow) or Computed Tomography scan or Magnetic Resonance Imaging, which help the oncologist determine the subsequent course of action
• Laryngoscopy: There are different ways of doing this, including, direct laryngoscopy (examination done by inducing the patient with general anesthesia and using a laryngoscope), indirect Laryngoscopy (using a small mirror to view the larynx under local anesthesia to prevent gagging) or fibre-optic laryngoscopy (a fibre-optic tube is inserted into the mouth or nose, which allows the viewing of the larynx and the hypo pharynx). This process is also referred to as the staging endoscopy, which is done to determine the extent of the tumor and its relationship with other essential organs in the region, like the esophageal inlet, pyriform apex and cervical esophagus.
• Biopsy: To confirm the diagnosis of throat cancer, a biopsy is performed, which is a simple process of removing a piece of the diseased tissue and examining it under a microscope. The alternative to biopsy is a FNAC (Fine Needle aspiration cytology).
• Once the procedure is scheduled, the nutritional status of the patient is assessed. Also a plan to surgically manage the airway is discussed by the surgeon and anesthesiologist

Laryngopharyngectomy with plastic reconstruction: The procedure

• The procedure involves the complete removal of the larynx and partial or complete removal of the pharynx. The removal of pharynx depends upon the localized extent of the cancer.
• Occasionally a part of the esophagus may also be removed ( oesphagectomy)
• A tracheotomy is performed whereby a hole is made in the neck to allow the patient to breath, during the procedure.
• After the surgical removal of the larynx and the pharynx, a reconstruction is required to allow the patient to talk and swallow easily
• This reconstruction is done using skin flap from the forearm or a flap from the intestines. A TEP (Transesophageal puncture) connects the windpipe with the food pipe through a small opening called stoma, which helps the patient regain the phonation ability, which is essential for speech. After the procedure, the patient covers the stoma with his fingers and forces air through the mouth to produce sustained speech. For this the patient is specially trained by a speech pathologist.
• There are two main procedures of doing the reconstruction surgery. In the first type, muscle and skin flaps from the area around the throat are rotated for reconstruction. Most often the muscle pectorlais major is used. This is called the Myocutaneous flaps procedure. The other alternative is which uses advanced microvascular surgery by using tissue from the intestine or the arm muscles. This procedure is called the free flap procedure.
• Once the procedure is completed, the wound is flushed and irrigated to remove all blood clots. The wound is closed in two layers.

Post operative care after Laryngopharyngectomy with plastic reconstruction:

• Post operative care includes special attention to the patient’s pulmonary function and nutritional balance.
• Regular post operative investigations are conducted to review the electrolyte balance of the patient.
• A feeding tube may be placed through the skin directly into the stomach through a procedure called gastrostomy. This is because most patients experience difficulty in eating after the procedure and inadequate nutrition may result in delayed healing.
• For patients who have undergone reconstructive surgery, a speech pathologist will help and train them in restoring their speech functions and ability to eat orally.

Potential risk factors associated with Laryngopharyngectomy with plastic reconstruction:

The risk factors include,

• Occurrence of a hematoma and blood clot formation which could cause compression of the upper windpipe and could be very risky
• Subcutaneous Infections are common between the third to fifth day after surgery.
• Phayrngocutaneous Fistulas may develop due to poor post operative nutrition.
• Narrowing may occur at the lower end of the pharyngeal reconstruction
• The patient may suffer from functional difficulties of swallowing food and drinks.

Laryngopharyngectomy with plastic reconstruction in India:

Indian doctors and surgeons have gained respect across the globe for their expertise and experience in the treatment of complex medical problems. With throat cancers being few of the most common cancers among Indian locals, Indian doctors and hospitals have adequate infrastructure and training to handle these medical problems

Laryngopharyngectomy with plastic reconstruction in Mexico:

Throat cancers require specialized and trained medical teams to address not only the removal of the tumor, but also to ensure effective reconstruction of the throat to retain some of the speech functions. Hospitals in Mexico have excellent infrastructure to provide curative as well as rehabilitative care, which is essential to hasten recovery and normalize the patient’s condition.

Laryngopharyngectomy with plastic reconstruction in Turkey:

As Turkey prepares to entire the league of European Union, its healthcare infrastructure and quality control policies are being raised to match international norms. Further, with Turkey’s ability to control cost and reduce the overall medical expense incurred by patients, it is emerging as a medical tourism destination for American patients seeking low cost high quality care.

Laryngopharyngectomy with plastic reconstruction in Jordan:

Healthcare infrastructure in Jordan is comparable to international standards, while the cost of medical care is a fraction of the cost incurred by patients in United States. Located in the heart of West Asia, Jordan is fast capitalizing on the opportunity to cater to international patients.

Laryngopharyngectomy with plastic reconstruction in South Korea:

Focused on oncology and reconstructive surgery, South Korean doctors and hospitals have gained international repute for high quality services at affordable costs. South Korean hospitals have top notch equipments to assist them in providing good quality of medical and surgical care.

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Medical Tourism Corporation facilitates Laryngopharyngectomy With Plastic Reconstruction in Europe (Turkey) and other overseas world-class oncology treatment destinations.