Quick Case Study

Duke Surgeon Performs a Partial Laryngectomy to Treat Laryngeal Cancer

Specialized procedure preserved patient’s voice and ability to breathe normally

Laryngopharynx or throat cancer with organs and tumors or cancerous cells 3D rendering illustration.

When his laryngeal cancer returned despite efforts to treat it with radiation, a 71-year-old male patient began pursuing surgical options to remove the tumor. One recommendation: a total laryngectomy or removal of his entire voice box, which would require him to breathe through a tube in his neck and halt his ability to speak naturally. 
The patient came to Duke for a second opinion, and surgical oncologist Russel Kahmke, MD, offered the patient an alternative option.
What surgery did Kahmke perform to preserve the patient’s ability to speak and breathe normally?

Based on the tumor’s location on the supraglottic larynx, its size and the patient’s overall good health, Kahmke determined that a partial laryngectomy was a viable option. 
“I thought that it would be possible to resect his cancer successfully, while maintaining his vocal cords, which was important to him,” says Kahmke. “We were very upfront with the patient about the risks and the possibility that we may have to convert to a total laryngectomy if we got positive margins or could not get good exposure through the mouth.”
Prior to surgery, Kahmke performed a tracheotomy to protect the patient’s airway from swelling and help prevent aspiration. He then utilized a transoral endoscopic approach to access the tumor, and he resected it successfully with negative margins. The patient remained in the hospital for a couple of days to manage swelling and to prepare him for the removal of the tracheotomy. 
During his recovery, the patient participated in swallowing therapy and voice therapy. He returned at regular intervals for follow-up care and assessment by Kahmke. Today, five years post-op, the patient is cancer-free. He experiences periods of inflammation, hoarseness and labored breathing on occasion, but he can talk and breathe normally, which has helped him maintain his quality of life.
“His goal was to be able to talk,” Kahmke said. “As doctors, we can't always give people what they want, but in this case, I’m glad we were able to preserve his function and also treat his cancer successfully.”

When to Refer

Call 800-633-3853 or log into Duke MedLink to make referrals for patients who have:

  • Hoarseness that doesn’t go away, accompanied by throat pain
  • Trouble swallowing
  • A history of tobacco use
  • A neck mass and sore throat
  • Persistent coughing
  • Blood in sputum