(2) If the operation was done under general anesthesia, place the patient in
a lateral recumbent position with the head extended. This will allow drainage through
the nose and mouth.
(3) Observe vital signs closely and be alert for changes that may indicate
bleeding, such as gurgling respirations or excessive swallowing.
(4)
Keep the patient as quiet as possible.
(5)
Place an ice collar around the neck to constrict blood vessels and
reduce pain.
c. An unconscious or bleeding patient should never be left alone. Suction
equipment should be available for use. If suctioning is necessary, it should be done
carefully and gently to avoid disturbing the operative sites.
d. Encourage the patient to take the diet prescribed by the physician. For the
first few days the diet will probably be liquid or semisolid. All foods and fluids should be
bland, avoiding citrus, acidic foods, and spices. Diet should be advanced as patient
tolerance dictates.
e. Utilize prescribed analgesics, since the throat will be sore for several days
postoperatively.
2-36. LARYNGECTOMY
a. Surgery of the larynx is done most often to remove a tumor or growth that
may be malignant.
(1) A malignant growth may occur on the vocal cords (intrinsic) or on
another part of the larynx (extrinsic). The type of surgery done depends upon the
location and involvement of the growth.
(2) Newly developed surgical procedures are being used in the
management of laryngeal growths. Some procedures involve resection of the larynx or
formation of an air passage from the trachea to the pharynx. The objective of these
procedures is to preserve the voice.
b. Partial laryngectomy is the removal of that portion of the vocal cord that is
involved with abnormal growth. A tracheostomy tube may be left in the neck wound for
a few days postoperatively. The neck wound will eventually heal, and the normal
respiratory system and voice are preserved.
c. Total laryngectomy is the removal of the larynx, vocal cords, thyroid cartilage,
and the epiglottis. The trachea is sutured to the anterior surface of the neck as a
permanent tracheostomy. The patient breathes exclusively through the neck opening
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