Many people have surgeries in which the larynx is completely removed or is replaced by a prosthetic device. However, nothing can truly replace the larynx other than another larynx. When finding a donor, specialists look for a donor with a blood type and tissue match. A fully matched laryngo-pharyngeal complex is required, including a thyroid, parathyroid, and five rings of the trachea. During the surgery, one team of surgeons will remove the larynx from the donor’s body and test it with a saline solution to ensure it is healthy. Then, another team will implant the larynx. In addition to the transplantation, the nerves and blood vessels supplying the larynx must be reconnected. The superior and recurrent laryngeal branches of the vagus nerve are innervated in order for the newly implanted larynx to gain motor and sensory function. This is crucial for speech and breathing function. It is also the most complicated part of the surgery as the larynx has the most complex muscle-based system of any structure. Ideally, all of these nerves will be reinnervated and the patient will have near normal motor and sensory functioning. However, in previous surgeries there have been complications that resulted in vocal fold paralysis. In this case, a tracheostomy may be necessary. The body will want to reject the new larynx and think of it as an intruder, so the patient must take anti-rejection medication for the rest of his or her life (1, 2).
Resources
1. Iskowitz, M. (1998). Transplanting the Larynx. Retrieved from http://speech-language-pathology-audiology.advanceweb.com/Article/Transplanting--the-Larynx.aspx
2. Birchall, M.A., Lorenz, R.R., Berke, G.S., Genden, E.M., Haughey, B.H., Siemionow, M., & Stome, M. (2006). Laryngeal transplantation in 2005: A review. American Journal of Tranplantation, 6, 20-26.
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