Laryngeal carcinoma is the primary reason for total laryngectomy, removal of the larynx. In 2011, 2360 people were diagnosed with laryngeal carcinoma in the UK (Jones et al. [135]). Organ preservation is the first line of treatment using concurrent chemoradiation but if this fails a total laryngectomy may be required. Large hypopharyngeal tumours involving the pyriform sinus, posterior pharyngeal wall and post‐cricoid regions may also warrant a laryngectomy if chemoradiation is unsuccessful.

In a small number of non‐cancer cases, patients may undergo a laryngectomy if they have severe dysphagia resulting in significant aspiration and multiple chest infections.

The larynx is found in the neck at the level of the third and sixth cervical vertebrae. It lies anterior to the oesophagus, situated at the top of the trachea (Mathieson [170]). It is made of bone and cartilage held together by muscles and membranes. As the upper airway is shared with the food passage, the main function of the larynx is to protect the airway from saliva and food and drink from entering the trachea and lungs. The larynx allows production of a cough to clear unwanted materials from the airway (Corbridge [57]) and is used for voicing. Within the larynx, held between the thyroid cartilage and the arytenoids, lie the vocal folds; as air from the trachea passes up towards the vocal folds, they vibrate to make sound. This is then directed up towards the resonating cavities, pharynx and nasal cavities to the mouth where the lips and tongue articulate to produce voice.