Abstract
Laryngectomy is a surgical procedure that involves the surgical removal of the laryngeal complex, thereby separating the upper from the lower respiratory tracts, resulting in a tracheostomy. In this way, respiration is achieved at the expense of the patient’s voice. A neopharynx is formed, serving only as a digestive passage between the mouth and the esophagus. Until the introduction of the procedure, patients with laryngeal cancer were considered terminally ill. Most often, the title of “First recorded laryngectomy” is held by Theodor Billroth in 1873; however, the outcome of the operation itself was doubtful, with later attempts having a 50% mortality rate. The first major leap in reducing patient mortality rates was the introduction of the two-step laryngectomy, performed by Themistocles Gluck in 1881. This achievement, along with the general advancements in the field of surgery at the time allowed his student Johannes Sørensen to perfect the method and further develop it into a modified single-stage laryngectomy. This procedure is the basis of contemporary methods.
Highlights
BackgroundA laryngectomy is defined as the surgical removal of all laryngeal structures and a section of the upper trachea
Laryngectomy is a surgical procedure that involves the surgical removal of the laryngeal complex, thereby separating the upper from the lower respiratory tracts, resulting in a tracheostomy
The first major leap in reducing patient mortality rates was the introduction of the two-step laryngectomy, performed by Themistocles Gluck in 1881
Summary
A laryngectomy is defined as the surgical removal of all laryngeal structures and a section of the upper trachea. Contrary to Billroth's night legendary status as a surgeon, Themistocles Gluck (30.11.1853, Iaşi - 25.04.1942, Berlin) was heavily neglected by his contemporary sources, receiving much more recognition from nonGerman peers and non-surgeons from Germany [25] This was mostly due to Ernst von Bergmann's (16.12.1836, Riga - 25.03.1907, Wiesbaden), the successor to von Langenbeck and a major authority among German surgeons’, contempt for his progressiveness, who at one point stated: 2020 Matev et al Cureus 12(6): e8804. Gluck and Sørensen together developed a single-stage operation, introducing tracheal dissection at the end of the procedure, reducing the risk of local infection with a permanent pharyngeal closure, accomplished in parallel. This improvement to the technique in 1890 led to a significant drop in mortality rates (as low as 4%). This is in alignment with the general philosophy that led to the birth of the operation in the first place - a sacrifice in the quality of life of the patient, to increase survivability [30]
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