admin In Massachusetts, a man has astonishingly regained his voice after surgeons excised his cancerous larynx and, in a groundbreaking procedure, replaced it with a donated one.
Transplants of the so-called voice box are exceedingly rare and are typically not an option for individuals with active cancer. Marty Kedian has become only the third person in the U.S. to undergo a total larynx transplant, with the previous cases, occurring years ago, being due to injuries. Globally, he is one of just a few patients to have this procedure.
Surgeons at the Mayo Clinic in Arizona offered Kedian the transplant as part of an innovative clinical trial. This trial aims to make the potentially life-changing operation available to more patients, including those with cancer, which is the most common reason for larynx removal.
“People need to keep their voice,” Kedian, 59, told The Associated Press four months after his transplant – still hoarse but able to keep up an hourlong conversation. “I want people to know this can be done.”
He became emotional recalling the first time he phoned his 82-year-old mother after the surgery “and she could hear me. … That was important to me, to talk to my mother.”
The study is limited in scope, with only nine additional participants set to be enrolled. However, it holds the potential to teach scientists best practices for these intricate transplants. The hope is that, in the future, this life-changing procedure could be extended to more individuals who are unable to breathe, swallow, or speak independently due to a damaged or surgically removed larynx.
“Patients become very reclusive, and very kind of walled off from the rest of the world,” said Dr. David Lott, Mayo’s chair of head and neck surgery in Phoenix. He started the study because “my patients tell me, ‘Yeah I may be alive but I’m not really living.’”
The larynx, often referred to as the voice box, is essential for breathing and swallowing. Vocal cords, which are flaps of muscular tissue, open to allow air into the lungs, close to prevent food or drink from entering the airway, and vibrate to produce speech when air passes through them.
The first two U.S. recipients of larynx transplants were at the Cleveland Clinic in 1998 and the University of California, Davis, in 2010. They had lost their voices due to injuries, one from a motorcycle accident and the other due to damage from a hospital ventilator. However, cancer is the leading cause of larynx removal. The American Cancer Society estimates that over 12,600 people will be diagnosed with some form of laryngeal cancer this year. While many now undergo voice-preserving treatments, thousands have had their larynxes completely removed, requiring them to breathe through a tracheostomy tube in their neck and face significant communication challenges.
Despite the fact that earlier U.S. transplant recipients achieved near-normal speech, doctors have been hesitant to adopt these transplants widely. This reluctance is partly because people can survive without a larynx, and the antirejection drugs necessary for the transplant could potentially trigger new or recurring tumors.
“We want to be able to push those boundaries but do it as safely and ethically as we can,” Lott said.
Head-and-neck specialists emphasise that the Mayo trial is crucial for advancing larynx transplants into a viable option.
“It isn’t a ‘one-off,’ but an opportunity to finally learn from one patient before operating on the next,” said Dr. Marshall Strome, who led the 1998 transplant in Cleveland.
This first attempt in a cancer patient “is the next important step,” he said.
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