OtorrinoDF Prime is a specialized ENT clinic group in Brasília, Brazil. The center treats adults, children, and seniors across several units in the Federal District. Key specialties include otorhinolaryngology, facial aesthetics, pulmonology, and sleep medicine. Founded in 2011, the group has a team of 13 ENT doctors.
More than 1,000 patients have been treated here since opening. Doctors trained at Stanford University and the University of São Paulo. The center uses Storz equipment for diagnostics and surgery. Tests include nasal and laryngeal videoendoscopy. The PRIME international program offers virtual consultations and result simulations for patients from abroad.
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More than 1,000 patients have been treated here since opening. Doctors trained at Stanford University and the University of São Paulo. The center uses Storz equipment for diagnostics and surgery. Tests include nasal and laryngeal videoendoscopy. The PRIME international program offers virtual consultations and result simulations for patients from abroad.
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Primary protocol: uncomplicated primary total laryngectomy with primary closure, no flap. Desk-based or light work earlier; manual work later. Depends on occupation, adjuvant radiotherapy, voice rehabilitation and general condition; some patients do not return to prior work."},"complication_rate_pct":{"min":20,"max":40,"unit":"percent","qualifier":"Limited model estimate: any early postoperative complication (mainly pharyngocutaneous fistula, wound infection or breakdown) within about 30-90 days of primary total laryngectomy in adults. Pharyngocutaneous fistula alone is roughly 10-30%, higher after prior radiation or chemoradiotherapy (salvage). Varies widely by series; not a cohort-attributed figure."},"contraindications":["Unresectable disease, such as tumor invasion of the prevertebral fascia or encasement of the common or internal carotid artery","Distant metastatic disease in which curative surgery is not appropriate (palliative surgery only in selected cases)","Medical unfitness for general anesthesia and major surgery (requires individual assessment)","Patient refusal of permanent loss of natural voice and a permanent neck stoma","Active uncontrolled infection or uncorrected severe malnutrition (relative; usually optimized first)","Tumor extension that makes functional or reconstructive closure unachievable (individual assessment)"],"days_in_clinic":{"min":7,"max":14,"unit":"nights","qualifier":"Primary protocol: adult total laryngectomy with primary pharyngeal closure, with or without neck dissection, uncomplicated course, without free-flap reconstruction. Counted from the day of surgery; longer with pharyngocutaneous fistula, flap reconstruction or other complications."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Reference event: day of surgery, uncomplicated primary protocol. Walking and mobilization begin within the first days in hospital. This range applies to strenuous exercise and heavy lifting, after wound healing and surgeon clearance. Swimming and water immersion are generally avoided or need special stoma protection."},"final_result_months":{"min":6,"max":12,"unit":"months","qualifier":"Reference event: day of surgery. Time to stable functional adaptation, including swallowing, stoma care and speech rehabilitation; longer if adjuvant radiotherapy is needed. Oncologic outcome is assessed through long-term surveillance."},"fly_home_after_days":{"min":14,"max":28,"unit":"days","qualifier":"Reference event: day of surgery, uncomplicated primary protocol, assuming discharge from hospital, no fistula, stable wound and stoma, oral intake established and surgeon clearance. Patient and carers should be trained in stoma care and carry suction and humidification supplies. Later with fistula, flap reconstruction or complications, and adjuvant therapy planning may affect timing."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"After surgery; wound, stoma, swallowing and nutrition review, with drain and suture removal as needed, usually soon after discharge."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":28,"unit":"days","qualifier":"After surgery; pathology review and adjuvant therapy planning with the tumor board."}},{"purpose":"rehabilitation","requirement":"routine","after":{"min":28,"max":60,"unit":"days","qualifier":"After surgery; speech-language pathology review, voice rehabilitation planning and prosthesis fitting or evaluation where relevant."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":120,"unit":"days","qualifier":"After surgery; start of regular cancer surveillance, which continues for years at intervals set by the oncology team."}}],"indications":["Advanced (T3-T4) laryngeal or hypopharyngeal cancer with cartilage invasion or extralaryngeal extension, not suitable for organ preservation","Nonfunctional larynx in selected T3 cancer","Recurrent or persistent laryngeal cancer after radiotherapy or chemoradiotherapy (salvage surgery)","Tumors or histologies not suitable for conservative treatment or resistant to radiotherapy (e.g., chondrosarcoma, sarcomas)","Severe laryngeal trauma precluding functional reconstruction","Nonfunctional larynx with chronic life-threatening aspiration when other options fail","Severe radionecrosis or chondronecrosis of the larynx"],"main_risks":["Pharyngocutaneous fistula, more likely after prior radiation or neck dissection","Wound infection, hematoma or wound breakdown","Pharyngeal stricture and swallowing difficulty","Stomal stenosis","Permanent loss of natural voice","Hypothyroidism","Chyle leak, mainly with neck dissection","Cancer recurrence","Anesthetic, cardiopulmonary and thromboembolic complications","Depression and psychosocial impact","Shoulder dysfunction or neck numbness after neck dissection"],"pain":"Moderate postoperative pain in the first days to weeks, controlled with multimodal analgesia. Neck tightness and numbness may persist, and swallowing discomfort is common early.","preparation":["Tumor staging with endoscopy, biopsy and imaging (contrast CT or MRI of the neck, chest CT, PET/CT if advanced)","Multidisciplinary tumor board review","Preoperative anesthesia and medical assessment, including cardiopulmonary and nutritional status","Laboratory work-up including blood count, renal and liver function, albumin, thyroid function and blood type","Optimization of anemia and comorbidities such as COPD and diabetes","Smoking and alcohol cessation, with monitoring for withdrawal","Counseling on loss of natural voice, stoma care and communication options with a speech-language pathologist","Dental assessment if radiotherapy is planned","Medication review, including anticoagulants, with fasting as instructed"],"recovery_timeline":[{"phase":"Hospital stay (about 7-14 nights)","description":"Reference event: day of surgery, uncomplicated primary protocol. Monitoring in a unit experienced in laryngectomy care, stoma suctioning and humidification, drains, tube feeding and stoma care teaching. Walking and mobilization usually begin within the first 1-2 days. Oral feeding starts after the surgeon confirms healing, often around days 7-10, depending on local practice.","restrictions":["No oral intake initially; tube feeding","Obligate neck breather: cannot be intubated orally or nasally, and all staff should know this","Nonverbal communication until rehabilitation starts","Light walking only; no lifting"]},{"phase":"Early recovery (about weeks 2-6)","description":"Wound healing, return to oral diet, stoma care and start of speech rehabilitation. Adjuvant radiotherapy or chemoradiotherapy may follow if pathology shows high-risk features. Light daily activities increase gradually.","restrictions":["Avoid heavy lifting and strenuous exercise","Protect the stoma from water, dust and cold air; use humidification and a stoma cover","No swimming or immersion"]},{"phase":"Rehabilitation (about weeks 6-12 and beyond)","description":"Voice rehabilitation with tracheoesophageal prosthesis, electrolarynx or esophageal speech; return to work and gradual return to strenuous exercise after surgeon clearance. Full adaptation may take 6-12 months.","restrictions":["Permanent stoma precautions, including avoiding open water and immersion","Water sports only with surgeon advice and special equipment"]},{"phase":"At any time","description":"Seek urgent assessment, in the emergency department if needed, for breathing difficulty, stoma blockage not cleared by suction, bleeding, fever, redness or swelling of the neck, saliva or fluid leaking from the wound, a rapidly enlarging neck swelling, chest pain, leg swelling, or inability to swallow. Mention to all clinicians that the airway is through the neck stoma. Voice prosthesis leakage, with coughing when drinking, also needs prompt review.","restrictions":["Do not delay urgent assessment until a scheduled visit"]}],"rehabilitation_days":{"min":30,"max":90,"unit":"days","qualifier":"Reference event: day of surgery, uncomplicated primary protocol. Ordinary functional recovery of swallowing, stoma care and basic communication; full voice rehabilitation can take longer."},"result_longevity":"Removal of the larynx and the separation of the airway from the swallowing passage are permanent. Oncologic control depends on stage, margins and adjuvant therapy, and is monitored through long-term surveillance. Voice prostheses, if used, need periodic replacement, often every few months.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Limited model estimate: unplanned return to the operating room within about 90 days (for fistula repair, hematoma, wound problems or stomal revision) after primary total laryngectomy in adults. Later pharyngeal dilation or stomal revision is outside this figure. Varies widely; higher after salvage surgery."},"scars":"Neck incision scar and a permanent end tracheostoma at the base of the neck; the scar is larger with neck dissection or flap reconstruction.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation under the primary protocol; voice prosthesis puncture may be done at the same time or in a later procedure (outside this numerical profile)."},"stages":[{"code":"total_laryngectomy","label":"Total laryngectomy with permanent tracheostoma, with or without neck dissection","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"Primary protocol: adult primary total laryngectomy under general anesthesia, inpatient, single operation."},"success":{"metric":"Technical completion of total laryngectomy with a healed pharyngeal closure and stable permanent tracheostoma, without major reoperation","value":70,"unit":"percent","horizon":"Within about 3 months after surgery","population":"Adults undergoing primary total laryngectomy with primary closure for advanced laryngeal cancer; lower after salvage surgery","evidence_status":"limited"},"techniques":[{"name":"Total laryngectomy with primary pharyngeal closure (primary protocol)","suits_whom":"Adults with advanced laryngeal cancer whose remaining pharyngeal mucosa can be closed without tension","recovery":"Inpatient recovery; oral feeding usually starts after healing is confirmed, with tube feeding in the meantime."},{"name":"Total laryngectomy with regional or free flap reconstruction (outside the primary numerical profile)","suits_whom":"Patients with insufficient pharyngeal mucosa, prior radiation, extralaryngeal extension or extended resection","recovery":"Longer operation and hospital course than the primary protocol; a vascularized flap may lower fistula risk in high-risk patients."},{"name":"Total laryngectomy with concurrent neck dissection (included in the primary profile when needed)","suits_whom":"Patients with nodal disease or high risk of nodal metastasis","recovery":"Longer operation and larger wound; neck dissection is a fistula risk factor and may cause shoulder symptoms."},{"name":"Primary or secondary tracheoesophageal puncture with voice prosthesis (outside the primary numerical profile)","suits_whom":"Selected patients wanting tracheoesophageal speech","recovery":"Done at laryngectomy or later; speech training follows."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":4,"max":8,"unit":"hours","qualifier":"Primary protocol: total laryngectomy with primary closure, with or without neck dissection, skin to skin; longer with free-flap reconstruction (outside this range)."},"initial_assessment_documents":["Laryngoscopy or endoscopy report","Biopsy and histopathology report","Neck and chest CT or MRI","PET-CT report (if available)","Previous radiotherapy or chemotherapy records (if available)","Recent blood tests and anesthesia fitness report"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single operation; stay about 2-4 weeks until discharge and surgeon clearance. Adjuvant therapy and surveillance usually continue at home."}}},"hrefLanguages":[{"rel":"alternate","hreflang":"ru","language":"ru","href":"https://ru.bookimed.com/clinics/country=brazil/city=brazilia/procedure=laringektomiya/"}],"questionsAndAnswers":[],"seoTests":{"thin_content":false,"no_txt_after_3_clinics":false},"offerFilters":{"offer_count":0,"price_filter":{"from":0,"to":0,"avg":0}},"leadsCount":{"leads_count":53971},"manualSeo":[],"updatedAt":"2026-10-28T09:20:07.650Z","activeCountries":["BR","ES","TR","TH"],"hasVideoReviewsByContext":true,"hasCriticalApiFallback":false}