This photo shows a total laryngectomy on a 45 year old heavy smoker gentleman presenting with hoarseness of the voice and dysphagia. He was diagnosed with laryngeal squamous cell carcinoma and the treatment was surgical. The larynx is your "voice box", the organ containing the vocal cords. The foremost risk factor for the development of laryngeal cancer is tobacco use. The risk of developing laryngeal cancer with tobacco increases with use and decreases after cessation. Malignant tumors of the larynx may affect laryngeal physiology depending on tumor location and size. They can spread by direct extension to adjacent structures, by metastasis to regional cervical lymph nodes, or more distantly, through the blood stream.Symptoms typically include hoarseness of the voice, persistent cough, a lump in the neck, stridor, and difficulty swallowing (dysphagia). Treatment depends on the location, type, and stage of the tumour and involve surgery, radiotherapy, or chemotherapy, alone or in combination. Laryngectomy (surgical removal of the larynx with the vocal cords) is done in severely affected patients. Photo credit : @ramzinakhle