Surgical procedure
A total laryngectomy is an operation where the larynx and the vocal cords are removed. Laryngectomy introduces dramatic changes into the body. Various functions in the head-neck area, such as breathing and coughing, are changed as a result of the surgery.
Pre-laryngectomy situation
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Before surgery, inhaled air flowed to the lungs through the nose and/or mouth.
Post-laryngectomy situation: a tracheostoma 
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After surgery, the patient no longer breathes through his/her nose and mouth, but through an opening in the neck (tracheostoma), to which the wind pipe has been attached.
The airway and foodway are now separate, choking from swallowing the wrong way is no longer possible. Breathing is possible only through the tracheostoma. This does not require additional effort.