Epiglottidectomy
CPT4 code
Name of the Procedure:
Epiglottidectomy
Summary
An epiglottidectomy is a surgical procedure to remove all or part of the epiglottis, a flap of cartilage located at the base of the tongue that helps keep food from entering the windpipe during swallowing.
Purpose
The primary purpose of an epiglottidectomy is to treat conditions like cancer of the epiglottis, severe infections, or significant trauma that impairs normal breathing, swallowing, or speech. The procedure aims to remove diseased or damaged tissue, alleviate symptoms, and improve airway function.
Indications
Epiglottidectomy is indicated for patients experiencing:
- Epiglottic tumors or cancers.
- Recurrent severe epiglottitis.
- Obstructive sleep apnea due to a dysfunctional epiglottis.
- Significant trauma or damage to the epiglottis.
Patient criteria:
- Diagnosis confirmed through imaging or endoscopy.
- Symptoms unresponsive to conservative treatments.
- Overall health sufficient to undergo surgery.
Preparation
Patients may need to:
- Undergo preoperative imaging studies (e.g., X-rays, CT scans).
- Complete blood tests and possibly a biopsy.
- Fast for at least 8 hours before surgery.
- Adjust or temporarily discontinue certain medications based on physician advice.
Procedure Description
- The patient is given general anesthesia.
- A laryngoscope is inserted through the mouth to view the epiglottis.
- Surgical instruments are used to excise the affected portion of the epiglottis.
- Cauterization or sutures may be applied to control bleeding.
- The procedure is performed using traditional surgical methods or laser technology.
Duration
The procedure typically takes 1-2 hours.
Setting
Epiglottidectomy is usually performed in a hospital operating room or a surgical center.
Personnel
The medical team typically includes:
- ENT (Ear, Nose, and Throat) surgeon
- Anesthesiologist
- Surgical nurses
- Possibly a respiratory therapist
Risks and Complications
Common risks:
- Infection
- Bleeding
- Swelling causing airway obstruction
Rare risks:
- Permanent changes in voice
- Aspiration (food or liquid entering the airway)
- Anesthesia-related complications
Benefits
- Relief from symptoms such as difficulty breathing and swallowing.
- Removal of malignant tissue in cases of cancer.
- Improved quality of life by addressing obstructive or dysfunctional conditions.
Recovery
Post-procedure care:
- Close monitoring in a recovery room.
- Pain management with prescribed medications.
- Instructions on diet (soft foods initially), hygiene, and activity restrictions.
Expected recovery time:
- Most patients can return to daily activities within 1-2 weeks, though complete recovery may take longer. Follow-up appointments ensure proper healing and function.
Alternatives
- Radiation therapy (for cancer).
- Antibiotics and steroids (for infections).
- Conservative treatments like CPAP for sleep apnea.
- Pros and cons vary based on the effectiveness and invasiveness of the alternative compared to epiglottidectomy.
Patient Experience
During the procedure:
- The patient will be under general anesthesia and thus not feel any pain.
After the procedure:
- Expect some throat pain or discomfort.
- Pain is managed with medication.
- Gradual dietary progression from liquids to solids is typically recommended.
- Patients may experience temporary changes in their voice and swallowing function.