Name of the Procedure:

Laryngoplasty for Laryngeal Stenosis with Graft, Without Indwelling Stent Placement (Age 12 or Older)

Summary

Laryngoplasty is a surgical procedure to widen a narrowed (stenotic) area of the larynx (voice box) using a graft. This version of the procedure is performed on patients aged 12 years and older without placing an indwelling stent.

Purpose

Laryngoplasty addresses laryngeal stenosis, a condition where the airway is narrowed, causing breathing difficulties. The surgery aims to open up the airway, allowing for improved breathing and better vocal function.

Indications

• Difficulty breathing due to a narrowed airway
• Stridor (high-pitched, wheezing sound while breathing)
• Recurrent episodes of airway obstruction
• Diagnostic confirmation of laryngeal stenosis through imaging or endoscopy

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Adjustments to medications, particularly those that affect blood clotting.
• Pre-procedure assessments like laryngoscopy, imaging studies, and possibly pulmonary function tests.

Procedure Description

1. The patient is given general anesthesia.
2. A surgical laryngoscope is inserted to expose the larynx.
3. The surgeon makes an incision to access the stenotic area.
4. A graft, commonly harvested from the patient's own rib cartilage or other suitable tissue, is placed to widen the narrowed section.
5. The graft is secured without placing an indwelling stent.
6. The incision is closed, and the surgical area is checked for stability.

Duration

The procedure typically takes 2 to 3 hours.

Setting

Performed in a hospital operating room.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist
• Surgical nurses
• Possibly a respiratory therapist

Risks and Complications

• Bleeding
• Infection
• Reaction to anesthesia
• Graft failure or displacement
• Scar tissue formation leading to recurrent stenosis
• Voice changes or hoarseness

Benefits

• Improved airway and breathing
• Reduction or elimination of stridor
• Enhanced vocal function
• Immediate improvement in breathing post-surgery, with full benefits realized within weeks to months

Recovery

• Hospital stay of 1-3 days for monitoring.
• Pain management with prescribed medications.
• Voice rest for a specified period.
• Follow-up appointments to monitor healing and functionality.
• Avoidance of strenuous activities or heavy lifting.

Alternatives

• Endoscopic dilation of the stenosis
• Tracheostomy to bypass the blockage
• Observation for mild cases
• Each alternative has its pros and cons, with less invasive options providing temporary relief compared to the more permanent solution offered by laryngoplasty.

Patient Experience

• The patient will be under general anesthesia and not feel anything during the surgery.
• Post-operatively, some discomfort and soreness in the throat and surgical site are expected.
• Pain management strategies include medication and supportive care, ensuring a relatively comfortable recovery process.