31584 Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed

Name of the Procedure:

Laryngoplasty with open reduction and fixation of fracture, including tracheostomy if performed. Common names: Vocal cord surgery, Laryngeal fracture repair.

Summary

In this procedure, doctors repair fractures in the larynx (voice box) by surgically realigning and stabilizing broken bones. The surgery often includes the insertion of a tracheostomy (a temporary breathing tube) to ensure the patient can breathe, aiding in proper healing.

Purpose

The procedure addresses laryngeal fractures, often caused by trauma. The main goals are to restore normal breathing, voice function, and structural integrity of the larynx, and to prevent complications like airway obstruction or voice loss.

Indications

• Trauma or injury to the throat leading to laryngeal fracture.
• Difficulty breathing, speaking, or swallowing due to laryngeal fracture.
• Visible deformity or significant pain in the neck area after trauma.
• CT scans or X-rays showing laryngeal fractures.

Preparation

• Patients must fast (no food or drink) for at least 6-8 hours before the procedure.
• Medication adjustments may be necessary, particularly blood thinners.
• Preoperative tests such as blood work, electrocardiogram (ECG), and imaging studies.

Procedure Description

1. Anesthesia: General anesthesia is administered to keep the patient asleep and pain-free.
2. Incision: A surgical cut is made in the throat to access the larynx.
3. Reduction: The fractured laryngeal bones are carefully realigned (reduced).
4. Fixation: Plates, screws, or other fixing devices are used to stabilize the bones.
5. Tracheostomy: If required, a temporary breathing tube is inserted through the trachea to ensure a clear airway.
6. Closure: The incision is closed with sutures or staples and dressed.

Duration

The procedure typically takes 2 to 4 hours.

Setting

The surgery is performed in a hospital operating room.

Personnel

• A specialized ENT (Ear, Nose, and Throat) surgeon.
• An anesthesiologist.
• Surgical nurses.
• Possibly a respiratory therapist.

Risks and Complications

• Infection
• Bleeding
• Scarring
• Airway obstruction
• Voice changes or hoarseness
• Need for long-term tracheostomy
• Difficulty swallowing
• Rare complications like anesthesia reactions

Benefits

• Restoration of normal breathing and voice function.
• Proper healing and alignment of laryngeal structures.
• Reduced risk of airway obstruction and long-term complications.
• Benefits are usually noticeable shortly after recovery.

Recovery

• Initial hospital stay of 1-3 days for monitoring.
• Pain management with medications.
• Instructions on cleaning and care of the tracheostomy if present.
• Restrictions on heavy lifting and strenuous activities for several weeks.
• Follow-up appointments to monitor healing.

Alternatives

• Non-surgical management with observation for minor fractures.
• Voice therapy to aid in recovery.
• Pros: Less invasive, minimal downtime.
• Cons: May not be effective for severe fractures, longer recovery, potential for incomplete healing.

Patient Experience

During the procedure, patients will be asleep and should not feel pain. Post-procedure, there may be pain or discomfort managed with medications. Some voice changes or difficulty swallowing may occur initially, improving with time and healing. Regular follow-up care is critical to ensure a smooth recovery.