Why it's done

The primary goal of laryngotracheal reconstruction surgery is to establish a permanent, stable airway for you or your child to breathe through without the use of a breathing tube. Surgery can also improve voice and swallowing issues. Reasons for this surgery include:

  • Narrowing of the airway (stenosis). Stenosis may be caused by infection, disease or injury, but it's most often due to irritation related to breathing tube insertion (endotracheal intubation) in infants born with congenital conditions or born prematurely or as a result of a medical procedure. Stenosis can involve the vocal cords (glottic stenosis), the windpipe just below the vocal cords (subglottic stenosis), or the main part of the windpipe (tracheal stenosis).
  • Malformation of the voice box (larynx). Rarely, the larynx may be incompletely developed at birth (laryngeal cleft) or constricted by abnormal tissue growth (laryngeal web), which may be present at birth or a result of scarring from a medical procedure or infection.
  • Weak cartilage (tracheomalacia). This condition occurs when an infant's soft, immature cartilage lacks the stiffness to maintain a clear airway, making it difficult for your child to breathe.
  • Vocal cord paralysis. Also known as vocal fold paralysis, this voice disorder occurs when one or both of the vocal cords don't open or close properly, leaving the trachea and lungs unprotected. In some cases where the vocal cords don't open properly, they can obstruct the airway and make breathing difficult. This problem can be caused by injury, disease, infection, previous surgery or stroke. In many cases, the cause is unknown.
March 01, 2016
References
  1. Lalwani AK. Stridor in children. In: Current Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed Jan. 7, 2016.
  2. Zeeshan A, et al. Laryngotracheal resection and reconstruction. Thoracic Surgery Clinics. 2014;24:67. Review.
  3. Tawfik KO, et al. Laryngotracheal reconstruction: A ten-year review of risk factors for decannulation failure. Laryngoscope. 2015;125:674.
  4. Raol N, et al. Comparison of hybrid laryngotracheal reconstruction to traditional single- and double-stage laryngotracheal reconstruction. Otolaryngology – Head and Neck Surgery. 2015;152:524.
  5. Flint PW, et al. Glottic and subglottic stenosis. In: Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Jan. 13, 2016.
  6. Sidell DR, et al. Surgical management of posterior glottic diastasis in children. Annals of Otology, Rhinology, and Laryngology. 2015;124:72.
  7. Balakrishnan K. (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 15, 2016.