Airway Reconstruction Surgery - How It Is Performed?

What Is Airway Reconstruction Surgery?

Airway reconstruction surgery is also known as laryngotracheal reconstruction surgery. Airway reconstruction surgery is done when there is an unusual narrowing of the windpipe (trachea). This type of surgery is also suggested by the doctor when there is an obstruction in the windpipe that needs to be removed. Airway reconstruction surgery is aimed at making the breathing process easy without the tracheotomy or breathing tube. In children, airway reconstruction surgery is mostly done because some are born with physical abnormalities, whereas in the case of adults, they may need this surgery when there is a narrowing windpipe due to various reasons.

Why Is Airway Reconstruction Surgery Performed?

The airway reconstruction surgery is done so as to clear and decongest the airway and to ensure that the person can breathe easily without the aid of any external things like a tube. Airway reconstruction surgery is considered a better option than a tracheotomy. A hole or an opening is created in the trachea through surgery in case of tracheotomy so as to breathe without any difficulty.

What Are the Indications for Airway Reconstruction Surgery?

There are many conditions that require airway reconstruction surgery. Some of them are as follows.

• Stenosis- Airway reconstruction surgery is required in case of stenosis as the airway becomes narrow. Stenosis can be caused by diseases, infections, and from injury. In some newborns, they can have some congenital condition that could be the reason for stenosis.

• Tracheomalacia- This condition refers to weak cartilage seen in infants. In tracheomalacia, the cartilage is immature and soft and will not be able to maintain a stiff and clear airway, which will make it difficult to breathe for the children.

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• Vocal Cord Paralysis- This condition might require airway reconstruction surgery. This condition is characterized by improper functioning of one or both vocal cords. Sometimes the vocal cord cannot open, which can result in eating difficulty as the airway is obstructed. This can be caused by various reasons like stroke and injury.

• Laryngotracheal Tumor- This tumor can obstruct the airway, and hence breathing will be difficult. This can be due to the accumulation of inflammatory tissues in the trachea when there is a narrowing of the airway resulting in breathing difficulties.

• Injury- In case of accidents when there is an injury to the windpipe, in such cases, this procedure can be done to resolve the problem with the airway.

• Asthma- Asthma is an inflammatory condition that can result in obstruction of the airway, making it difficult to breathe. Certain infections can also cause airway conditions resulting in breathing difficulty and may require airway reconstruction surgery.

• Reflux Disease- In this condition, there can be inflammation which can make breathing difficult and may require airway reconstruction surgery.

• Congenital Conditions- When the larynx is not formed properly, then it can result in airway problems. In some cases, people can have an incomplete formation of the larynx resulting in a laryngeal cleft. This can be formed due to a problem during the developing stage or from an infection or scarring from a medical procedure.

Other than this, autoimmune diseases and radiation therapy can also result in breathing problems. Surgery can also sometimes result in airway blockage and may require airway reconstruction surgery to correct this.

What Are the Types of Airway Reconstruction Surgery?

Airway reconstruction surgery can be done in two ways: open surgery or endoscopic medical procedure. Open airway reconstruction surgery is done by making an incision to perform the surgery, whereas an endoscopic procedure is done by inserting instruments through the mouth, and there is no incision externally.

How to Prepare for the Procedure?

The doctor will explain the surgery before the surgery, which depends upon the type of surgery performed. Follow the instructions given by the doctor prior to the surgery so as to prepare well before the surgery. In case the patient is a child, it is better to carry things that the child loves so as to make them at ease in the hospital. The doctor will instruct their parents to avoid food and water prior to the surgery. For children, the surgery is mostly scheduled for the morning to ensure they are on an empty stomach so as to avoid many complications like aspiration. If they eat or drink anything prior to the surgery, then the surgery will most likely be postponed. Talk to the doctor in advance about the duration of stay required in the hospital following the surgery so as to apply for leaves and make arrangements accordingly. Clear all the doubts that one has about the surgery with the doctor prior to the surgery.

What Are the Complications and Risks Associated?

There are many risks associated with airway reconstruction, as is with other surgeries, and they are discussed below.

• Anesthesia- There are chances that one might have side effects from the anesthesia, like nausea, sore throat, sleepiness, and shivering.

• Pneumothorax- This is a rare complication seen in airway reconstruction surgery. Pneumothorax is a condition when the lungs collapse partially or completely, which can result when the pleura is damaged during the surgery.

• Infections- There are chances of infection following an airway reconstruction surgery. In such cases, there can be fever and drainage from the incision site.

• Difficulty In Speaking- Following the surgery, there can be difficulty in speaking as well as a sore throat. There can be swallowing difficulty as well as a result of the surgery.

• Stent Displacement- If a stent or endotracheal tube is placed following the surgery, there are chances for them to get displaced. If they get dislodged they can cause subcutaneous emphysema, which is air leakage to chest tissue.

These complications will depend on the type of airway reconstruction surgery performed.

Conclusion:

Airway reconstruction surgery is a procedure done in conditions where there is some problem with the windpipe that is either narrowing of the windpipe or some blockage in the windpipe. There are some other conditions also that might require airway reconstruction surgery. So if there are any symptoms or signs noticed, consult a doctor for further investigations.

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