Airway Reconstruction
Restore comfortable breathing, protect the voice, and reduce dependence on tracheostomy with a personalized airway reconstruction plan. Our team evaluates and treats both children and adults with narrowed or unstable airways using the least invasive option that’s safe and effective.
What Is Airway Reconstruction?
Airway reconstruction includes a spectrum of procedures designed to widen, stabilize, or rebuild the breathing passage from the voice box (larynx) to the windpipe (trachea). It may be performed endoscopically (through the mouth without external incisions) or as an open surgery through a small neck or chest incision—depending on the cause and severity of the narrowing.
Common conditions we treat
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- Subglottic or tracheal stenosis (narrowing from scarring, prolonged intubation, trauma, or autoimmune disease)
- Laryngotracheal stenosis (combined narrowing of the voice box and windpipe)
- Tracheomalacia or airway collapse
- Laryngeal webs and congenital airway anomalies
- Unilateral or bilateral vocal fold immobility
- Tracheostomy dependence
- Post-surgical or radiation-related airway narrowing
- Spasmodic dysphonia
We lower risk by using meticulous technique, pre-treating reflux and inflammation, and closely monitoring healing with scheduled follow-ups.
- Minimally Invasive (Endoscopic) Approaches
- Open Reconstruction
- Pediatric vs. Adult Care
- What to Expect
- Balloon dilation to gently widen short, soft stenoses
- Laser or cold-instrument scar lysis to remove obstructing tissue
- Topical or injectable therapies (e.g., steroid or mitomycin-C) to reduce scar recurrence
- Endoscopic posterior cordotomy or partial arytenoidectomy for select cases of bilateral vocal fold immobility
- Airway stents or T-tubes when temporary internal support is needed
These are outpatient or short-stay procedures with quicker recovery, best for shorter, softer, or early-stage stenoses.
- Laryngotracheal Reconstruction (LTR): cartilage grafts (often from the rib) expand the subglottis/larynx; may be single-stage (no trach at the end) or double-stage (temporary stent or trach while healing).
- Cricotracheal Resection (CTR): removal of the scarred segment with re-joining of healthy ends; often used for severe subglottic/tracheal stenosis.
- Slide Tracheoplasty: commonly used in children with long-segment tracheal narrowing.
- Segmental Tracheal Resection/Anastomosis: for discrete tracheal stenosis or benign tumors.
- Children: greater focus on growth, feeding, and speech development; techniques like LTR or slide tracheoplasty are common.
- Adults: scarring after intubation or autoimmune conditions are frequent causes; CTR or endoscopic protocols are often effective while balancing voice, airway, and reflux control.
Before surgery
- Medication optimization (e.g., reflux control), smoking cessation, and airway hygiene plan
- Pre-op clearance and anesthesia planning
Day of surgery
- Procedure length varies by approach; you’ll recover in the PACU or ICU depending on complexity
- Some open reconstructions use a temporary stent or endotracheal tube as an internal “splint”
Recovery
- Pain is usually well-controlled; voice rest or limited talking may be advised
- Short-term changes in voice or swallowing can occur as swelling resolves
- Follow-up endoscopy is standard to monitor healing and address any early scar formation
- Most patients resume light activity within 1–2 weeks after endoscopic procedures and several weeks after open surgery (your plan will be individualized)