Reconstructing the airway to improve function.

There are many reasons why airway reconstruction may be necessary for your child. When it is necessary, know that the ENT experts at Florida Hospital for Children have performed thousands of procedures over the years and utilize the most advanced procedures and treatments available, backed by the latest research and a multi-disciplinary team that will provide your child with the best care possible.

Airway reconstruction falls into two basic categories: open, in which the airway is accessed through an incision in the neck, and endoscopic, which is a minimally invasive surgery (MIS) procedure that greatly reduces pain, recovery time and complications. The area that can be reconstructed extends from the top of the voice box to the trachea, the cartilage reinforced tube that connects the mouth to the lungs.

Who is a candidate for airway reconstruction?

Children and adolescents who either have a congenital defect or have had a medical procedure that caused airway issues are the best candidates for airway reconstruction. These include:

• Babies who were born prematurely and have a history of intubation.
• Children who have some form of tracheal or laryngeal problem.
• Children who suffer from laryngeal cleft, laryngeal atresia, tracheal stenosis, or glottic or subglottic stenosis.
• A child who had a tracheotomy tube.

Types of procedures used

The type of procedure depends on the condition. Working closely together, our ENT team will determine the best course of action, utilizing a optima procedure that offers the most positive outcome.

Common procedures include:

Laryngotracheal Reconstruction: Also known as laryngotracheoplasty, this procedure is used to correct an airway that is narrowed. This “stenosis” can be acquired or congenital. Used for treating severe subglottic and tracheal stenosis, cartilage may harvested from the ribs is used to open the airway, increasing flow.

Cricotracheal Resection (CTR): In this procedure, the narrowed portion of the airway just below the voice box is removed. The voice box is then connected to the wind pipe. It is used mostly to treat subglottic stenosis as well as other abnormalities of the airway.

Tracheal Resection: This procedure is used to cure stenosis completely. The narrowed section of the trachea is removed and the ends are sewn back together. In some cases the surgeon will use a stent to join the sections.

Slide Tracheoplasty: This involves the reconstruction and expansion of the trachea segments. By opening and sliding the trachea upon itself, it shortens and widens the windpipe.

Before any procedure is performed your doctor will go over everything in detail so you can make informed choices about your child’s care and understand the surgery in jargon-free terms.