Airway Reconstruction

Why does my child need an airway reconstruction?

Moderate to severe subglottic stenosis (narrowing of the windpipe just below the vocal cords) causing shortness of breath, cough, noisy breathing, recurrent croup, hoarseness

Congenital tracheal stenosis (narrowing of the windpipe) causing trouble breathing

Tracheotomy tube dependence- Some children need surgery to help open the trachea (windpipe) so they can breathe more easily before removing their tracheotomy tube

What does an airway reconstruction involve?

Open airway reconstruction is also known as laryngotracheoplasty or laryngotracheal reconstruction.  It involves going through the skin on the neck to make the trachea (windpipe) bigger with a graft that is usually taken from a small part of a rib in the chest.  Other grafts can be from the ear cartilage or thyroid cartilage.  This is different from procedures through the mouth and voice box with endoscopic cameras to treat narrow areas or cysts in the trachea.  There are two main kinds of laryngotracheal reconstruction: single stage and double stage.

Single stage– The narrow spot in the trachea is opened in a single surgery and the graft is usually held in place with a temporary breathing tube through the mouth or nose.  If your child has a tracheotomy tube in place it is removed at the time of the reconstruction.  Your child will spend a week or more in the hospital after surgery while healing takes place before the breathing tube is removed.

Double stage– The tracheotomy tube is left in place and a stent may be used to hold open the graft and help with healing.  The stent is removed at a later time with an additional surgery.  The tracheotomy tube is removed at a later time after the stent is removed when the trachea is well healed and open.  Your child will spend 2-3 nights in the hospital typically and go home with their tracheotomy tube.

What are some of the risks and complications of an airway reconstruction?

Trouble breathing, trouble eating, scar on the skin or in the windpipe, change in voice, hoarseness, injury to the lung or pneumothorax when harvesting the rib graft, bleeding