Dysphonia After Laryngotracheal Reconstruction

Abstract

The main objective of airway reconstruction is to establish a patent laryngeal airway without the need of a tracheostomy tube as well as being able to support respiration, airway protection, and voicing (Kelchner et al. Pediatric voice: a modern, collaborative approach to care. San Diego: Plural Publishing; 2014). To achieve these goals, several surgical techniques may be used to either expand the airway diameter, remove the stenosed segment, or slide the airway. The most common airway expansion procedure is laryngotracheoplasty (LTP) with anterior and/or posterior costal cartilage grafts, while the most common resection procedure is cricotracheal resection (CTR). Slide tracheoplasty improves the airway diameter by sliding one segment of the airway onto the other, effectively doubling the size of the slid section. Each of these procedures has its advantages and disadvantages regarding surgical correction of the stenotic airway. Similarly, these techniques, as well as the initial airway injury, impact voice outcome to different degrees.