Airway Reconstruction surgery is also known as laryngotracheal reconstruction surgery. It is a surgery option that is used to widen the narrow windpipe called the trachea. This type of surgery is also recommended by your doctor when something is obstructing your windpipe and it needs to be removed. The purpose of the laryngotracheal reconstruction surgery is to make it easy for you to breathe without the help of tracheotomy or a breathing tube. Airway Reconstruction surgery is often required by children because some are born with physical abnormalities, but adults may need it when their windpipe narrows due to a variety of reasons.
The benefit of the Airway Reconstruction surgery is that it clears up and decongests the airway and ensures you can breathe normally without the aid of anything else, such as a tube. Laryngotracheal reconstruction surgery is considered a better option than tracheotomy. A tracheotomy is a medical procedure that requires a hole or opening to be created in your trachea through surgery so that you can breathe without difficulty. The opening is created through the neck and into the windpipe.
There are numerous conditions that require Airway Reconstruction surgery. Some of the most common conditions are as follows.
Apart from these causes, autoimmune diseases and radiation therapy can cause airway obstruction which leads to problems in breathing. Surgery can sometimes lead to airway blockage too which requires Airway Reconstruction surgery.
There are two ways in which an Airway Reconstruction surgery can take place; open-airway surgery or endoscopic medical procedure. In open-Airway Reconstruction surgery, an incision is made to perform the surgery. In endoscopic procedure, instruments are inserted through your mouth.
You need to speak to your doctor about whether you are the right candidate for Airway Reconstruction surgery, or not. Usually, the two types of reconstruction surgeries are recommended to children or adults, when the stenosis is mild. That is, when the airway is not too narrow then your doctor will recommend the surgery. Your doctor will discuss any other problems that you are dealing with such as other medical issues and if you experience symptoms that may point to other problems. Once he does that he will be able to decide and let you know if you are eligible for Airway Reconstruction surgery.
People who suffer from severe stenosis need to take a different approach. This applies to people who have medical problems that can complicate Airway Reconstruction surgery. Such conditions include conditions that are associated with lung or heart among others. When this is the case, your doctor can recommend that instead of having the Airway Reconstruction surgery once, you have multiple-stage open-airway reconstruction. In this, the medical procedures are divided so that you have them within a span of a few weeks or even years. It depends on your condition and health.
The Airway Reconstruction surgery preparation will be explained by your doctor in detail depending on the type of surgery that will be performed. Follow every single instruction of your doctor to ensure you are properly prepared for the surgery. If your child is having Airway Reconstruction surgery, then it is a good idea to have something that your child loves the most in the hospital. This will make him feel at ease and they will be more comfortable in the hospital. You can have a stuffed animal or toys they love the most. This can be great during the recovery process because they will have their favourite item with them.
There is a particular time, before the surgery, where you will have to avoid eating and drinking. Your doctor might advise you not to eat or drink anything for a few hours before the surgery. For children, the Airway Reconstruction surgery is usually scheduled for the morning time to ensure they have an empty stomach. The reason why you are advised against eating for a few hours before surgery is because it can lead to several complications if you eat or drink. An example of a complication is aspiration. If you eat or drink something by mistake, then the surgery will definitely be postponed.
Depending on the type of surgery that will be performed, you need to make arrangements accordingly. You may need to apply for leave in advance. Ask your doctor about how long you will need to stay in the hospital for so that you can make the necessary arrangements with regards to work and your home. You may need your partner to stay somewhere close to the hospital. Else if your child is the one who is having the surgery then you want to make arrangements to stay close-by so that you can visit often and spend time with your child. You should clearly ask your doctor about any questions you have regarding preparations.
There are many risks associated with Airway Reconstruction surgery. Remember that these are risks so it is not 100% that you will have them. There is just a chance that you might have these problems.
The complications and risks depend on the type of Airway Reconstruction surgery performed. You should ask your doctor about any risks in advance so you are aware of what problems can occur.
We are going to discuss the Airway Reconstruction surgery when open-Airway Reconstruction surgery is performed and when endoscopic reconstruction is performed. This will enable you to understand how each is performed.
Your doctor will decide whether this surgery will be done in one-stage or in multiple stages. He might want to use a variety of techniques when performing the surgery, depending on your case. Most people who undergo the Airway Reconstruction surgery have already had a surgery called tracheotomy. Hence, in the one stage reconstruction strategy, the tube is first removed if you had a tracheotomy surgery done earlier. After this, grafts are used to widen your airway. A graft is a cartilage from thyroid or the ribs that are cut into particular shaped pieces. The airway is widened by placing the grafts into the trachea in a proper way.
Following this, a tube is put into your mouth and then into the trachea. Your doctor can put the tube through your nose as well which is an alternative. This tube is called the endotracheal tube. The tube is placed such that the grafts are fully supported inside the trachea. Your doctor may decide to leave the endotracheal tube there for weeks or days. The number of days or weeks he will keep it there depends on how long the healing process. Healing depends on where the grafts are positioned and how many grafts are used.
Your doctor reconstructs or widens your airway. This is done similar to the previous procedure where grafts are used and inserted in the trachea. In double-state reconstruction, the tube is left as it is. Alternatively, a stent is put in place.
Next, your doctor leaves it in place until the healing process is complete. This can take more than six weeks for some people. Your doctor will remove the tube in the next stage.
A method was introduced in 2013 which combined single-stage and double-stage reconstruction. This technique is called hybrid reconstruction. In this procedure, a lengthy stent is placed in the tube that is already in place. In addition, another stent that is shorter is placed through the trachea opening. This helps provide another airway through which you can breathe during the surgical procedure and post-surgery. Resection is another procedure that may be suggested by your doctor. There are cases where the windpipe’s narrow section might be removed altogether; the sections that remain are sewn together.
This is a comparatively less invasive procedure than an open-Airway Reconstruction surgery. There are no incisions done in this procedure. It involves using a thin tube called a laryngoscope. This has surgical instruments along with a rod that has a camera and light attached to it. This tube is then inserted in your mouth and then into the airway. The surgery is then performed. Your doctor might use this method for placing grafts. Else, he may use balloons or lasers among other methods to widen the airway. Sometimes surgery is not the best choice, especially in people who have a very narrow airway.
Once the procedure is completed, you might need to be on a ventilator. This is especially true for children who are getting the surgery done. Sometimes sedation might be required so that the tube does not come off. The sedation duration and breathing help may depend on age and medical conditions. You will require time to heal after the Airway Reconstruction surgery. You will most probably be required to stay in the ICU until the airway heals. Your hospital stay might be anywhere between one week or more depending on your condition and how fast you are recovering from the surgery.
The time it takes to recover will depend on how complex your surgery was and whether any complications occurred after the surgery was completed. Sometimes, if the obstruction is severe then recovery might take longer. For people who have had endoscopic reconstruction, the recovery might be faster. This treatment option can be done on an outpatient basis and so there are chances that you may go home on the same day that you have been operated on. You may have to be in the hospital for a few days depending on how you are after the surgery completes.
Your doctor will recommend tests after surgery has been performed. The tests such as endoscopic tests will be done. Your doctor will tell you when you need to come in for tests. These tests help your doctor determine how the airway is healing and whether any problems have occurred. If any problem has occurred then it will be able to get treated faster, when diagnosed early. You will most probably have problems speaking or swallowing food and drinks, after surgery. Your doctor might recommend speech therapy or other therapies for that. The recovery process can be discussed with your doctor.
Your doctor will discuss the precautions that you need to take after the reconstruction surgery. The precautions will depend on the type of Airway Reconstruction surgery that you have. If you are not sure about the post-surgery care then you should outright ask this to your doctor. If there is anything that may be difficult to follow in terms of precautions then you need to address this to your doctor too. You should discuss precautions in advance when you are discussing the treatment option of Airway Reconstruction surgery. This will ensure you are able to take good care of yourself so you heal fast.
Tracheal stenosis may also result as a side effect when radiation therapy is used to treat a tumour in the head or neck.
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