CPT® Code 31390

The procedure described by CPT® Code 31390 is a pharyngolaryngectomy with radical neck dissection (RND) performed without reconstruction. This surgical intervention involves the removal of the larynx, which is the voice box, along with a portion of the pharynx, the part of the throat behind the mouth and nasal cavity. The primary indication for this procedure is typically laryngeal cancer that has either invaded the pharynx or has metastasized to this area. In some cases, severe injuries to the throat or neck, or other diseases not related to cancer, may also necessitate the excision of both the pharynx and larynx. Before the pharyngolaryngectomy is performed, a tracheostomy is established to facilitate anesthesia administration and ensure the patient's airway is secure during the procedure. The surgical approach begins with a horizontal incision in the neck at the level of the thyroid cartilage, allowing access to the larynx. The surrounding tissues are carefully dissected to expose the larynx, which is then removed along with various structures in the neck, including lymph nodes and muscles, as part of the radical neck dissection. The procedure concludes with the creation of a tracheostoma, which is a permanent opening in the neck that allows the patient to breathe directly through the trachea. It is important to note that in this specific code, no reconstruction of the pharynx and larynx is performed during the same surgical session, distinguishing it from related procedures where reconstruction may occur. This comprehensive approach is critical for managing advanced laryngeal cancers and ensuring the best possible outcomes for patients undergoing this complex surgery.