CPT® Code 31554

The procedure described by CPT® Code 31554 is known as laryngoplasty, specifically performed for the correction of laryngeal stenosis in patients aged 12 years or older. Laryngeal stenosis refers to the narrowing of the airway in the larynx, which can occur in various forms, including partial or circumferential narrowing of the supraglottis, glottis, or subglottis. This condition can be congenital, often resulting from the failure of the laryngeal lumen to recanalize after the formation of the epithelial lamina, particularly affecting the subglottic area. Congenital laryngeal stenosis may present as membranous, circumferential, symmetric, or cartilaginous, with deformities in the cricoid cartilage or tracheal ring that can protrude into the airway either symmetrically or asymmetrically. Acquired laryngeal stenosis can arise from various factors, including trauma from endotracheal intubation, gastroesophageal reflux, infections, autoimmune disorders, malignancies, amyloidosis, inhalation burns, or radiation exposure. Patients with laryngeal stenosis may exhibit symptoms such as inspiratory or biphasic stridor, apnea, tachypnea, dyspnea, voice hoarseness, aphonia, and dysphagia. The primary goal of laryngoplasty is to create an adequate airway while preserving or improving the quality of the voice. During the procedure, an incision is made at the level of the larynx to access the thyroid cartilage, and a burr is used to create a window in the cartilage. The perichondrium is then undermined, and an endoscope is utilized to visualize the larynx, allowing for the dissection of the stenotic area to remove any obstructive tissue or excess cartilage. A graft, which may be sourced from autogenous costal cartilage, auricular cartilage, thyroid cartilage, or buccal mucosa, is fashioned and sutured into place. Additionally, an indwelling stent made of molded silicone or Teflon may be placed in the airway to secure the graft and expand the reconstructed area, or an endotracheal tube may be left in place for stenting purposes. The procedure concludes with the removal of the endoscope and closure of the incision.