CPT® Code 31584

Laryngoplasty with open reduction and fixation of fracture is a surgical procedure aimed at addressing fractures of the larynx, which typically occur due to direct trauma to the neck region. This procedure involves a series of meticulous steps to ensure proper alignment and stabilization of the laryngeal structures. The surgery begins with a horizontal skin incision made over the larynx, specifically at the level of the cricothyroid membrane, which is a critical landmark in the neck. To facilitate adequate exposure of the larynx, a subplatysmal apron flap is created and elevated to the level of the thyroid notch. This allows the surgeon to access the larynx effectively. During the procedure, the strap muscles, which are located in the midline of the neck, are divided and retracted laterally to provide a clear view of the larynx. Depending on the specific location and severity of the fracture, the thyroid cartilage may need to be opened using an oscillating saw to gain access to the laryngeal cavity. Once opened, the larynx is examined internally to assess the extent of the injury, including any damage to the vocal cords or mucosal surfaces. If lacerations are found, they are repaired with sutures to restore integrity to the laryngeal structure. In cases of laryngeal cartilage fractures, the damaged cartilage is carefully debrided and repositioned to its normal anatomical position. To ensure stability at the fracture site, various methods of immobilization are employed, including wire sutures, metal alloy miniplates, or absorbable miniplates. Finally, the neck incision is meticulously closed in layers to promote optimal healing. It is important to note that if a tracheostomy is performed during the procedure, it is included as part of the overall surgical intervention.