epiglottidectomy

DEFINITION of epiglottidectomy

epiglottidectomy is the surgical excision of all or part of the epiglottis, the leaf-shaped cartilaginous structure that overlies the glottis to prevent aspiration during deglutition. It is distinguished from supraglottic laryngectomy (removal of the entire supraglottic laryngeal compartment including the epiglottis, false vocal folds, and aryepiglottic folds) and from epiglottoplasty (surgical reconstruction or reshaping of the epiglottis rather than removal). The underlying mechanism involves transection of the thyroepiglottic ligament and dissection of the epiglottic cartilage from the pre-epiglottic space, either via an external cervical approach (thyrotomy/laryngofissure) or an endoscopic transoral approach; physiologic epiglottidectomy is not a recognized entity, while pathologic epiglottidectomy is performed for neoplastic disease, refractory epiglottic abscess, or severe laryngomalacia. Clinically relevant subtypes include total epiglottidectomy (31420), partial epiglottidectomy preserving the aryepiglottic folds (31420), endoscopic laser epiglottidectomy (31540, 31541), and epiglottidectomy performed as a component of supraglottic laryngectomy (31367, 31368). It is commonly confused with arytenoidectomy — the key difference is that epiglottidectomy removes the supraglottic cartilage shield above the vocal cords, whereas arytenoidectomy removes the paired arytenoid cartilages at the posterior glottis that are essential for vocal cord abduction and adduction.

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ETYMOLOGY of epiglottidectomy

greek

Component	Origin	Meaning
epi- / (not applicable)	[Greek] ἐπί (epí) ([eh-pee])	“upon,” “over,” “on” — directional prefix indicating position above or on a surface
glottid-	[Greek] γλωττίς (glōttís) ([gloh-tees]), from γλῶττα (glōtta) ([gloh-tah]) “tongue"	"mouth of the windpipe,” “glottis,” “tongue” — combining form denoting the vocal aperture or the structure above it
-ectomy	[Greek] ἐκτομή (ektomē) ([ek-toh-may]), from ἐκτέμνειν (ektemnein) ([ek-tem-nin]) “to cut out”	Noun-forming suffix — “surgical excision of” | “cutting out”

The word entered English in the 1940s as epiglottidectomy (noun), coined in New Latin from Greek ἐπί (epi-) + γλωττίς (glottis) + -ectomy — literally “surgical excision of the epiglottis.” The earliest recorded surgical use dates to approximately 1949. The root glott- (“tongue/windpipe opening”) connects epiglottidectomy to the entire -glottis family: epiglottis (epi- + glottis → structure above the glottis), glottis (the vocal apparatus of the larynx), and periglottic (pertaining to the area around the glottis). The epi- prefix is highly productive in medical terminology, appearing in epidermis, epiglottis, epinephrine, epiphysis, and epistaxis.

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🔀 ALIASES / ALTERNATE TERMS

• Epiglottidectomic / epiglottidectomized (adjective form — include 2-3 clinical collocations where this adjective form appears, e.g., “epiglottidectomic defect,” “epiglottidectomic margin,” “epiglottidectomized airway”)
• Epiglottis excision / epiglottis removal (lay and clinical term; note specialty context — e.g., otolaryngology-head and neck surgery, pediatric airway surgery)
• Partial epiglottidectomy (define briefly — e.g., removal of a portion of the epiglottic cartilage preserving the aryepiglottic folds and supraglottic framework; note relationship to main term as a lesser manifestation)
• Epiglottic stripping (clinical synonym used in specific context — e.g., endoscopic removal of the epiglottic mucosa and submucosa; coded under 31540 when performed via direct laryngoscopy)
• Supraglottic laryngectomy|Supraglottic laryngectomy (define this alias briefly and note its ICD-10-CM code — e.g., oncologic resection of the entire supraglottis including the epiglottis, false cords, and aryepiglottic folds; reported with 31367 or 31368)
• Total laryngectomy|Total laryngectomy (systemic or syndromic form — e.g., complete removal of the larynx including the epiglottis as part of definitive treatment for advanced glottic or supraglottic malignancy; 31360, 31365)
• Traumatic epiglottidectomy (define by cause — e.g., avulsion or surgical debridement of the epiglottis after penetrating neck trauma or caustic ingestion)
• Iatrogenic / postoperative epiglottidectomy (define by cause — e.g., incidental or planned removal during other laryngeal or pharyngeal surgery; document with complication codes if unintended)
• Anterior epiglottic resection (organ/tissue-specific form with ICD-10-CM code range — e.g., removal of the anterior cartilaginous portion facing the base of tongue; no separate ICD-10-CM code)
• Aryepiglottic fold resection (organ/tissue-specific form with ICD-10-CM code range — e.g., excision of the fold connecting the arytenoid to the epiglottis, often performed with partial epiglottidectomy; no separate ICD-10-CM code)
• Lingual surface epiglottidectomy (organ/tissue-specific form with ICD-10-CM code range — e.g., resection of the anterior lingual surface for tumor or laryngomalacia; no separate ICD-10-CM code)
• Laryngeal surface epiglottidectomy (organ/tissue-specific form with ICD-10-CM code range — e.g., resection of the posterior laryngeal surface facing the glottis; no separate ICD-10-CM code)

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🔗 RELATED TERMS

• Epiglottoplasty — the opposite of epiglottidectomy; surgical reconstruction, reshaping, or augmentation of the epiglottis to restore laryngeal protection during swallowing or to treat laryngomalacia; distinguished from epiglottidectomy as preservation/repair versus removal
• Glottidectomy — shares the glott- root; excision of the glottis (true vocal cords and rima glottidis) rather than the epiglottis; a more profound phonatory and airway procedure
• supraglottitis (epiglottitis) — shares the epiglott- root; acute bacterial or viral inflammation of the supraglottic structures including the epiglottis; the disease entity most commonly precipitating urgent airway intervention and, in rare refractory cases, epiglottidectomy; J05.10, J05.11
• Laryngomalacia — congenital or acquired flaccidity of the supraglottic structures causing inspiratory stridor; severe cases may require partial epiglottidectomy or supraglottoplasty as treatment
• Excision — the surgical mechanism of cutting out tissue; in otolaryngology, the fundamental operative principle underlying epiglottidectomy and related laryngeal resections
• Excisional — adjective describing surgical removal by cutting; e.g., “excisional biopsy,” “excisional margins”
• Wound healing / mucosal regeneration — the cellular proliferative and remodeling process underlying recovery of the laryngeal mucosa and pre-epiglottic space following epiglottidectomy
• Acute epiglottitis — the infectious/inflammatory disease most commonly associated with epiglottidectomy when abscess, necrosis, or refractory airway obstruction occurs; J05.10, J05.11
• Malignant neoplasm of supraglottis — squamous cell carcinoma or other malignancy involving the epiglottic cartilage and supraglottic mucosa requiring oncologic resection; C32.1
• Malignant neoplasm of anterior surface of epiglottis — carcinoma localized to the anterior (lingual) surface of the epiglottis, distinct from supraglottic tumors; C10.1
• Benign neoplasm of larynx — noncancerous growths such as chondromas, papillomas, or fibromas arising from the epiglottis; D14.1
• Epiglottic abscess / laryngeal abscess — suppurative infection of the epiglottis or adjacent laryngeal structures potentially necessitating drainage or excision; J38.7
• Congenital malformation of larynx — structural anomalies including congenital cleft or fissure of the epiglottis that may require surgical revision; Q31.8
• Direct laryngoscopy — primary diagnostic and operative tool for evaluating epiglottic pathology and performing endoscopic epiglottidectomy; 31525, 31535, 31540

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CODING CORNER

🏥 ICD-10-CM CODES

Acute Epiglottitis and Supraglottitis

Code	Description
J05.10	Acute epiglottitis without obstruction
J05.11	Acute epiglottitis with obstruction

Neoplastic Conditions of Epiglottis and Supraglottis

Code	Description
C10.1	Malignant neoplasm of anterior surface of epiglottis
C32.1	Malignant neoplasm of supraglottis (includes epiglottis and aryepiglottic folds)
D02.0	Carcinoma in situ of larynx (includes epiglottis)
D14.1	Benign neoplasm of larynx (includes epiglottis and supraglottic structures)

Other Inflammatory and Structural Diseases

Code	Description
J38.1	Polyp of vocal cord and larynx (includes laryngeal and epiglottic polyps)
J38.7	Other diseases of larynx (abscess, cellulitis, necrosis, ulcer, disease NOS)

Congenital Malformations

Code	Description
Q31.8	Other congenital malformations of larynx (congenital fissure of epiglottis, laryngocele)

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🔧 COMMON CPT CODES (Epiglottidectomy-Related Diagnosis & Treatment)

CPT Code	Description
31420	Epiglottidectomy (open excision of all or part of the epiglottis)
31367	Laryngectomy; subtotal supraglottic, without radical neck dissection
31368	Laryngectomy; subtotal supraglottic, with radical neck dissection
31540	Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis
31541	Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope
31525	Laryngoscopy, direct, diagnostic, except newborn (separate procedure)
31535	Laryngoscopy, direct, operative, with biopsy
31500	Intubation, endotracheal, emergency procedure (for acute epiglottitis with airway compromise)
99284	Emergency department E/M, level 4 (for acute epiglottitis requiring airway intervention)
99285	Emergency department E/M, level 5 (for imminent airway obstruction)
99291	Critical care, first 30-74 minutes (for postoperative airway monitoring or severe epiglottitis)

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⚠️ Coding Note: Code 31420 describes an open/external epiglottidectomy; when the procedure is performed endoscopically, report 31540 or 31541 instead. For oncologic resections, sequence the most specific malignancy code first—[[C32.1]] for supraglottic lesions and C10.1 for anterior epiglottic surface lesions—with 31420 or 31367 as the procedure. An undercoding alert applies when the operative note documents “epiglottic stripping,” “laser excision of epiglottis,” or “endoscopic removal of epiglottic tumor”—these trigger phrases indicate 31540 rather than 31420. Modifier -51 may apply when epiglottidectomy is performed with tracheostomy or neck dissection at the same session; modifier -59 (or subset XE/XP/XS/XU) may override NCCI edits if diagnostic laryngoscopy (31525) is performed on a separate date of service from therapeutic excision. Modifier -22 may be warranted for unusually difficult resections with extensive pre-epiglottic space dissection or prior radiation fibrosis.

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DERIVATIONS of epiglottidectomy

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(roots, (word) => econtains([[Epiglottidectomy]].roots, word))) > 0 AND file.name != [[Epiglottidectomy]].file.name
SORT file.name ASC

Query functionality

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(definition, (word) => econtains([[Epiglottidectomy]].definition, word))) > 0 AND file.name != [[Epiglottidectomy]].file.name

Med roots dictionary Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms