Laryngoplasty is a broad category of open surgical procedures performed to repair, reconstruct, or functionally alter the larynx and its supporting cartilaginous framework in response to congenital anomalies, acquired trauma, stenosis, vocal cord paralysis, burns, or post-laryngectomy defects. Unlike endoscopic or transoral approaches, laryngoplasty specifically refers to open external access procedures that remodel the laryngeal skeleton itself — distinguishing it from injection augmentation or thyroplasty, which is a subset of laryngoplasty focused solely on phonosurgical modification of the thyroid cartilage to reposition the vocal folds. The underlying mechanism may involve cartilage grafting, fracture fixation, web resection with keel placement, medialization implantation, or cricoid splitting — each targeting a distinct structural problem in the laryngeal framework. Physiologically, the procedure can be corrective (e.g., restoring a patent airway in subglottic stenosis) or restorative (e.g., improving glottic closure in vocal cord paralysis leading to dysphonia and aspiration). Clinically relevant subtypes most commonly encountered in inpatient profee coding include laryngoplasty for laryngeal web removal with keel placement (J38.7), laryngoplasty for laryngeal stenosis with cartilage graft (J38.6), medialization laryngoplasty for vocal cord paralysis (J38.00, J38.01, J38.02), and laryngoplasty for fracture repair (S12.8XXA and related trauma codes). It is commonly confused with laryngectomy — note the key difference: laryngoplastyrepairs or reconstructs the larynx while laryngectomy involves removal of all or part of it.
The word entered English in the 1890s as laryngoplasty (noun), formed from New Latin, combining Greek larynx (“upper windpipe, voice box”) + Greek -plastia (“molding, shaping”) — literally “surgical molding of the voice box.” The combining form laryngo- (“larynx”) connects laryngoplasty to the entire laryngo- root family: laryngoscopy (laryngo- + -scopy → visual examination of the larynx), laryngectomy (laryngo- + -ectomy → surgical removal of the larynx), and laryngitis (laryngo- + -itis → inflammation of the larynx). The surgical suffix -plasty is among the most productive in ENT and reconstructive medicine, appearing in rhinoplasty, tympanoplasty, pharyngoplasty, palatoplasty, and tracheoplasty.
🔀 ALIASES / ALTERNATE TERMS
Laryngeal Reconstruction(broad clinical synonym; used interchangeably in ENT operative reports and inpatient documentation — encompasses open structural repair of the laryngeal framework)
Laryngeal Framework Surgery(umbrella term used in otolaryngology/laryngology for any procedure modifying laryngeal cartilage — includes medialization, arytenoid repositioning, and cricothyroid approximation)
Thyroplasty(phonosurgical subtype of laryngoplasty — modifies the thyroid cartilage specifically; four Isshiki types: Type I medialization, Type II lateralization, Type III relaxation/shortening, Type IV stretching/lengthening)
Medialization Laryngoplasty(most common subtype; implant placed through a cartilage window to medialize a paralyzed vocal fold; also called Type I thyroplasty; coded under 31591)
Laryngoplasty with Cartilage Graft(open repair using autologous cartilage, most often costal or thyroid cartilage, to reconstruct or augment the laryngeal framework; coded under 31551, 31552, 31553, 31554 by age)
Cricoid Split(anterior laryngoplasty variant used primarily in neonates and pediatric patients for subglottic stenosis — involves incision of the cricoid cartilage anteriorly ± posteriorly to expand the subglottis; coded under 31587)
Laryngeal Web Repair(laryngoplasty performed to excise congenital or acquired glottic/subglottic web with keel/stent placement to prevent re-stenosis; coded under 31580)
Laryngoplasty NOS(not otherwise specified — used for burns, reconstruction after partial laryngectomy, or other indications not captured by a more specific code; coded under 31588)
Phonosurgery(lay/clinical synonym in voice medicine for any surgical procedure performed primarily to improve voice quality, including laryngoplasty variants)
Laryngeal Fracture Repair(traumatic indication subtype — open reduction and internal fixation of fractured laryngeal cartilage, typically with plating; coded under 31584)
🔗 RELATED TERMS
Laryngectomy — the opposite of laryngoplasty in intent; involves partial or total removal of the larynx rather than repair; partial laryngectomy may necessitate subsequent laryngoplasty for reconstruction (ICD-10: Z90.29 status post, CPT: 31360, 31365)
Thyroplasty — shares the laryngo- root family and is the most clinically common subtype of laryngoplasty; specifically remodels the thyroid cartilage to alter vocal fold position or tension; four Isshiki types
Laryngeal Stenosis — the most common structural indication for laryngoplasty requiring cartilage graft; defined as narrowing of the laryngeal lumen, graded by Cotton-Myer scale; (J38.6)
Vocal Cord Paralysis — primary functional indication for medialization laryngoplasty; results in dysphonia, aspiration, and ineffective cough when glottic closure is incomplete; (J38.00, J38.01, J38.02)
Subglottic Stenosis — pediatric-predominant indication for cartilage graft laryngoplasty (LTP); may be congenital or acquired post-intubation; Cotton-Myer Grades III-IV typically require surgical intervention; (J38.6, Q31.1)
Laryngeal Web — congenital or acquired membranous band in the glottis or subglottis; primary indication for laryngoplasty with keel placement (31580); coded as (Q31.0 congenital, J38.7 acquired)
Dysphonia — key functional outcome being treated by laryngoplasty in vocal cord paralysis cases; hoarseness or altered voice quality due to incomplete glottic closure; (R49.0)
Aspiration — serious complication of glottic insufficiency in vocal cord paralysis; medialization laryngoplasty can reduce aspiration risk by improving glottic competence; (J69.0)
laryngoscopy — primary diagnostic and surveillance tool for laryngeal pathology preceding laryngoplasty; flexible fiberoptic and direct laryngoscopy used to evaluate vocal fold mobility, web formation, and stenosis grade; (31575, 31526)
Tracheotomy / Tracheostomy — may be required as airway protection during laryngoplasty in pediatric cases or severe stenosis; can be integral to the procedure (included in 31584) or staged separately
Arytenoid Adduction / Arytenopexy — adjunct procedure to medialization laryngoplasty used when posterior glottic gap persists; mechanically repositions the arytenoid cartilage to improve posterior commissure closure; often reported with 31591
Glottoplasty — related phonosurgical procedure; endoscopic partial webbing of the anterior glottis to lower voice pitch; distinct from open laryngoplasty
Laryngoscopy, direct, operative, with or without tracheoscopy; for aspiration, with or without dilation
31599
Unlisted procedure, larynx (use for endoscopic laryngoplasty per AAO-HNS guidance)
⚠️ Coding Note: For inpatient profee coding, laryngoplasty CPT codes are highly site- and technique-specific — the single biggest coding error is defaulting to 31588 (NOS) when a more specific code applies; always review the operative report for whether a keel/stent (31580), cartilage graft (31551-31554), medialization implant (31591), fracture fixation (31584), or cricoid split (31587) was performed. Sequence the structural or functional diagnosis (e.g., J38.6 stenosis, J38.01 paralysis) as the principal diagnosis when the laryngoplasty is the reason for admission; post-procedural subglottic stenosis (J95.5) is sequenced as principal when the operative report confirms an iatrogenic etiology. Undercoding alert:31591 (medialization laryngoplasty) is frequently undercoded as 31588 NOS when the operative report clearly documents implant placement for vocal cord paralysis — the documentation trigger phrase is “implant placed through cartilage window” or “medialization of the paralyzed vocal fold” — query the surgeon if not explicitly stated. Per AAO-HNS guidance, endoscopic laryngoplasty is NOT reportable with any of the open codes above and requires 31599 (unlisted); failure to distinguish open vs. endoscopic approach is a common payer audit trigger. For pediatric cases involving cartilage graft, code selection between 31551-31554 hinges entirely on two criteria: patient age (≤12 vs. >12) and whether tracheotomy was performed — confirm both from the anesthesia record and operative report before code assignment.
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