Surgeons at Stradiņš Hospital have successfully performed a complex laryngeal reconstructive procedure on a patient with severe laryngeal stenosis. Thanks to the coordinated efforts of a multidisciplinary team, the patient regained the ability to breathe through her natural airway, no longer requires a tracheostomy, and has recovered her ability to speak.
The procedure is the first of its kind ever to be performed in Latvia.
The patient had experienced breathing difficulties and persistent hoarseness since childhood, with her symptoms progressively worsening in recent years.
She had initially been scheduled for a different elective procedure, but severe difficulties with intubation made the operation impossible. As her respiratory condition deteriorated, she was admitted to the Intensive Care Unit, where her treatment was taken over by the otolaryngology team at Stradiņš Hospital.
Further examinations revealed a significant narrowing of the subglottic region of the larynx. In collaboration with thoracic surgeons, tissue samples were taken from the affected area and the upper trachea for further evaluation. Although the medical team initially sought to stabilise the patient’s condition without the use of a tracheostomy tube, her breathing continued to deteriorate.
As a result, the team decided to perform a tracheostomy to restore adequate airflow and ensure safe, effective breathing.
According to otolaryngologist Dr Romāns Dzalbs, laryngeal reconstruction is among the most technically demanding procedures in head and neck surgery. The larynx is one of the most anatomically and functionally complex organs in the human body and, unlike many other organs, it cannot currently be transplanted or artificially grown, making the treatment of such patients particularly challenging.
The team’s objective was not only to restore a patent airway but also to preserve the larynx’s three essential functions: breathing, swallowing and speech.
Following a comprehensive assessment, the patient was prepared for reconstructive laryngeal surgery. During the procedure, the larynx was fully opened while carefully preserving the delicate nerves, cartilages, joints and muscles responsible for its function. Cartilage harvested from the patient’s rib was used to widen the narrowed airway, and a specially designed stent was implanted to stabilise the reconstructed structure while the new laryngeal framework healed.
The tracheostomy tube was temporarily left in place below the reconstruction to ensure a secure airway during the post-operative recovery period.
The operation was performed by a multidisciplinary surgical team comprising otolaryngologists Dr Romāns Dzalbs and Dr Elza Rāte, thoracic surgeons Dr Artjoms Špaks and Dr Krista Grigoroviča, operating theatre nurse Anita Innus, anaesthetist Dr Sarmīte Plūme, and nurse anaesthetist Natālija Matvejeva.
Treatment was carried out in several stages. Following reconstruction of the larynx, the stent was removed, and, in the final stage of treatment, the tracheostomy was successfully closed. The patient’s rehabilitation has been led by speech and language therapist Tince Strazdiņa.
More than six months after surgery, the patient’s condition remains stable. She is breathing normally through her natural airway, speaks without difficulty, and has returned to her normal daily life with significantly improved breathing.
According to Dr Dzalbs, the treatment was a complex, multi-stage process whose success depended on close collaboration between specialists from multiple disciplines. One of the principal aims of laryngeal reconstruction is to restore natural airway function and avoid the need for a permanent tracheostomy. The successful outcome has enabled the patient to regain both respiratory and speech function and return to a full and active life.
Stradiņš Hospital provides highly specialised head and neck surgical care, including the treatment of complex airway and laryngeal disorders that require close collaboration between specialists across multiple medical disciplines.
02.07.2026.
