What is Tracheal Shave (chondrolaryngoplasty)

Tracheal shave (chondrolaryngoplasty) is a surgery to make the thyroid cartilage smaller. The thyroid cartilage is the V-shaped cartilage on the voice box (larynx) and shows as a bump in front of the neck.

It is also called the Adam’s apple. In men, the bump is usually larger and sticks out from the neck more than it does in women.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Changes in how the voice sounds.
• Trouble breathing.
• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs.

What happens before the procedure?

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Antibiotic medicine.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay incision healing after surgery. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine injected into the area around your larynx to numb the area and prevent bleeding.
  • A medicine to control swelling (steroid medicine).
• A small incision will be made in your neck, in one of your natural skin folds.
• The muscles under your skin and over your larynx will be separated to show the thyroid cartilage around the larynx.
• The cartilage that sticks out will be shaved down. This is usually the upper portion of the cartilage that forms the V-shaped tip.
• In some cases, a flexible telescope may be passed through your nose and into your throat while the cartilage is being shaved. This helps protect your vocal cords.
• The muscles over the larynx will be moved back into place.
• Your incision will be closed with stitches (sutures) and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• Your IV will be removed when you are able to eat and drink.
• You will be given pain medicine as needed.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• Tracheal shave is a generally safe and effective procedure to change the appearance and prominence of the thyroid cartilage. Talk with your surgeon about expected outcomes and be sure to follow postoperative instructions.
• Before the procedure, follow instructions from your health care provider about eating and drinking.
• Plan to have someone take you home from the hospital or clinic.

Tracheal Shave, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Neck soreness for 1–2 weeks.
• Bruising.
• Swelling.
• A weak voice.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Sleep with your head and neck raised (elevated). Try propping yourself up with extra pillows in bed or sleeping in a reclining chair.

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay incision healing after surgery. If you need help quitting, ask your health care provider.
• You may eat your normal diet as directed by your health care provider. Eat soft foods if you have discomfort when you swallow.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

• More redness, swelling, or pain around your incision.
• Fluid or blood coming from your incision.
• Unusual warmth around your incision area.
• Pus or a bad smell coming from your incision.
• A fever.
• Pain that gets worse.
• Changes in your voice that are getting worse, such as hoarseness.

Get help right away if you have:

• Noisy breathing.
• Trouble breathing.

Summary

• After the procedure, it is common to have soreness, bruising, and swelling.
• Take pain medicine as directed by your health care provider. Icing may also help with pain control.
• Contact your health care provider if you have signs of infection or any problems with breathing.