Abstract
Airway reconstruction surgery has undergone substantial evolution over the past decade owing to advances in surgical techniques, perioperative care, biomaterials, and tissue engineering. Reconstruction of the laryngotracheal complex remains one of the most technically demanding fields in otorhinolaryngology because of the need to restore airway patency while preserving phonation, swallowing, and respiratory function. Although congenital airway abnormalities predominate in pediatric populations, acquired stenosis secondary to prolonged intubation, trauma, inflammatory diseases, and malignancies represents the major indication for reconstruction in adults. Contemporary treatment strategies emphasize individualized surgical planning based on lesion characteristics, patient age, comorbidities, and multidisciplinary assessment. Recent innovations, including minimally invasive endoscopic procedures, slide tracheoplasty, cartilage grafting, robotic-assisted surgery, three-dimensional imaging, patient-specific implants, and regenerative medicine, have significantly improved functional outcomes while reducing perioperative morbidity. Despite these advances, postoperative restenosis and long-term airway stability remain important clinical challenges. This review summarizes current concepts, modern surgical techniques, emerging technologies, and future perspectives in airway reconstruction surgery for both adult and pediatric patients.