Types of airway obstruction
The most common forms of airway obstruction or narrowing are:
- Procedural: The result of extended intubation (for use of a ventilator, typically beyond ten days)
- Traumatic: Caused by an auto accident, sports injury or assault
- Congenital: Present at birth, caused by folds in the throat that are either immobile or cartilage that is too soft or "floppy"
Airway obstruction treatments
Treatment of airway obstruction always involves some type of surgery. There are three types:
- Tracheotomy, bypassing the obstruction. This relatively straightforward operation involves making a hole in the trachea through the front of the neck and inserting a short curved tube. Once this procedure is performed, the larynx is no longer being traumatized. The tube used in this procedure is more secure than the endotracheal tube passed through the mouth (typically used for intubation), and is shorter and easier to manage. Tracheotomy can cause some damage to the trachea, but fortunately that is very rare.
- Endoscopic opening of the airway. This surgery is performed through a rigid tube, either cutting or removing scar tissue, usually with a CO2 laser.
- Open reconstruction of the airway with either removal of the obstructed segment or enlarging of the obstructed segment with cartilage grafts.
The type of obstruction, its location and severity, as well as your overall health status and personal needs, will determine which approach is appropriate for you.
Henry Ford Ear, Nose and Throat (Otolaryngology) physicians have vast experience in all three of the types of surgery necessary to repair airway obstruction. When the condition extends too far into the chest, we collaborate with Thoracic Surgeons to develop an appropriate personalized treatment plan.
The goal of our airway team is always to restore the airway to normal and to eliminate the need for a tracheostomy tube. Most endoscopic surgeries are out-patient procedures. Some patients may spend the night for observation. Patients who undergo complicated open reconstructive surgery are cared for in the state-of-the-art surgical intensive care unit at Henry Ford Hospital where their airway is carefully monitored. Following surgery we continue to monitor how well our patient’s airway is healing using video-endoscopy in the Department of Otolaryngology endoscopy suite.
For patients not treatable with the surgeries described above or who are not healthy enough to tolerate an open reconstruction, a stent is needed, in which case we collaborate with the Department of Pulmonology.