Airway disorders

Airway disorders are conditions that affect passageways that allow air to travel into and out of your lungs. These passageways are part of your respiratory system and include upper and lower airways.

Your upper airways are in your face, head, and neck. They comprise your nasal cavities, sinuses, throat (pharynx), and voice box (larynx).

Lower airways in your neck and chest include your trachea (windpipe), bronchi, and bronchioles. Your trachea connects your voice box to your bronchi, the tubes that carry air to your lungs. The bronchioles are small passageways that branch off from the bronchi.

Penn Medicine’s team of otorhinolaryngologists has deep expertise in diagnosing and treating all types of airway disorders, including complex lower airway disorders. Our otolaryngology experts often work with other specialists from pulmonology, thoracic surgery, speech and language pathology, and oncology to improve your airway function and quality of life. We create a care plan tailored to your needs using the latest treatment options available.

The symptoms you experience depend on the type of airway disorder you have. They can be short-term (acute) or long-term (chronic). Some common signs and symptoms include:

• Breathing problems
• Chest congestion
• Chronic cough
• Noisy breathing, like wheezing
• Shortness of breath

Airway disorders can be caused by chronic diseases, inflammation, allergies, infection, structural abnormalities, or damage to the airways.

Numerous conditions can cause airway disorders, including:

• Airway cancers (tumors in the larynx, trachea, or bronchi)
• Airway fistulas (abnormal connections between airway structures)
• Airway stenosis (narrowing in the larynx, vocal cords, trachea, and bronchi) 
• Asthma (inflammation and narrowing of the lower airways, along with excess mucus buildup)
• Bronchiectasis (the bronchi become damaged from infections that don’t go away and permanently widen)
• Bronchitis and bronchiolitis (inflammation of the bronchi and bronchioles with mucus buildup)
• Cystic fibrosis (genetic condition that causes abnormal mucus to build up in the airways)
• Noncancerous airway tumors
• Lung diseases
• Obstructive sleep apnea (blockage in your upper airway while you sleep)
• Sinusitis (sinus inflammation)

Treatment depends on the type of airway disorder you have. Your doctor may prescribe medications to decrease inflammation or treat an infection. They may also recommend seeing a speech and language pathologist to learn breathing techniques and exercises to help you feel better.

For more serious concerns, your doctor may perform a procedure such as:

• Dilation: This minimally invasive procedure treats airway stenosis. Your surgeon guides an endoscope through your nose or mouth into the narrowed part of your airway. They widen the area using a laser or tiny balloon. They may also use steroid injections to maintain the effect of dilation.
• Stenting: Immediately after dilation or during a future procedure, your doctor inserts a hollow metal or silicone tube (stent) into the airway to prop it open.
• Laser therapy: Your doctor may use laser therapy to destroy cancerous or noncancerous airway tumors blocking the airway.
• Ablation therapy: Ablation involves using heat or extreme cold (cryotherapy) to destroy tumors or scar tissue that blocks airways.
• Surgery: You may need surgery to repair a fistula, remove a tumor, or treat severe stenosis that doesn’t respond to less invasive procedures. Resection is used to cut out the stenosis and reconnect the ends of the airway.