Hyderabad: World Airway Disorders Day is observed every year on July 10 across the globe. This day of awareness, support, and education was founded by Coping With Laryngomalacia, Inc. in 2015.
Airway disease is a term used to describe a set of symptoms indicating that a person is having a bronchia spasm, which happens when the airway is irritated by something. On that day, make an impact by painting your nails blue and starting the conversation that noisy breathing is never normal.
Understanding Airway Disorders
Airway disorders include a wide variety of conditions that affect a child’s breathing passages. The airway is made up of structures called the larynx (voice box), pharynx (the back of the mouth and nose), trachea (windpipe) and bronchi (lung passages).
These diseases affect the tubes (airways) that carry oxygen and other gases into and out of the lungs. They usually cause a narrowing or blockage of the airways. Airway diseases include asthma, chronic obstructive pulmonary disease (COPD), bronchiolitis, and bronchiectasis (which also is the main disorder for persons with cystic fibrosis). People with airway diseases often say they feel as if they're "trying to breathe out through a straw."
What is laryngomalacia?
Laryngomalacia is a larynx (voice box) abnormality that can happen in newborn babies. It occurs when weak, floppy tissues above the voice box temporarily fall back over the airway. It’s the most common cause of noisy breathing in babies. Laryngomalacia sounds like a high-pitched squeak (stridor) when your baby breathes in. It usually isn't serious. But, in severe cases, it can cause breathing and feeding issues, among other complications.
Signs and symptoms
If your child is born with laryngomalacia, symptoms may be present at the time of birth and can become more obvious within the first few weeks of life. It is not uncommon for noisy breathing to get worse before it improves, usually around four to eight months of age. Most children outgrow laryngomalacia by 18 to 20 months of age. Symptoms include:
- Noisy breathing (stridor) — An audible wheeze when your baby inhales (breathes in). It is often worse when the baby is agitated, feeding, crying or sleeping on his back
- High pitched sound
- Difficulty feeding
- Poor weight gain
- Choking while feeding
- Apnea (breathing stoppage)
- Pulling in neck and chest with each breath
- Cyanosis (turning blue)
- Gastroesophageal reflux (spitting, vomiting and regurgitation)
- Aspiration (inhalation of food into the lungs)
Types of Airway Diseases
There are several types of airway diseases, including:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Non-cystic fibrosis bronchiectasis
- Cystic fibrosis
- Reactive airway disease
Reactive airway disease: Reactive airway disease describes a set of symptoms that may or may not be caused by asthma. The symptoms include coughing, wheezing, and shortness of breath.
Pediatric Airway Disorders
Conditions affecting a child’s airway can cause breathing and feeding difficulties, and impact their ability to safely grow. The Children’s Health Airway Management Program (CHAMP) provides personalized care for all pediatric airway concerns.
Treatments
Children with airway disorders require highly personalised care. Treatments may range from simple, ongoing monitoring to complex surgery.
Medication
Antihistamines and epinephrine (EpiPen) can reduce airway swelling and inflammation of the nasal passages, throat, and tongue caused by an allergic reaction. When an infection is to blame, antibiotics and anti-inflammatory medicines can reduce swelling to unblock airways.
EXIT Procedure (Ex-utero Intrapartum Therapy)
Some airway disorders that are diagnosed before birth may be treated with this procedure during the baby’s delivery. Pediatric otolaryngologists perform the EXIT procedure to open the airway before the umbilical cord is cut.
Endoscopic Surgery
A lighted tube called an endoscope is inserted through the mouth to access a blocked airway in the nasal passages, windpipe, voice box, or lungs. Surgeons use small tools that are passed through the tube to remove a blockage or inflate balloons to expand narrow passageways.
Open Surgery
In some cases, open surgery (in which an incision is made in the neck to access the airway) is required to clear an airway blockage.
Airway Reconstruction Surgery
Certain airway disorders require reconstruction surgery to rebuild or expand parts of the airway, such as the voice box or windpipe. Reconstruction procedures can be performed with endoscopic or open-surgical techniques. Conditions that may need reconstruction include laryngeal cleft, laryngomalacia, subglottic or tracheal stenosis, tracheal rings, and tracheomalacia.
Swallowing and Feeding Therapy
The therapist will help the child improve chewing, sucking, and tongue movements and strengthen the muscles in the mouth and throat that are used for swallowing.
Tests and Procedures
Diagnosing and caring for children with airway disorders requires many types of imaging. Pediatric otolaryngologists may request the following tests or procedures.
X-Ray, CT Scan, or MRI
Imaging of the head, neck, and chest are taken to check for blockages. These tests are fairly quick and are painless.
Bronchoscopy
A tube called a bronchoscope is inserted through the nose or mouth and into the lower airway to check for foreign objects and other possible causes of airway blockages. This procedure is done while your child is asleep under general anaesthesia.
Laryngoscopy
A flexible tube called an endoscope is inserted into the nose or mouth to examine the voice box (larynx), vocal cords, and throat. Usually, this procedure can be done in the clinic while your child is awake. In cases that require a more thorough evaluation or intervention, your child would be asleep under general anaesthesia.
