Typical candidates, or those warranting an evaluation of the airway, are those patients who have been born with a defect of the airway (congenital anomalies of the nose, voice box and trachea), those who have acquired a defect, or those for which no diagnosis exists who show signs of airway obstructions such as stridor. This includes patients who currently have a tracheostomy and are unable to be decannulated, patients with noisy breathing after neck or laryngeal trauma, and patients with speech and language difficulties related to airway defects.
How one acquires an airway obstruction varies. Sometimes, there could be a pre-existing minor birth defect in the larynx or trachea requiring a child to be intubated by passing a tube into the airway. This could then worsen the pre existing condition – e.g congenital subglottic stenosis. Children may have a history of prolonged intubation for premature birth and associated comorbidities of the heart, lungs and gastrointestinal or neurological causes.
Adults may have a history of intubation in an intensive care setting, which may cause tracheal stenosis. Trauma to the neck and larynx are also possible examples of acquired defects leading to airway obstruction. Tracheostomy tubes themselves can also cause stenosis and will require laryngotracheal evaluation and possible reconstruction.
The following is a list of candidates who may present with respiratory difficulty and require an airway evaluation and reconstruction: