Laryngeal obstruction Causes: Infection Tumors Foreign bodies Trauma Allergy Malformation Laryngeal paralysis

Laryngeal obstruction symptoms： inspiratory dyspnea inspiratory stridor depression of suprasternal fossa, intercostal and supraclavicular space or epigastrium while inspiration hoarseness and even cyanosis

Laryngeal obstruction classification: Ⅰ°there is no symptoms at rest. But slight inspiratory dyspnea and stridor may occur during crying or on exertion

Laryngeal obstruction classification: Ⅱ°slight inspiratory dyspnea during quiet respiration, and exaggeration on exertion. Sleeping and taking the meal is nearly normal , no evidence of hypoxia.

Laryngeal obstruction classification: Ⅲ°：with marked inspiratory dyspnea, loud stridor, depression of suprasternal and supraclavicular fossae and intercostal spaces, cyanosis, restless and struggles for air hunger, with quick pulse, high blood pressure and refuse meals.

Laryngeal obstruction classification: Ⅳ°：extremely dyspneic, restless, sweating, cyanoticsis. Pulse is rapid, irregular, weak and thready. B.P. drops. Finally circulatory collapse may occur or may die of asphyxia or cardiac failure.

Laryngeal obstruction Treatment Ⅰ°：etiological treatment, antibiotics and corticosteroid.

Laryngeal obstruction Treatment Ⅱ°：etiological treatment . in case of tumors of the larynx, trauma, bilateral vocal cords paralysis, tracheotomy is indicated.

Laryngeal obstruction Treatment Ⅲ°：If the laryngeal obstruction is caused by inflammation, medical treatment can be administrated under close observation. Tracheotomy should be prepared. If dyspnea is not relieved, tracheotomy should be performed immediately.

Laryngeal obstruction Treatment Ⅳ°：Tracheotomy

Tracheotomy Tracheotomy is a surgical procedure in which an opening is made in the anterior wall of the trachea to establish an airway.

Tracheotomy Tracheotomy is often temporary and reversible if the patient is able to breathe through an unobstructed upper airway

Tracheotomy Anatomy：2nd-4th ring of trachea Indication： Laryngeal obstruction Secretion obstructed in lower respiratory tract (coma) Before some major head & neck surgery

Tracheotomy Complications Hemorrhage Subcutaneous emphysema Pneumothorax Difficulty of decannulation Laryngeal or tracheal stenosis

Cricothyrotomy Employed in first-aid cases. Making an opening in the membrane between the cricoid cartilage and thyroid cartilage and insert a cannula. After the situation becomes stable, ordinary tracheotomy should be performed.