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

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

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

5. 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.

6. 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.

7. 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.

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

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

10. 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.

11. Laryngeal obstruction
Treatment
Ⅳ°：Tracheotomy

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

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

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

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

21. 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.