Pediatric otolaryngologists—ear, nose, and throat doctors—at Hassenfeld Children’s Hospital at NYU Langone provide expert diagnosis and treatment of many airway abnormalities that affect breathing in children. Our providers offer a compassionate and personalized approach that starts with determining the cause of the airway abnormality. We then create the best treatment plan based on your child’s age and the type of airway obstruction.
Airway abnormalities can be congenital, meaning present at birth, or acquired. Symptoms may include stridor, or noisy breathing, along with wheezing, sleep apnea, blue spells, and chest congestion. Our specialists manage the full spectrum of disorders that can block the airway, including these:
complete tracheal rings, in which the rings of cartilage that form the trachea, or windpipe, are small and O-shaped rather than large and C-shaped
glottic stenosis, or narrowing of the larynx, commonly known as the voice box
subglottic stenosis, or narrowing of the airway below the vocal cords
tracheal stenosis, or narrowing of the trachea
tracheomalacia, the narrowing or collapse of the airway as your child exhales
tracheal web, membranous tissue that blocks the trachea
laryngeal atresia, upper airway blockage that occurs when the larynx does not properly develop in the womb
laryngeal cleft, an abnormal opening between the voice box and the esophagus
laryngomalacia, in which tissues located in the throat above the vocal cords are too soft and flop into the airway
saccular cyst, a cyst that forms in voice box tissue
subglottic cyst, a cyst that forms just below the vocal cords
vocal cord paralysis, in which nerve function in one or both vocal cords is disrupted, causing vocal cord tissues to relax and block the airway
In addition to a medical history and physical exam, our doctors may order imaging tests such as a CT scan or MRI scan to view the structures in your child’s airway to determine what is causing symptoms.
Our doctors may also perform one of the following diagnostic procedures:
flexible laryngoscopy, in which an endoscope, a thin, flexible tube with a light and camera on the end, is placed through the nose to examine the airway and vocal cords
microlaryngoscopy, in which an endoscope is placed in the mouth to view the airway and vocal cords
bronchoscopy, in which an endoscope is inserted through the nose or mouth to examine the lower airways
After a thorough assessment, your child’s doctor can discuss a treatment plan with you.
Personalized Treatment Options
Treatment options vary by condition. Your child’s doctor may recommend watchful waiting to manage laryngomalacia or subglottic stenosis if the condition is mild and does not greatly interfere with breathing. As your child grows, the doctor checks to make sure the airway is enlarging to make more space for airflow.
Other conditions that narrow the trachea or larynx may require surgery. These are some of the surgical procedures our doctors perform:
laryngotracheal reconstruction, in which surgeons place a graft made from ear, rib, or thyroid cartilage into the airway to make it wider
cricotracheal resection, in which surgeons remove the narrow part of the airway just below the voice box and then sew the voice box and trachea back together
slide tracheoplasty, a procedure in which surgeons divide and then make incisions in two sections of the narrow portion of trachea. The surgeons slide one section into the other, creating a shorter but wider airway
endoscopic airway dilation, in which doctors use an endoscope to insert a balloon that inflates to widen the airway below the vocal cords
laryngotracheal cleft repair, endoscopic repair of the opening between the voice box and trachea
supraglottoplasty, a procedure to remove tissue obstructing the upper part of the voice box
laryngeal reinnervation, to create a nerve supply for a paralyzed vocal cord