Airway disorders affect the normal flow of air through the breathing passages and can interfere with breathing, voice production, and the ability to clear secretions. Symptoms may include noisy breathing, shortness of breath, exercise intolerance, stridor, or recurrent respiratory infections. While some airway symptoms are mild or intermittent, persistent or progressive breathing difficulties require specialist assessment.
Airway problems may arise from structural narrowing, inflammation, scarring, or functional abnormalities involving the larynx, trachea, or bronchi. Accurate diagnosis is essential to determine the cause, assess severity, and guide safe and effective treatment.
Ms Aphrodite Iacovidou provides specialist assessment and management of airway disorders within her laryngology and airway practice, offering both minimally invasive and complex surgical solutions tailored to individual patient needs.
What Are Airway Disorders ?
Airway disorders encompass a range of conditions that affect the structure or function of the upper and central airway, particularly the larynx (voice box), subglottis, and trachea. These conditions may affect breathing at rest, during exertion, or while sleeping, and can occur in both adults and children.
Symptoms vary depending on the underlying condition and may include breathing difficulty, wheezing or stridor, voice changes, sleep disturbance, or recurrent chest infections. Some airway disorders are present from birth, while others develop following inflammation, injury, surgery, or prolonged intubation.
Conditions commonly managed include:
- Airway stenosis
- Subglottic stenosis
- Tracheal stenosis
- Laryngotracheal narrowing
- Exercise-induced laryngeal obstruction (EILO)
- Laryngomalacia
- Obstructive sleep apnoea
- Snoring related to upper airway obstruction
Early specialist assessment allows timely intervention and reduces the risk of worsening airway compromise.
Expert Airway Disorders Treatment
Assessment begins with a detailed clinical history and examination, focusing on breathing symptoms, voice changes, exercise tolerance, and sleep-related concerns. Diagnostic evaluation may include flexible nasoendoscopy and airway assessment to visualise the larynx and upper airway.
For patients with suspected airway narrowing, endoscopic airway evaluation under anaesthetic may be recommended. This allows direct visualisation of the airway from the vocal cords to the bronchi and helps guide treatment planning.
Treatment options are individualised and may include medical management, endoscopic procedures, or surgical intervention. Ms Iacovidou offers a full range of airway treatments, including steroid injections, laser therapy, balloon dilatation, and reconstructive airway surgery where indicated. Many procedures are performed endoscopically through the mouth without external incisions.
Care is delivered with continuity from diagnosis through treatment and follow-up, with careful attention to safety, symptom improvement, and long-term airway function.
What is Chronic Cough?
A chronic cough is a cough that lasts for eight weeks or longer. It’s more than just a nuisance; it can also be a sign of an underlying health issue. Many people experience occasional coughing, but a chronic cough can disrupt daily life and make it hard to sleep or work.
What are the treatment options?
Treatment for a chronic cough depends on the underlying cause. Here are some common options:
Addressing Underlying Conditions: The first step often involves treating whatever is causing the cough, such as using asthma inhalers or medications for GORD.
Lifestyle Changes: Quitting smoking, avoiding irritants (like pollution or strong scents), and keeping indoor air clean can help.
Over-the-Counter Remedies: Cough suppressants and expectorants can provide temporary relief, especially for a cough caused by postnasal drip.
Prescriptions: For more severe cases, doctors might prescribe medications like corticosteroids for inflammation or antibiotics for bacterial infections.
Cough Desensitization: This therapeutic approach aims to reduce the sensitivity of the cough reflex over time through gradual exposure to the triggers. Working with a speech therapist or specialized healthcare provider, patients can learn techniques to modify their cough reflex and improve symptoms.
Superior Laryngeal Nerve Block: This is a specific treatment option where a mixture of anaesthetic and steroid is injected into the area around the superior laryngeal nerve to reduce sensitivity in the throat and alleviate the cough reflex. This is repeated over a few weeks until there is improvement of symptoms.
Laryngeal Botox: In some cases, injecting botulinum toxin (botox) into the laryngeal muscles can help relax these muscles, decreasing sensitivity and improving cough symptoms, particularly for those with laryngeal hypersensitivity.
What can an ENT (Ear, Nose, and Throat) doctor do to help me?
An ENT doctor can help diagnose and treat chronic coughs by conducting thorough examination and tests, such as laryngoscopy to look at the throat and vocal cords. They can identify underlying issues like postnasal drip, allergies, or GORD. Treatment options including procedures like superior laryngeal nerve blocks and laryngeal botox to reduce throat sensitivity. They can also offer lifestyle advice to avoid irritants and may collaborate with other healthcare providers (SLT) for comprehensive care. If you’re struggling with a chronic cough, seeing an ENT doctor can be an important step toward relief.
What are the causes of chronic cough (in order of incidence)?
Postnasal Drip: This is one of the most common causes of chronic cough, occurring when mucus from the sinuses drips down the back of the throat, triggering a cough.
Asthma: Chronic coughing can be a symptom of asthma, a condition that causes the airways to become inflamed and constricted.
Gastroesophageal Reflux Disease (GORD): Stomach acid can flow back into the oesophagus, irritating the throat and causing a cough. 4. Chronic Bronchitis: A type of chronic obstructive pulmonary disease (COPD) characterised by long-term cough and mucus production.
Laryngeal Hypersensitivity: This occurs when the larynx (voice box) becomes overly sensitive, leading to a cough reflex in response to minor irritants, such as smoke, cold air, or even talking.
Infections: Conditions like pneumonia or tuberculosis can also lead to chronic cough, though they are less common compared to other causes.
Smoking: Persistent coughing can result from smoking, which damages the lungs and airways.
Medications: Certain medications, particularly ACE inhibitors used for hypertension, can cause coughing as a side effect.
Why Choose Ms Aphrodite Iacovidou for Airway Disorders Treatment
Ms Aphrodite Iacovidou FRCS (ORL-HNS) is a Consultant ENT Surgeon specialising in airway and laryngology disorders, with extensive experience managing both routine and complex airway conditions. She is a substantive Consultant at the National Centre for Airway Reconstruction, Imperial NHS Healthcare Trust, based at Charing Cross Hospital.
FAQs
When should I seek specialist assessment for airway symptoms?
You should seek specialist assessment if you experience persistent or worsening breathing difficulties, noisy breathing such as stridor or wheeze, shortness of breath during activity, exercise intolerance, or repeated respiratory infections. Airway symptoms that interfere with sleep, voice, or daily activity should not be ignored, as some airway conditions can progress if left untreated.
What causes airway disorders?
Airway disorders can result from structural narrowing, inflammation, scarring, or functional abnormalities affecting the larynx, subglottis, or trachea. Some conditions are present from birth, while others develop after infection, injury, surgery, prolonged intubation, or chronic inflammation. Identifying the exact cause is essential to determine severity and guide safe, effective treatment.
How are airway disorders diagnosed?
Diagnosis begins with a detailed clinical history and examination focusing on breathing, voice, exercise tolerance, and sleep-related symptoms. Investigations often include flexible nasoendoscopy to visualise the larynx and upper airway. In selected cases, an endoscopic airway assessment under anaesthetic may be recommended to directly examine the airway from the vocal cords to the bronchi and accurately plan treatment.
Are airway disorders always treated with surgery?
No. Treatment depends on the underlying condition and its severity. Some airway disorders can be managed with medical treatment or minimally invasive endoscopic procedures such as steroid injections, laser therapy, or balloon dilatation. Surgery is reserved for cases where conservative or endoscopic options are insufficient, and many procedures can be performed through the mouth without external incisions.
Who provides specialist airway disorders treatment in London?
Airway disorders are best managed by ENT surgeons with specialist training in laryngology and airway reconstruction. Ms Aphrodite Iacovidou offers consultant-led assessment and personalised airway treatment across West and Central London, with expertise spanning minimally invasive techniques and complex airway surgery for both adults and children.
