airwaypatency

Airway patency, also referred to as maintaining an open airway, denotes the degree to which the conducting airways from the nose and mouth to the tracheobronchial tree remain unobstructed, allowing gas exchange. Patency is influenced by airway size, airway wall tone, external compression, and airway secretions or foreign material. It is essential for adequate ventilation and oxygenation.

Obstruction can be intrinsic (inside the airway) and extrinsic (external compression). Intrinsic causes include edema from infection or allergic reactions, mucus plugs, tumors, congenital anomalies, or inflammation; extrinsic causes include neck swelling, masses, or displacement that narrows the airway. Dynamic collapse may occur in conditions such as obstructive sleep apnea or laryngomalacia.

Assessment and monitoring rely on clinical examination and diagnostic tools. Observations of breathing effort, stridor, wheeze, and cyanosis are primary. Additional methods include capnography and pulse oximetry to assess ventilation and oxygenation, spirometry and flow-volume loops to characterize obstruction, and imaging (radiographs or CT) for anatomic detail. Bronchoscopy provides direct visualization and potential therapeutic relief.

Management aims to preserve or restore patency and prevent hypoxemia. Short-term measures address obstruction or secretions; longer-term strategies include airway adjuncts, relief of external compression, bronchodilation and anti-inflammatory therapy, and, if necessary, advanced airway support such as endotracheal intubation or tracheostomy. In sleep-disordered breathing, modalities like CPAP or BiPAP may maintain patency, while chronic causes may require surgical or medical interventions. In anesthesia, planning for difficult airway management is essential.