Airway (Breathing Passage)
Overview
Airway (숨통) is a common term referring to the passage through which breathing occurs, i.e., the airway. Medically, it denotes the path of air movement from the nose, pharynx, larynx, trachea, to the bronchi, and obstruction of this path poses an immediate threat to life. The expression "airway is open" indicates a state where the airway is secured and smooth breathing is possible, while "airway is blocked" refers to airway obstruction or respiratory distress.
Main Content
1. Anatomical Structure
The main components of the airway are divided into the upper and lower airways. The upper airway includes the nasal cavity, oral cavity, pharynx, and larynx; the lower airway comprises the trachea, bronchi, bronchioles, and alveoli. The larynx houses the vocal cords, responsible for phonation and airway protection. The trachea is a tube approximately 10–12 cm long, supported anteriorly by C-shaped cartilage and posteriorly by smooth muscle.
2. Physiological Function
The primary function of the airway is to serve as a passage for air. During inhalation, contraction of the diaphragm and intercostal muscles lowers intrathoracic pressure, allowing air to enter the lungs through the airway. During exhalation, the muscles relax, expelling air. The airway mucosa removes foreign substances through ciliary movement and mucus secretion, and performs humidification and warming functions.
3. Causes of Airway Obstruction
- Foreign body aspiration: Food, toy pieces, etc., blocking the airway. Common in infants and young children; treated with the Heimlich maneuver.
- Edema: Mucosal swelling due to allergic reactions (anaphylaxis), laryngitis, burns, etc.
- Tumors: Intraluminal airway tumors or tumors from adjacent organs (thyroid, esophagus) compressing the airway.
- Infections: Croup (laryngitis), epiglottitis, peritonsillar abscess, etc.
- Trauma: Neck injuries, complications after tracheostomy.
- Neurological issues: Respiratory muscle paralysis due to stroke, Guillain-Barré syndrome, etc.
4. Emergency Treatment and Management
- Basic airway maintenance: Head-tilt chin-lift or jaw-thrust to secure the airway.
- Heimlich maneuver: Abdominal thrusts to expel foreign bodies.
- Airway adjuncts: Oropharyngeal airway, nasopharyngeal airway, laryngeal mask airway, endotracheal intubation.
- Surgical airway: Cricothyrotomy, tracheostomy.
- Pharmacotherapy: Epinephrine (anaphylaxis), steroids (reduce edema), antibiotics (infection).
5. Related Diseases
- Asthma: Reversible airway obstruction due to bronchial hyperresponsiveness. Wheezing, dyspnea, cough.
- Chronic Obstructive Pulmonary Disease (COPD): Irreversible airway obstruction due to airway inflammation and alveolar destruction.
- Laryngomalacia: Weak laryngeal cartilage in infants causing airway narrowing during inspiration.
- Sleep Apnea: Repeated airway obstruction during sleep due to relaxation of pharyngeal muscles.
Recent Trends
As of 2024–2025, the following changes and trends are notable in airway management.
- Telemedicine and Airway Management: Since the COVID-19 pandemic, telemedicine has been activated, leading to the development of protocols for initial assessment of dyspneic patients via video calls. Apps for real-time monitoring of respiratory status, especially in asthma exacerbations or allergic reactions, have been introduced.
- Smart Airway Adjuncts: Endotracheal tubes and laryngeal mask airways with built-in sensors have been developed, enabling real-time monitoring of intubation position, airway pressure, and leakage. Products approved by the FDA in 2024 have begun clinical use.
- 3D-Printed Airway Stents: Patient-customized airway stents are being produced via 3D printing, increasingly used to effectively treat airway obstruction due to tumors or stenosis. Stents using biodegradable materials are also under research.
- AI-Based Airway Assessment: Technology that automatically detects airway stenosis, tumors, and foreign bodies by analyzing chest CT or bronchoscopic images using AI has reached commercialization. In early 2025, a domestic university hospital introduced an AI-based airway obstruction diagnosis system for pilot operation in the emergency room.
- Advances in Non-Invasive Ventilation: High-flow nasal cannula and continuous positive airway pressure (CPAP) devices have been miniaturized and lightweighted, with models available for home use. Notably, a wearable CPAP device enhancing convenience for sleep apnea patients was released in late 2024 and has attracted attention.
Related Topics
- [[Airway Management]]
- [[Dyspnea]]
- [[Heimlich Maneuver]]
- [[Asthma]]
- [[Chronic Obstructive Pulmonary Disease]]
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