Breathing is something we do thousands of times each day, yet rarely notice. When the airway becomes narrowed, obstructed or unstable, breathing can become laboured, affecting exercise, daily activities, sleep and overall quality of life. At Shri VAS Clinic, we provide specialised care for adult and paediatric airway disorders, combining precise diagnosis, advanced endoscopic assessment and specialised laryngeal expertise to restore a safe, stable and functional airway, and the freedom to breathe comfortably.
Where every breath matters.
We breathe around 20 times every minute, yet rarely notice it. Breathing is so effortless that it fades into the background of everyday life. It is only when we run, exercise or climb stairs that we become aware of our breath.
Now imagine having to think about every single breath you take.
When the airway is narrowed or obstructed, breathing can become an effort rather than an unconscious act. Noisy breathing, stridor, breathlessness, disturbed sleep and difficulty with routine activities can profoundly affect everyday life. At Shri VAS Clinic, we provide specialised care for adult and paediatric airway disorders, looking beyond the symptom to understand where the airway is compromised, why it is happening and how it behaves during breathing.
Conditions We Treat
- Stridor and noisy breathing
- Upper airway obstruction
- Congenital and acquired airway disorders
- Laryngomalacia
- Vocal cord paresis, paralysis and impaired vocal fold movement, including bilateral vocal cord paralysis
- Glottic and subglottic stenosis
- Laryngotracheal stenosis (in adults and children)
- Idiopathic and exercise-related dynamic laryngeal obstruction
- Aspiration-related airway problems
- Tracheostomy and difficult decannulation
Advanced Airway Assessment
Some airway problems are structural and evident at rest, while others are dynamic and appear only during breathing, exertion or specific activities. Our evaluation therefore combines anatomical and functional assessment.
Our assessment may include:
- Endoscopic evaluation of the airway
- Flexible tracheoscopy and bronchoscopy
- Direct laryngoscopy and rigid bronchoscopy (examination under anaesthesia)
- Exercise-based airway assessment for dynamic obstruction
- Flow-volume loops and pulmonary function tests
- Radiological investigations, including CT, reconstructed CT, virtual tracheoscopy and virtual bronchoscopy
- Swallowing assessment, including Flexible Endoscopic Evaluation of Swallowing (FEES)
- Structured, protocol-based tracheostomy assessment and decannulation
Treatment
Treatment is tailored to the cause, location, severity and functional impact of the airway disorder, ranging from conservative care to advanced endoscopic and reconstructive surgery. We provide elective and emergency management of routine as well as complex and complicated airway disorders, including:
- Conservative and medical management
- Emergency airway management and procedures
- Laryngomalacia surgery for significant disease
- Management of bilateral vocal cord paralysis, including Kashima’s posterior cordotomy
- Botulinum toxin (Botox) injections for selected laryngeal disorders
- Endoscopic treatment of airway stenosis, including balloon dilatation, coblation and laser-assisted procedures
- Laryngotracheal reconstructive surgery, including tracheal resection and anastomosis, partial cricotracheal resection and anastomosis, and anterior/posterior cricoid grafting
- Airway stenting
- Tracheostomy and comprehensive protocol-based decannulation management
Our approach combines precise diagnosis, advanced airway techniques and specialised laryngeal expertise to achieve a safe, stable and functional airway, restoring the freedom to breathe without a tube.
Breathe freely. Live fully.
Common questions
What causes noisy breathing or stridor in an adult?
Most often a narrowing somewhere between the vocal folds and the trachea: vocal cord paralysis, scarring after intubation, or laryngotracheal stenosis. Stridor needs assessment rather than observation, because the degree of narrowing decides the treatment.
Can a tracheostomy tube be removed?
In many cases, yes. Decannulation follows a structured protocol: assess the airway above the tube, confirm the swallow is safe, then stage the removal. It is a planned process, not a single decision.
Do you treat children?
Yes. Paediatric airway disorders including laryngomalacia and congenital narrowing are part of this clinic, with surgery reserved for cases where the type and severity warrant it.