Transoral management of obstructing tumors of the upper airway

Airway obstruction secondary to tumor presents an acute and complex challenge to otolaryngologists. Airway control is of utmost importance. The surgeon must be familiar with various methods for intubation to adapt to potential obstacles presented by head and neck tumors. Tracheotomy must always be considered, with the caveat that the risk of stomal recurrence following laryngectomy may be increased. Transoral debulking offers an alternative to tracheotomy as temporary method of airway improvement prior to definitive treatment of the tumor. CO2 laser and microdebrider debulking techniques are discussed.