Common Causes of Airway Obstruction in Adults 

1. Decreased Level of Consciousness (most common) 

Tongue obstruction 
Causes: 
Alcohol or drug intoxication 
Sedatives / opioids 
Stroke 
Post-ictal state 
General anaesthesia 
Note: Loss of pharyngeal muscle tone → posterior tongue collapse. 

2. Foreign Body Aspiration 
Food (eg; meat bolus, fish bone) 
Dentures 
Vomitus 
Risk factors: Elderly, intoxication, neurological disease 
Presentation: Sudden choking, coughing, unilateral wheeze, or stridor 

3. Inflammation & Oedema 

Anaphylaxis 
Angioedema (ACE-inhibitors, hereditary) 
Infections 
Epiglottitis (rare but life-threatening in adults) 
Peri-tonsillar or retropharyngeal abscess 
Post-intubation laryngeal oedema 
Inhalation injury / burns 
Note: Voice changes + stridor + swelling → secure airway early. 

4. Tumours 

Head and neck cancers 
Laryngeal 
Oropharyngeal 
Hypopharyngeal 
Endobronchial tumours 
Note: Progressive hoarseness, dysphagia, weight loss, haemoptysis 
 
5. Trauma 

Facial fractures 
Neck hematoma 
Laryngeal injury 
Blood or secretions obstructing airway 
Note: Assume airway compromise until proven otherwise. 

6. Lower Airway Obstruction 

Asthma (severe / status asthmaticus) 
COPD exacerbation 
Mucus plugging 
Bronchospasm 
Note: Red flag: Silent chest = impending respiratory failure. 

7. Structural & Mechanical Causes 

Tracheal stenosis (post-intubation) 
Goiter 
Mediastinal mass 
Tracheomalasia 

8. Functional / Sleep-Related 

Obstructive sleep apnoea 
Vocal cord dysfunction 

Key points: 

 
Notes: 
Most common cause of airway obstruction in adults: loss of consciousness → tongue 
Stridor = upper airway obstruction 
Wheeze = lower airway obstruction 
Secure airway early if oedema or bleeding is progressing