The airway is comprised of the pathway from the nose to the lungs, and disease can affect any point along this pathway. Most diseases of the airway are manifested by noisy or obstructed breathing, which can be caused by nasal masses, narrowing of the back of the nostrils (otherwise known as choanal atresia), large adenoids and tonsils, floppiness of the larynx and trachea (otherwise known as laryngotracheomalacia), masses on or paralysis of the vocal cords, and narrowing of the airway below the larynx (otherwise known as subglottic stenosis). Evaluation by an ENT usually includes flexible Fiberoptic examination of the airway from the nostrils to the larynx, and treatment includes endoscopic procedures and open neck surgery performed in the operating room.