Airway Center

Airway trauma can occur in several ways:

• Tracheal laceration after intubation
• Trachea-esophageal fistula, an abnormal connection in one or more places between the trachea and esophagus
• Persistent tracheal stoma that develops when a tracheostomy site does not heal

Bronchial stenosis is the narrowing of the bronchial tubes, which are the tubes that allow air in and out of the lungs. It can be caused by a variety of cancers, but it’s also seen in patients suffering from autoimmune disorders, post lung transplant, post radiation therapy or prior infections.

Similar to tracheobronchomalacia but much more common, excessive dynamic airway collapse occurs when the airway narrows after significant collapse of the posterior tracheal and bronchial membranous walls. This is typical in patients suffering from emphysema and obesity.

The glottis, the space between the vocal cords, is important in speech and breathing. Glottic stenosis is a condition where the space between the vocal cords is narrowed. This may cause issues with not only breathing, but also hoarseness and voice change. Additionally, swallowing problems may accompany this disorder. This problem may be caused by trauma to the larynx or after radiation therapy.

Tracheobronchomalacia refers to the weakness of the airway cartilaginous structures, causing it to collapse when breathing. It can be caused by autoimmune and connective tissue disorders, such as relapsing polychondritis or Ehlers-Danlos syndrome.

Tracheal tumors are rare and can be benign or malignant. Malignant tracheal cancers include adenoid cystic carcinoma, squamous cell carcinoma and carcinoid tumors. Often, patients will have symptoms for a long time and see many doctors before receiving a diagnosis. This is because tracheal tumors are difficult to diagnose and symptoms are often attributed to more common disorders such as asthma. The diagnosis is usually made by a dedicated neck or chest CT scan and bronchoscopy.

Bronchial tumors can be benign, but are often due to lung cancer or tumoral deposits from other cancers, including lymphoma, melanoma, breast, colon and kidney cancers.

Tracheal and subglottic stenosis is the narrowing of the trachea or the larynx, causing breathing problems. Most often, tracheal stenosis occurs when scar tissue forms in your trachea due to intubation or prior tracheostomy. Sometimes, prior airway infections such as tuberculosis, can lead to stenosis, or it can occur without a cause at all.

Subglottic stenosis can occur without a clear cause, but can be been seen in patients diagnosed with granulomatosis with polyangiitis (GPA) or relapsing polychondritis.

This technique stretches the airway to improve airway size and reduces symptoms. Bronchoscopic or laryngoscopic dilatations are often performed in combination with laser treatments of the airway scar tissue or tumor. Sometimes, insertion of dedicated airway stents is needed to maintain the airways opened.

During airway stenting, a tube is inserted to maintain an open airway. Stents are either silastic or metallic depending on if the stenosis is benign or malignant, the shape and location of the airway narrowing.

Metallic Airway Stent Procedure Photos

Silicone Airway Stent Procedure Photos

This procedure uses an indwelling laryngeal stent to improve the opening of the airway between the vocal cords in patients with posterior glottic stenosis.

Laser therapy uses ablation for tumoral tissues or precise scar tissue removal in benign airway stenosis. Laser therapy can be a standalone treatment or in combination with other techniques depending on the form of airway narrowing.

Laser Therapy Procedure Photos

This procedure involves using a laser to remove the stenosis to improve airway size.

A variety of hot or cold therapies are used, such as electrocautery, argon plasma coagulation and cryotherapy are used to destroy scar tissue or tumor.

Photodynamic therapy, also known as light therapy, is a form of localized light-activated chemotherapy for inoperable airway tumors or for those with advanced cancers that cause airway blockages.

This procedure is used as an additional treatment for subglottic stenosis to decrease risk of recurrent symptoms.

Tracheal resection and reconstruction surgeries removes the affected airway segment and joins the airway back together. We perform laryngotracheal resection and reconstruction when the diseased airway segment is higher up in the neck and involves the cricoid cartilage. We also perform this surgery to treat tracheal stenosis and tracheal tumors.

Tracheal Resection and Reconstruction Surgery Photos

During tracheo-esophageal fistula surgery, the abnormal connection between the airway and the esophagus is repaired by suturing the defect closed and placing healthy tissue such as muscle in the repaired area.

Posterior tracheoplasty strengthens the back wall of the trachea with bioprosthetic materials for patients with tracheomalacia.