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Pulmonary Intervention for Airway Conditions

Interventional pulmonologists at ¶¶Òõ¶ÌÊÓƵ’s Tracheal and Bronchial Disorders Treatment Program work with thoracic surgeons and head and neck surgeons to diagnose and manage airway conditions. These conditions include tracheobronchomalacia (TBM), tracheal stenosis, tracheoesophageal fistula, and tracheal or bronchial tumors, which can be noncancerous or cancerous, including carcinoid tumors.

Our interventional pulmonologists specialize in bronchoscopy to evaluate, diagnose, and treat airway conditions. During bronchoscopy, a long, flexible tube with a camera on its end is placed through the mouth and into the trachea and bronchi. Interventional pulmonologists may also use a rigid bronchoscope to evaluate the airways and perform therapeutic interventions. The bronchoscope helps the care team view tissue in the airways, biopsy tissue, and perform minimally invasive treatments that do not require incisions or surgery.

Advanced Diagnostic Tests

To diagnose airway conditions, interventional pulmonologists use the following specialized tools and tests:

  • a rigid bronchoscope with a beveled edge, which allows doctors to remove deeper tissue samples than flexible bronchoscopy and to place stents to keep the airway open, helping to assess whether surgery is a treatment option
  • endobronchial ultrasound, which uses an ultrasound device to assess whether a tumor is growing into the many layers of the airway
  • robotic bronchoscopy, during which an ultrathin scope using a precise navigation system finds and biopsies lesions deep in the airways
  • narrow-band imaging or autofluorescence—imaging techniques that enhance the view of the tracheal and bronchial lining and help determine whether tumor tissue is present  

Pathologists evaluate tissue samples taken for biopsy to determine whether tumors are cancerous or benign. If a tumor is cancerous, our doctors may collaborate with specialists at ¶¶Òõ¶ÌÊÓƵ Perlmutter Cancer Center to create your care plan.

Interventional Approaches to Care

Our interventional pulmonologists treat airway conditions in several different ways. These approaches, delivered through a bronchoscope, include the following:

  • thermal therapy, which uses intense cold or heat to destroy tracheal or bronchial tissue that may be obstructing the airway
  • steroid injections or topical mitomycin, a type of chemotherapy used to decrease tissue inflammation or growth that can be associated with tracheal stenosis
  • endoscopic stent placement to seal a tracheoesophageal fistula or to open the airway in people who have tracheal stenosis or TBM; if a stent improves symptoms of TBM, surgery may be the next step in treatment
  • photodynamic therapy, which uses lasers to destroy tumor cells after medication has made them sensitive to light

Our doctors may also recommend continuous positive airway pressure therapy, commonly known as CPAP, which uses pressurized air to hold the airways open to manage some cases of TBM.

If an interventional pulmonary procedure is not the best treatment option for managing an airway condition, our doctors may discuss the possibility of airway surgery with you.