Central Airway Obstruction: Benign Strictures, Tracheobronchomalacia, and Malignancy-related Obstruction

Abstract

The purpose of this article is to provide an update on methods for palliating symptoms in patients with histologically benign and malignant central airway obstruction. We review the published literature within the past decade on postintubation, posttracheostomy, and TB- and transplant-related airway strictures; tracheobronchomalacia; and malignant airway obstruction. We review terminology, classification systems, and parameters that impact treatment decisions. The focus is on how airway stent insertion fits into the best algorithm of care. Several case series and cohort studies demonstrate that airway stents improve dyspnea, lung function, and quality of life in patients with airway obstruction. Airway stenting, however, is associated with high rates of adverse events and should be used only when curative open surgical interventions are not feasible or are contraindicated.

Keywords: airway obstruction; airway stents; bronchial stenosis; bronchomalacia; choke points; excessive dynamic airway collapse; flow limiting segments; laryngotracheal stenosis; stenting; tracheal stenosis; tracheobronchomalacia; tracheomalacia.