Central Airway Obstruction (CAO)
Our Approach to TreatmentHouston Methodist pulmonologists offer the latest medical and surgical interventions for central airway obstruction (CAO), a complex condition that may cause life-threatening breathing problems and significantly impact a patient’s quality of a life. The management of CAO requires a team approach with pulmonologists, medical and radiation oncologists, anesthesiologists, head and neck surgeons, thoracic surgeons and interventional pulmonologists.
The Houston Methodist Lung Center in the Texas Medical Center offers a single center of expertise in the diagnosis and management of advanced cases of CAO.
Our CAO experts specialize in:
- Bronchoscopy, both rigid and flexible, for CAO diagnosis and treatment
- Resection/debulking/dilation of obstructing lesions with:
- Balloon dilation
- Airway stent deployment (metallic or plastic) for maintenance of airway patency
CAO refers to multiple processes or diseases that cause an obstruction of the airways (windpipe) and block air flow.
CausesCAO can be malignant (cancer-related) or benign (non-cancer related).
Malignant CAO causes include:
- Lung cancer
- Non-lung cancer (breast, colon, rectal or kidney) that metastasizes or spreads to the airways
- Cancerous tumors that invade the airways, grow within the airway or develop close enough to the airways to affect it
- Cancer that extends into the airways
Benign CAO causes include:
- Complications from prior intubation (breathing tube placement) or tracheostomy
- Inflammation (causes range from foreign objects to rheumatologic diseases)
- Non-cancerous airway growths
- Infections like tuberculosis or fungal diseases
- Shortness of breath
- Shortness of breath lying flat
- Coughing up blood
- Chest discomfort
- Trouble swallowing
Obstructions may not cause symptoms until airflow is severely reduced. Patients with pre-existing lung conditions like COPD may experience symptoms with relatively small obstruction. Sudden shortness of breath may signal an airway blockage caused by a foreign object.
- Chest X-ray
- CT scan (computed tomography of the chest)
- Virtual bronchoscopy
- Bronchoscopy (essential for diagnosing CAO) to determine type, location, size and pathology of lesion
- Interventional bronchoscopy
- Electrosurgery (electrocautery) uses electric current to heat and destroy tissue
- Argon plasma coagulation (APC) is a form of electrosurgery used to treat tumors
- Cryotherapy: uses a freezing agent to treat malignant and nonmalignant CAO
- Photodynamic therapy (PDT) uses drugs called photosensitizing agents, along with LASER light to kill cancer cells
- Airway dilation with the rigid bronchoscope or a special balloon
- Airway stents (silicone, metallic and hybrid)
Our physicians at Houston Methodist specialize in managing pulmonary hypertension at the following convenient locations.
Accredited center for pulmonary hypertension and pulmonary fibrosis
6445 Main St.
Houston, TX 77030
Houston Methodist Baytown Hospital
4401 Garth Rd.
Baytown, TX 77521
Houston Methodist Clear Lake Hospital
18300 Houston Methodist Dr.
Nassau Bay, TX 77058
Houston Methodist Sugar Land Hospital
16655 Southwest Frwy.
Sugar Land, TX 77479
Houston Methodist West Hospital
18500 Katy Frwy.
Houston, TX 77094
Houston Methodist Willowbrook Hospital
18220 State Hwy. 249
Houston, TX 77070
Houston Methodist The Woodlands Hospital
17201 Interstate 45 South
The Woodlands, TX 77385