Central Airway Obstruction (CAO)
Our Approach to Treatment
Houston 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 is done by Interventional pulmonologists who work collaboratively with the following specialties: medical and radiation oncologists, anesthesiologists, otolaryngologists and thoracic surgeons.
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:
- Laser
- Cryotherapy
- Electrocautery/electrodissection
- Balloon dilation
- Airway stent deployment (metallic or plastic) for maintenance of airway patency
What Is Central Airway Obstruction?
CAO refers to multiple processes or diseases that cause an obstruction of the airways (windpipe) and block air flow.
Causes
CAO 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
Diagnostics
- 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
Symptoms
- Shortness of breath
- Shortness of breath lying flat
- Cough
- Coughing up blood
- Hoarseness
- Chest discomfort
- Wheezing
- 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.
Treatments
- Interventional bronchoscopy
- Laser
- 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)