Interventional bronchoscopy for obstructing benign airway tumors: which modality is ideal?

In the early 19th century, rigid illuminating tubes were used to visualize the tracheobronchial tree (1). Since that time, bronchoscopic diagnostic and treatment modalities including interventional bronchoscopic techniques now encompass a myriad of indications. Despite the many options, the management of airway obstruction from both malignant or nonmalignant causes is a complex problem that requires thorough evaluation by a multidisciplinary team including interventional bronchologists, thoracic surgeons and chest radiologists (2). In the case of nonmalignant airway obstructing lesions, the choice of therapy, whether surgically curative or minimally-invasive endoscopic-based, very much depends on tumor pathology, size, wall invasion depth, anatomical location, the acuity and degree of symptoms from airway compromise, patient co-morbidities, and also operator experience and expertise (1,3).