Interventional Pulmonology

In interventional pulmonology, endoscopy and other cutting-edge techniques are used to cure patients with severe lung ailments or disease. Usually those who seek such techniques have severe breathing problems due to airway blockage. This includes many patients who suffer from malignancies.

Other non-malignant diseases that result in airway blockage are:
- amyloidosis
- relapsing polychondritis
- tracheobronchomalacia
- Wegener's granulomatosism,
- tracheal or sub-glottic stenosis
- pulmonary alveolar proteinosis
- tracheobronchial papillomatosis

Aside from these, patients who seek interventional pulmonology treatment may be suffering from:
- pleural effusions
- lung nodules or masses
- mediastinal adenopathy

Who Performs Interventional Pulmonology?
Interventional pulmonology procedures are usually offered by pulmonologists who have undergone extra training or extra specializations. Usually, a team made up of different specialists is put together or consulted in order to provide full and comprehensive treatment for patients who require interventional pulmonology procedures. These specialists, in addition to the interventional pulmonologists themselves, include:
- otolaryngologists
- anesthesiologists
- thoracic surgeons
- head and neck surgeons

Types of Interventional Pulmonology
There are many procedures available to interventional pulmonology teams or doctors, such as the following:

- Flexible, Laser, and Rigid Laser Bronchoscopy:
Bronchoscopy is a procedure that is used to diagnose and screen the airways of a person for possible diseases.

In flexible bronchoscopy, doctors insert a flexible endescope (also called a bronchoscope) through the mouth and nose of a patient. As the bronchoscope is gently pushed through the different airways of the lung, images from the lung are immediately displayed on a video screen. Small tools can be attached to the end of bronchoscopes, and such bronchoscopy can also be utilized along with other methods for treating lung ailments.

Laser bronchoscopy can be used to resection benign bronchial and tracheal strictures.

Rigid bronchoscopy, often administered under anesthesia and used in medical emergencies, can remove foreign objects causing blockage from the lungs using a long, rigid metal tube. Due to the larger diameter of the tube used in rigid bronchoscopy as compared to flexible bronchoscopy, doctors can utilize a greater number of techniques. The vocal cords, voice box, trachea, and many branches of the bronchi can be viewed or operated upon using different bronchoscopy methods.

- Bronchial Stenting: Bronchial stenting is often used to address the side effects of advanced lung cancer, such as coughing, having difficulty breathing, and pneumonia caused by the constriction of airways. In this procedure, a doctor uses a bronchoscope to insert a stent made up of wire mesh into the constricted airway. The stent is then expanded, therefore also expanding the constricted airway.
Endobronchial Brachytherapy: In this procedure, internal radiation is delivered in order to treat recurrent unresectable airway cancers. Low-dose and high-dose rates can be used, and this procedure is often used in tandem with laser resection or stenting.

- Balloon Bronchoplasty: Like bronchial stenting, balloon bronchoplasty is often used to relieve constricted airways. Doctors insert a deflated balloon into the constricted airways of the patient's lungs. The balloon is then inflated with water, thereby expanding the airways of the lungs. Sometimes, this is used after bronchial stenting, which can be done first in order to ensure and maintain a protected airway.

- Thoracentesis: This procedure removes pleural effusions, or the fluid build-up, that occurs between the lining of the lungs (the pleura) and the wall of the chest. Chest X-rays are usually first performed on a patient. Then under local anesthetic, a needle is first inserted into the chest wall. A catheter is placed over the needle, and the needle will be removed. Fluid may then be collected and then sent to a laboratory for further analysis.

 


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