Endoscopic therapies and stents for benign airway disorders: where are we, and where are we heading?

Benign strictures of the airway can be complex and challenging to manage. Although resection has the best long-term results, this is not always feasible, and there will be groups of patients who require additional therapy for failure after open operations or who are not surgical candidates and require endoluminal management. A number of stents are available; however, not all perform well for the longer duration that will be required for patients with benign compared with malignant strictures. For this reason, stenting should be considered a temporary solution or a last resort for patients with benign airway strictures. Combinational modalities hold promise; for example, radial laser incisions with dilatation and mitomycin C for tracheal stenosis. Many techniques, however, have been associated with failure, particularly for long strictures. Spray cryotherapy is a new technique that may have advantages over other treatments by modulating the healing response and resulting in improved healing and less refibrosis. A number of current and new therapies are reviewed in this article.