Abstract

Esophageal cancer is the most common cause of extrapulmonary malignant central airway obstruction (MCAO). MCAO is usually managed by a multidisciplinary approach involving tumor debulking, stent placement, and palliative radiotherapy. MCAO is a challenge in itself; here, it becomes even more challenging as it was accompanied by grade 3 oral submucous fibrosis, nasal synechiae, and multiple enlarged cervical nodes causing excessive compression of the trachea along with acute hypercapnic respiratory failure. Herein, a 65-year-old woman with multiple challenges, where death was imminent, managed with a collaborative approach involving awake nasal intubation in the sitting position and placement of a stent via a flexible bronchoscope, as rigid bronchoscopy was not possible in view of limited mouth opening. Overcoming these challenges led to completing the procedure successfully and palliating the symptoms.

Cite this article as: Niwas R, Chawla G, Chauhan NK, Dutt N. Esophageal cancer, central airway obstruction, and lots more: A collaborative approach to a challenging scenario. Turk Thorac J 2021; 22(2): 175-8.