Benign airway obstruction: a clinical practice review of causes and managements principles

: Benign airway obstruction occurs in a group of heterogeneous diseases with the potential for both high symptom burden and a challenging clinical course. The diverse pathophysiology causing benign obstruction includes not just a multitude of spontaneous diseases such as infections, autoimmune diseases, and benign tumors, but also the iatrogenic causes of intubation and tracheostomy, as well as the complications from lung transplantation. Despite the pathology, there is a tendency of both under diagnosis and delay in diagnosis, as well as variability in the predicted clinical course. Management of patients with benign airway obstruction requires an understanding of both the underlying process and the data supporting disease-specific interventions. New technology and studies in the fields of otolaryngology, pulmonology, and thoracic surgery have improved and diversified available treatments and treating providers can consider endoscopic intervention, surgical options, and systemic medical therapies. The objectives of this review include describing the commonalities and differences in the presentation and treatment of common causes of benign airway obstruction, as well as an up-to-date literature review of the current management strategies. We aim to highlight recent updates to diagnosis and management, as well as the need for a multidisciplinary approach for both management and further study of this diverse and challenging group of diseases.