Tracheal/Bronchial Disorders

Complex disorders of the trachea, esophagus, and aerodigestive tract can significantly interfere with essential functions such as breathing, swallowing, and speaking, often requiring highly specialized evaluation and treatment. At the Institute for Thoracic Surgery in Miami, Florida, Mark R. Dylewski, M.D., provides specialized surgical care for patients with complex tracheal and aerodigestive disorders, including Zenker’s diverticulum, tracheal and esophageal stenosis, tracheoesophageal fistulas, and obstructing tumors of the airway and esophagus. These conditions may result from benign disease, prior surgery or instrumentation, inflammation, infection, trauma, or malignancy and often require a coordinated multidisciplinary approach. Dr. Dylewski utilizes advanced diagnostic techniques and individualized surgical strategies, including minimally invasive, endoscopic, robotic-assisted, and open procedures when appropriate, with the goal of restoring airway and digestive tract function while achieving safe and definitive treatment of the underlying disease.

Complex aerodigestive disorders involving the trachea, esophagus, larynx, and surrounding structures require specialized evaluation and highly individualized treatment. Patients may present with breathing or swallowing difficulties, stridor, chronic cough, aspiration, recurrent respiratory infections, hoarseness, or airway or esophageal obstruction. Evaluation may include advanced CT and dynamic imaging, bronchoscopy, laryngoscopy, upper endoscopy, contrast esophagography, and pulmonary function testing, with tissue diagnosis and staging when malignancy is suspected. Because these disorders frequently involve multiple anatomic structures and can be technically challenging to treat, experience in complex aerodigestive surgery and access to a comprehensive range of therapeutic options are critical. Depending on the underlying disease, treatment may include advanced endoscopic techniques, airway or esophageal dilation, stenting, laser therapy, cryotherapy, and endoscopic tumor debulking, as well as robotic-assisted and other minimally invasive surgical approaches. More extensive disease may require complex open resection and reconstruction of the trachea, airway, or esophagus, sometimes involving combined procedures to address tumors or disease extending across multiple structures. Optimal management often requires a multidisciplinary approach involving thoracic surgery, otolaryngology, gastroenterology, interventional pulmonology, medical and radiation oncology, radiology, and reconstructive specialists. The ability to integrate advanced endoscopic therapies with robotic-assisted surgery, complex open techniques, and sophisticated reconstructive procedures provides a comprehensive treatment strategy for patients with some of the most challenging benign and malignant disorders of the aerodigestive tract.

Complications from Stents and Interventions of the Aerodigestive System

Aerodigestive interventions, including airway and esophageal stenting, dilation, endoscopic tumor treatment, and other therapeutic procedures, can provide important relief for patients with complex obstruction or fistula formation but may also be associated with significant complications. Depending on the location and type of intervention, complications can include stent migration, obstruction, granulation tissue formation, bleeding, infection, perforation, airway or esophageal injury, fistula formation, recurrent stenosis, aspiration, and tumor or tissue ingrowth. Airway stents may also cause mucus plugging, impaired airway clearance, or compression of adjacent structures, while esophageal stents can be complicated by reflux, migration, recurrent obstruction, or perforation. Management of these complications often requires advanced endoscopic and surgical expertise, including bronchoscopy, endoscopy, stent revision or removal, dilation, laser therapy, cryotherapy, tissue debulking, and, in selected cases, complex surgical reconstruction.

At the Institute for Thoracic Surgery in Miami, Florida, Mark R. Dylewski, M.D., and the multidisciplinary team provide specialized evaluation and treatment for patients with complex complications following aerodigestive interventions. The ability to combine advanced bronchoscopy and endoscopy with robotic-assisted surgery, minimally invasive techniques, and complex open reconstruction allows treatment to be tailored to the specific anatomy and underlying cause of the complication. Particularly challenging cases may require close coordination among thoracic surgery, gastroenterology, interventional pulmonology, otolaryngology, oncology, radiology, and reconstructive specialists. This multidisciplinary expertise is essential when complications involve both the airway and esophagus or when previous interventions have altered the normal anatomy. The goal is to safely resolve the complication, restore airway and esophageal function, control the underlying disease, and whenever possible avoid the need for increasingly invasive procedures.

The Institute for Thoracic Surgery in Miami, Florida offers a highly specialized approach to the evaluation and treatment of complex aerodigestive disorders. Led by Mark R. Dylewski, M.D., the Institute brings together experienced specialists from multiple disciplines to develop individualized treatment strategies for patients whose disease involves the airway, esophagus, and surrounding structures. Complex conditions often require expertise that extends beyond a single surgical specialty, and successful treatment often depends on the coordination of integrated solutions.  The Institute's ability to coordinate thoracic surgeons, gastroenterologists, interventional pulmonologists, otolaryngologists, medical and radiation oncologists, radiologists, and reconstructive specialists allows complex cases to be evaluated from multiple perspectives and treated through a unified multidisciplinary plan. This comprehensive model is particularly important for patients with difficult airway or esophageal strictures, tracheoesophageal fistulas, obstructing tumors, recurrent disease, or conditions requiring complex airway or esophageal reconstruction.