Airway/Tracheal Program

The Airway and Tracheal Surgery Program in the Division of Thoracic Surgery at Massachusetts General Hospital is a national leader in specialized care for a wide range of airway and tracheal conditions.
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Call to request an appointment or refer a patient: 617-726-6826

Overview

The Airway and Tracheal Surgery Program at Massachusetts General Hospital provides specialized treatments for both common and rare disorders of the trachea, offering patients state-of-the-art evaluation, diagnosis and care.

Our team of highly skilled thoracic surgeons use a variety of techniques, including tracheal reconstruction, to restore proper function of the airway (trachea and bronchi), and voice. We work closely with specialists in Chest Radiology, Interventional Radiology the Center for Laryngeal Surgery and Voice Rehabilitation and the Mass General Cancer Center's Center for Thoracic Cancers multidisciplinary clinic.

Patients may be referred to us by physicians treating an underlying condition that has created the airway/tracheal issue, such as cancer or obstruction caused by benign disease. Patients can contact individual thoracic surgeons to inquire about treatment options. We offer surgical options for patients with airway obstructions from benign blockages (strictures) or tumors. 

What to Expect

New patients undergo a comprehensive evaluation. We carefully review the recommended course of treatment with each patient and his or her family. If the patient elects to undergo a procedure, we explain each step, using diagrams and illustrations. Our chest radiologists have cutting-edge equipment and are amongst the leaders nationally in the field. Careful collaboration with our anesthesiology, radiologic, pulmonary and voice specialists ensure the best possible treatment and outcomes. Complex airway problems require sophisticated x-ray evaluation.

In the operating room, while the patient is under general anesthesia, we examine the airway (trachea and bronchi) using a bronchoscope, a thin, tube-like imaging instrument for precise evaluation and measurements. 

Anesthesiologists play a critical role in the management of patients with airway problems.  We have a very skilled group with whom we have worked for many years.  They are amongst the most experienced anesthesiologists in the country dealing with airway management.  The intensive care team sees patients with airway surgery on a weekly basis. The nurses and doctors play a critical role in the care of these complicated patients. Our floor nurses are well-trained and know how to help patients recover from surgery.

After surgery, the surgeon reviews the procedure recovery and course of treatment with the patient and family. Each patient has a plan to follow to ensure the best outcomes.  Plans and results are communicated to referring physicians so that everyone is on the same page. 

Superb Surgical Results

Our high volume of surgery for airway and tracheal conditions - and skilled team of surgeons, anesthesiologists, nurses, physical therapists, and speech therapists - help us to attain excellent results in treating patients with complex conditions. Our team will work with you to develop a personalized treatment plan.

Innovative Research Approach

As a research and teaching facility, Mass General is dedicated to advancing knowledge of tracheobronchial disease and producing the next generation of thoracic surgeons skilled at managing airway conditions. Many procedures used in treating tracheal disorders carry the imprint of Mass General surgeon Hermes Grillo, MD, known as "the father of airway surgery." In the 1960s and 1970s, Dr. Grillo invented novel techniques of tracheal reconstruction that allowed patients with previously untreatable conditions to undergo surgery. This tradition has been carried on by the current group of Mass General thoracic surgeons.

Recent innovative efforts include:

  • Initiatives to identify the causes of idiopathic subglottal stenosis, a rare inflammatory disorder of unknown cause predominantly found in women.
  • Creation of a tracheal surgery database to study outcomes and prognosis of patients with airway problems with the goal of improving patient outcomes.
  • Research into possible tracheal substitutes involving regenerative medicine and stem cells.
  • Our Regenerative Medicine Laboratory (Ott Laboratory)  is a national leader in developing novel techniques to replace damaged organs.  These efforts include investigations to replace the airway and lung.
  • Bioprostheses, implanted devices, have been used to solve very complicated problems of the airway and esophagus for which no other solutions exist.

Our Surgeons

  • Allan, James Stuart, MD

    617-724-1103

    Accepting New Patients

    Clinical Interests
    • Lung cancer
    • Esophageal cancer
    • Hyperhidrosis
    • Benign and malignant diseases of the chest
    • Myasthenia gravis
    • Airway surgery
    • Lung transplant
    Board Certifications
    • Surgery, American Board of Surgery
    • Thoracic Surgery (Cardiothoracic Vascular Surgery), American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery
  • Gaissert, Henning A., MD

    617-726-5341

    Accepting New Patients

    Clinical Interests
    • Lung cancer
    • Chest wall tumors
    • Emphysema and Volume reduction surgery
    • Tracheobronchial disorders
    • Thymoma and surgical treatment of myasthenia gravis
    • Hyperhidrosis
    • Esophageal cancer
    Board Certifications
    • Thoracic Surgery (Cardiothoracic Vascular Surgery), American Board of Thoracic Surgery
    • Surgery, American Board of Surgery
    Locations
    • Boston: Division of Thoracic Surgery
    • Newton: Newton Wellesley Hospital
  • Lanuti, Michael, MD

    617-726-6751

    Accepting New Patients

    Clinical Interests
    • General thoracic surgery
    • Esophageal cancer, Barrett's esophagus
    • VATS / Minimally Invasive Thoracic Surgery
    • Lung cancer and lung cancer molecular screening
    • Minimally invasive lung surgery
    • Endobroncial ultrasound for lung cancer staging
    • Navigation bronchoscopy of lung nodules
    • Radiofrequency Ablation of Lung Tumors
    • Esophageal cancer
    • Tracheobronchial disorders
    • Mediastinal tumors (Thymoma, Schwannoma, Germ Cell Tumors)
    • Palmar hyperhidrosis
    • Thymoma and surgical treatment of myasthenia gravis
    Board Certifications
    • Surgery, American Board of Surgery
    • Thoracic Surgery (Cardiothoracic Vascular Surgery), American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery
    • Newton: Newton Wellesley Hospital
  • Mathisen, Douglas James, MD

    617-726-6826

    Accepting New Patients

    Clinical Interests
    • Airway surgery
    • Lung cancer
    • Esophageal cancer
    Board Certifications
    • Thoracic Surgery, American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery
  • Morse, Christopher R., MD

    617-726-2811

    Accepting New Patients

    Clinical Interests
    • Esophageal cancer
    • Minimally invasive esophageal resections (esophagectomy)
    • Laparoscopic antireflux surgery/GERD
    • Laparoscopic paraesophageal hernia repair
    • Laparoscopic re-operative antireflux surgery
    • Barrett's esophagus
    • Esophageal cancer, Barrett's esophagus
    • Esophageal disease
    • Esophageal anomalies
    • Lung cancer
    • Minimally invasive pulmonary (lung) resections
    • Airway surgery
    • Thoracic surgery
    • Benign and malignant diseases of the chest
    • Idiopathic Laryngotracheal Stenosis
    Board Certifications
    • Surgery, American Board of Surgery
    • Thoracic Surgery, American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery
  • Muniappan, Ashok, MD

    617-643-8990

    Accepting New Patients

    Clinical Interests
    • Lung cancer
    • Esophageal cancer
    • VATS / Minimally Invasive Thoracic Surgery
    • Mediastinal tumors (Thymoma, Schwannoma, Germ Cell Tumors)
    • Diaphragmatic hernias, GERD, Barretts esophagus, Achalasia
    • Surgical management of tracheal and bronchial disorders
    Board Certifications
    • Surgery, American Board of Surgery
    • Thoracic Surgery (Cardiothoracic Vascular Surgery), American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery
  • Ott, Harald C., MD

    617-726-2311

    Accepting New Patients

    Board Certifications
    • Surgery, American Board of Surgery
    • Thoracic and Cardiac Surgery - General, American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery
  • Wright, Cameron Dorrans, MD

    617-726-5801

    Accepting New Patients

    Clinical Interests
    • Tracheal surgery
    • Lung cancer
    • Mediastinal tumors
    • Thymoma
    • Esophageal cancer
    • Minimally invasive chest surgery
    • VATS (Video-Assisted Thoracic Surgery)
    • Pulmonary thromboendarterectomy
    • Idiopathic Laryngotracheal Stenosis
    Board Certifications
    • Surgery, American Board of Surgery
    • Thoracic Surgery (Cardiothoracic Vascular Surgery), American Board of Thoracic Surgery
    Locations
    • Boston: Division of Thoracic Surgery

Conditions We Treat

Among the tracheal disorders we treat are various forms of stenosis (abnormal narrowing of the airway), including:

  • Congenital tracheal stenosis (birth-related): a condition in which infants are born with an abnormally small trachea.
     
  • Idiopathic subglottic stenosis (cause unknown): a condition that predominantly affects women and results in symptomatic narrowing at the voicebox (larynx) and trachea. Excellent results have been achieved in 90-95% of patients with a surgical procedure developed at Mass General.[1]

  • Post-intubation tracheal stenosis: injury resulting from a breathing tube placed in the airway or a tracheostomy while patients are on a breathing machine (ventilator). In over 95% of patients, a surgical procedure can fix this problem. [2]

  • Tracheal tumors: airway tumors that grow and cause difficulty breathing requiring specialized techniques for removal and preservation of the airway and voice. We have the largest single institution experience in the country dealing with these rare tumors.

  • Tumors of the carina (lower trachea and pathway to the lungs): lung cancer and primary (adenoidcystic squamous cancers) tumors that can develop in the lower trachea and requiring complex surgical techniques to remove and reconstruct this part of the airway.

  • Tracheoesophageal fistulas (communication between airway and esophagus): this life-threatening condition can occur after prolonged intubation (ventilator) or as a result of other operations and requires specialized techniques for repair of both the airway and esophagus to prevent infection of the lungs and preserving the airway, voice and ability to swallow. Mass General has the largest experience with this type of condition.

  • Tracheomalacia: a softening of the cartilages of the airway making it very difficult to breathe and clear secretions.

References

[1] Wang H, Wright CD, Wain JC, Ott HC, Mathisen DJ. Idiopathic subglottic stenosis: factors affecting outcome following single-stage repair. Ann Thorac Surg 2015;100:1804-11.

[2] Grillo HC, Donahue DM, Mathisen DJ, Wain JC, Wright DC. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg 1995;109:486-93.p>

Publications

The surgeons in the Massachusetts General Hospital Airway and Tracheal Surgery Program have published numerous publications in nationally recognized journals. 

  • Wright CD, Graham BB, Grillo HC, Wain JC, Mathisen DJ. Pediatric tracheal surgery. Ann Thorac Surg 2002;74:308-14.

  • Wang H, Wright CD, Wain JC, Ott HC, Mathisen DJ. Idiopathic subglottic stenosis: factors affecting outcome following single-stage repair. Ann Thorac Surg 2015;100:1804-11.

  • Grillo HC, Donahue DM, Mathisen DJ, Wain JC, Wright DC. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg 1995;109:486-93.

  • Mitchell JC, Mathisen DJ, Wright CD, Wain JC, Donahue DM, Moncure AC, Grillo HC. Clinical experience with carinal resection. J Thorac Cardiovasc Surg 1999;117:39-53.

  • Gaissert HA, Grillo HC, Shadmehr MB, Wright CD, Gokhale M, Wain JC, Mathisen DJ. Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina. Ann Thor Surg 2004;78:1889-97.

  • Gaissert HA, Grillo HC, Shadmehr BM, Wright CD, Gokhale M, Wain JC, Mathisen DJ. Laryngotracheoplastic resection for primary tumors of the proximal airway. J Thorac Cardiovasc Surg 2005;129:1006-09.

  • Muniappan A, Wain JC, Wright CD, Donahue DM, Gaissert HA, Lanuti M, Mathisen DJ. Surgical treatment of nonmalignant tracheoesophgeal fistulae: a thirty-five year experience.Ann Thorac Surg. 2013 Apr;95(4):1141-6.

  • Wright CD, Grillo HC, Hammoud ZT, Wain JC, Gaissert HA, Zaydfudim V, Mathisen DJ. Tracheoplasty for expiratory collapse of central airways. Ann Thorac Surg 2005;80:259-266.

Contact

Contact Us

Division of Thoracic Surgery

Founders 755 Fruit Street Boston, MA 02114
  • Phone: 617-726-6826
Request an Appointment Request a second opinion

Call to request an appointment or refer a patient: 617-726-6826

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