A Proposed classification system of central airway stenosis

¹ Lungenklinik Hemer, Hemer, Germany
² Beth Israel Deaconess Medical Center, Boston, USA
³ Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
⁴ Tulane University Medical Center, New Orleans, Louisiana, USA
⁵ Hopital A. Calmette, CHRU de Lille, France

^* To whom correspondence should be addressed. E-mail: freitag-hemer{at}t-online.de.

	Abstract

Tracheobronchial stenosis, a serious problem of adults and children, has multiple causes and has been treated in many ways. While developing an international multicenter study to evaluate efficacy of airway stents, we realized that no adequate description of central airway stenosis, regarding type, location and degree has been published. Thus, comparing results of different treatment modalities in different centers has been difficult due to a lack of uniformity of classification. Reports are typically descriptive and precise classification schemes have not adequately addressed either the trachea or the main bronchi. We propose a standardized classification scheme with descriptive pictures and diagrams for rapid and uniform classification of central airway stenosis. Our system divides stenoses into structural and dynamic and further classifies them by degree of stenosis, location and transition zone. Multiple sites can be described and each is transformed into a simple numerical scoring system prompted by a diagram that can be easily captured for subsequent uniform analysis across sites. A pilot validation of the system with 18 Pulmonologists of varying training background showed strong precision and agreement between observers. Such a system will enhance our ability to study the effectiveness of treatment modalities for central airway stenosis.