Our windpipes are hollow tubes that begin as a single tube from the lower part of our voice box (below the Adam’s apple) in our neck and end into our two lungs after dividing into two branches (left & right tubes). The division (branching) of the single wind pipes takes place beneath our breast bone. The two smaller left and right windpipes then end into the left and right lungs respectively.

Before their branching out, the wind pipe is called trachea, and after the branching out they are called “right main bronchus” and “left main bronchus.” The diameter of the trachea ranges from 12 millimetre to 18 millimetre in diameter. This is equivalent to a 50 cent coin to 1 dollar coin in diameter. The diameter of the right and left main bronchus is about 10 millimetres in diameter.

Like pneumonia (lung infection), Tuberculosis (TB), and cancer can affect our lungs, certain diseases can affect our wind pipes. These are TB, lung cancer, Adenoid cystic carcinoma, leiomyoma, etc. In case of a disease affecting the wind pipe, the wind pipe often gets partially or completely blocked. This is also called Airway Stenosis in medical language. Since the diameter of the wind pipes is only 1 dollar coin in maximum diameter, even a small amount of narrowing can affect breathing significantly.

People with wind pipe blockage experience varying degree of shortness of breath and suffocation depending upon the degree of blockage. Due to blocked wind pipe they often experience noisy breathing (stridor) or wheezing. Wheezing or stridor is a sound that is produced because of the air flowing through a narrowed wind pipe similar to the mechanism how flute, whistle or trumpet produces musical sound when blown into. When this happens, a CT scan of the chest and a bronchoscopy is needed to ascertain the level and degree of the narrowing of the wind pipe.

Treatment is planned after the CT scan and bronchoscopy. Treatment to open up a blocked wind pipe is called “recanalization of the airway.” Recanalization of the airway means re-opening. This reopening can require burning away of the tumour causing blockage by laser light or placing a stent (small tube) in the blocked segment of the wind pipe. Laser therapy uses heat to burn away the tumour.

This does not require any cutting on the chest or operation as the procedure is carried out bronchoscopically by passing the instruments through the mouth. The stent can be made of metal or silicone. Silicone stents are preferable as they can be removed easily after cancer has shrunk by chemotherapy or radiotherapy, but they are harder to place. On the other hand, the metal stents are easier to place but harder to remove.

These pictures illustrate a case of a patient with tumour in the wind pipe (trachea) causing almost complete blockage. The 2nd picture shows the opened wind pipe after removal of the tumour using bronchoscopy. The 3rd picture shows the branching of the wind pipe into right and left wind pipes which were not visible prior to the removal of the tumour. The last picture shows the tumour pieces that were removed.

These pictures illustrate a case of a patient with blockage of the right wind pipe from lung cancer. The first picture shows the right lung to be collapsed (seen as white) from the blockage of the right wind pipe. The 2nd picture shows the tumour protruding from the right wind pipe on the bronchoscopy. The 3rd picture shows how a metal stent has been placed in the right wind pipe. The last picture shows the re-opened right lung seen a black similar to unaffected left lung.

These pictures illustrate another case of a patient with blockage of the right wind pipe from lung cancer. The first picture shows the CT scan showing the tumour in the right wind pipe pointed by a red arrow. The 2nd picture shows a silicone stent that has been placed in the right wind pipe. The 3rd picture shows how the silicone stent is placed and opens up the blockage in the right wind pipe pointed by the yellow arrow.