Tracheobronchial pathology is uncommon and consists of benign tracheal or b
ronchial stenosis, primary malignant neoplasms of the airway, lung cancer w
ith central airway involvement, and metastatic tumors to the airway or medi
astinum resulting in extrinsic or intrinsic airway pathology. These problem
s can produce significant morbidity and are also often immediately life thr
eatening if they produce critical airway narrowing. Successful management o
f airway lesions may correct or palliate impending suffocation, dyspnea, an
d obstructive pneumonia. Techniques for airway construction may prevent the
need for a lifelong tracheostomy and allow preservation of laryngeal funct
ion in benign strictures as well as provide treatment with curative intent
for airway tumors. Patients with lung cancer or low-grade bronchial tumors
may be resected using bronchoplastic techniques in situations that would no
t otherwise be amenable to standard surgical resection. These patients may
also benefit from the pulmonary preservation that bronchoplastic procedures
allow. Successful outcomes depend largely on careful patient selection and
careful attention to the meticulous details of airway reconstruction.