- Original article
- Open access
- Published:
Montgomery tracheal t-tube stenting as a single first-line treatment in postintubation laryngotracheal stenosis
The Egyptian Journal of Otolaryngology volume 34, pages 293–300 (2018)
Abstract
Objective
The aim was to evaluate the use of Montgomery tracheal T-tube stenting as a single first-line treatment for postintubation laryngotracheal stenosis (LTS), addressing the outcomes, its main complications, and how to manage them.
Materials and methods
From March 2012 to April 2017, 25 patients with postintubation LTS had contraindication(s) for laryngotracheal surgery and were treated by Montgomery tracheal T-tube stenting as a single first-line treatment. The preoperative, operative, and postoperative follow-up data were collected retrospectively and analyzed.
Results
Successful outcome was reported in 16 (64%) patients, whereas seven (28%) patients had recurrent stridor after T-tube removal. It was reinserted in two of them, and the rest were subjected to other surgical procedures. Mortality was reported in two patients. Complications of different nature, severity, and durations were reported, and most of them were detected and managed successfully by applying close follow-up protocols.
Conclusion
Montgomery tracheal T-tube stenting is a very valuable modality in the treatment of LTS as a single first-line treatment when surgical option is contraindicated. It has a relatively low incidence of treatable complications; however, false sense of security must be avoided to ensure good outcome.
References
Grillo HC. Management of non-neoplastic diseases of the trachea. General Thorac Surg 1999; 6:885–897.
Anand VK, Alemar G, Warren ET. Surgical considerations in tracheal stenosis. Laryngoscope 1992; 102:237–243.
Grillo HC, Donahue DM, Mathisen DJ, Wain JC, Wright CD. Postintubation tracheal stenosis: treatment and results. J Thorac Cardiovasc Surg 1995; 109:486–493.
Marulli G, Rizzardi G, Bortolotti L, Loy M, Breda C, Hamad AM. Single-staged laryngotracheal resection and reconstruction for benign strictures in adults. Interact Cardiovasc Thorac Surg 2008; 7:227–230.
Bibas BJ, Terra RM, Junior ALO, Tamagno MFL, Minamoto H, Cardoso PFG. Predictors for postoperative complications after tracheal resection. Ann Thorac Surg 2014; 98:277–282.
Erelel M, Kaya S, Toker A. Anastomotic stenotic complications after tracheal resections. J Bronchol Interv Pulmonol 2010; 17:142–145.
D’Andrilli A, Ciccone AM, Venuta F, Ibrahim M, Andreetti C, Massullo D, et al. Long-term results of laryngotracheal resection for benign stenosis. Eur J Cardiothorac Surg 2008; 33:440–443.
Carretta A, Casiraghi M, Melloni G, Bandiera A, Ciriaco P, Ferla L. Montgomery T-tube placement in the treatment of benign tracheal lesions. Eur J Cardiothorac Surg 2009; 36:352–356.
Dumon JF, Cavaliere S, Diaz-Jimenez JP, Vergnon JM, Venuta F. Seven-year experience with the Dumon prosthesis. J Bronchol 1996; 3:6–10.
Puma F, Ragusa M, Avenia N, Urbani M, Droghetti A, Daddi N. The role of silicone stents in the treatment of cicatricial tracheal stenoses. J Thorac Cardiovasc Surg 2000; 120:1064–1069.
Liu HC, Lee KS, Huang CJ, Cheng CR, Hsu WH, Huang MH. Silicone T-tube for complex laryngotracheal problems. Eur J Cardiothorac Surg 2002; 21:326–330.
Montgomery WW. T-tube tracheal stent. Arch Otolaryngol 1965; 82:320–321.
Myer CM III, O’connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994; 103:319–323.
Bruns J, Hauser WA. The epidemiology of traumatic brain injury: a review. Epilepsia 2003; 44(s10):2–10.
Cooper J, Todd T, Ilves R, Pearson F. Use of the silicone tracheal T-tube for the management of complex tracheal injuries. J Thorac Cardiovasc Surg 1981; 82:559–568.
Lee SY. Mucosal tenting suture with stenting in the treatment of chronic laryngotracheal stenosis. J Trauma 1993; 34:8–16.
Gaissert HA, Grillo HC, Mathisen DJ, Wain JC. Temporary and permanent restoration of airway continuity with the tracheal T-tube. J Thorac Cardiovasc Surg 1994; 107:600–606.
Ko P-J., Liu C-Y., Wu Y-C., Chao Y-K., Hsieh M-J., Wu C-Y. Granulation formation following tracheal stenosis stenting: Influence of stent position. Laryngoscope 2009; 119:2331–2336.
Saghebi SR, Zangi M, Tajali T, Farzanegan R, Farsad SM, Abbasidezfouli A, et al. The role of T-tubes in the management of airway stenosis†. Eur J Cardiothorac Surg 2013; 43:934–939.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Osman, M.E., Roushdy, M.M., Abdel-Haleem, A.K. et al. Montgomery tracheal t-tube stenting as a single first-line treatment in postintubation laryngotracheal stenosis. Egypt J Otolaryngol 34, 293–300 (2018). https://doi.org/10.4103/ejo.ejo_46_18
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/ejo.ejo_46_18