Results of Montgomery T-Tube in Primary Treatment of Laryngotracheal Stenosis

Abstract

Introduction: For tracheal stenosis, tracheal resection and anastomosis is widely considered the treatment of choice. However, this surgical approach is not feasible when the glottis and subglottis are involved or in patients with a poor general condition and tracheal stents are a plausible means of providing a permanent or temporary airway opening. Objectives: Evaluate the features and the results of patients with Montgomery T-tube in tracheal stenosis. Methods: Fifteen patients with Myer-Cotton grades 2-3 circular cicatricial tracheal stenosis who received a Montgomery T-tube between 2002-2011 were analyzed in terms of age, gender, etiology, duration of intubation, location and size of the stenotic segment on computed tomography(CT), follow-up time with the T-tube, the complications that occurred after T-tube removed and additional tracheal surgery. Conclusion: A T-tube can be applied in tracheal stenosis at the first treatment before attempting surgery. The patients should be closely followed-up due to the possibility of re-stenosis and other complications.

Share and Cite:

H. Aslan, S. Öztürkcan, E. Eren, M. Başoğlu, M. Songu, E. Kulduk, A. Kılavuz and H. Katılmış, "Results of Montgomery T-Tube in Primary Treatment of Laryngotracheal Stenosis," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 2 No. 5, 2013, pp. 151-155. doi: 10.4236/ijohns.2013.25033.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. J. Ballenger and J. B. Snow, “Havayolu Kontrolü ve Laringotrakeal Stenoz. Otolaringoloji’de,” Nobel Tip Kitabevi, Istanbul, 2000, pp. 466-494.
[2] C. W. Cummings, J. M. Frederickson, L. A. Harker, C. J. Krause, M. A. Richardson and D. E. Schuller, “Glottik and Subglottic Stenosis,” In: R. T. Cotton and G. H. Zalzal, Eds., Otolaryngology Head and Neck Surgery, Mosby, Baltimore, 1998, pp. 303-321.
[3] H. C. Herrington, S. M. Weber and P. E. Andersen, “Modern Management of Laryngotracheal Stenosis,” Laryngoscope, Vol. 116, No. 9, 2006, pp. 1553-1557. doi:10.1097/01.mlg.0000228006.21941.12
[4] S. Ercan and M. Yüksel, “Trakea Cerrahisi,” In: M. Yüksel, G. Kalayci, Eds., Gogüs Cerrahisi, Bilmedya Grup, Istanbul, 2001, pp. 727-746.
[5] R. Meyer and I. Flemming, “Recontructive Surgery of the Trachea,” Thieme, New York, 1982, p. 25.
[6] C. M. Meyer III, D. M. O’Connor and R. T. Cotton, “Proposed Grading System for Subglottic Stenosis Based on Endotracheal Tube Sizes,” Annals of Otology, Rhinology, and Laryngology, Vol. 103, No. 4, 1994, pp. 319-323.
[7] B. E. Mostafa and A. El Halafawi, “Clinical Facts,” In: B. E. Mostafa, C. Chaouch-Mberek and A. El Halafawi, Eds., Tracheal Stenosis: Diagnosis and Treatment, 2012, pp. 17-32
[8] P. Marques, L. Leal, J. Spatley, et al., “Tracheal Resection with Primary Anastomosis: 10 Years Experience,” American Journal of Otolaryngology, Vol 6, No. 30, 2009, pp. 415-418. doi:10.1016/j.amjoto.2008.08.008
[9] M. Mandour, M. Remacle, P. Van de Heyning, et al., “Chronic Subglottic and Tracheal Stenosis: Endoscopic Management vs. Surgical Reconstruction,” European Archives of Otorhinolaryngology, Vol. 7, No. 260, 2003, pp. 374-380. doi:10.1007/s00405-002-0578-3
[10] A. Gallo, A. Pagliuca, A. Greco, S. Martellucci, A. Mascelli, M. Fusconi and M. De Vincentis, “Laryngotracheal Stenosis Treated with Multiple Surgeries: Experience, Results and Prognostic Factors in 70 Patients,” Acta Otorhinolaryngologica Italica, Vol. 3, No. 32, 2012, pp. 182-188.
[11] J. Strausz and C. T. Bolliger, “Interventional Pulmonology,” Monograph, 2010, pp. 190-202.
[12] A. Carretta, M. Casiraghi, et al., “Montgomery T-Tube Placement in the Treatment of Benign Tracheal Lesions,” Cardiothorac Surgery, Vol. 2, No. 36, 2009, pp. 352-356. doi:10.1016/j.ejcts.2009.02.049
[13] W. W. Montgomery, “T-Tube Tracheal Stent,” Archives of Otolaryngology, No. 82, 1965, pp. 320-321. doi:10.1001/archotol.1965.00760010322023
[14] P. Keszler, “Tracheal T Tube: For Indwelling Intubation as an Alternative Management Method,” In: H. C. Grillo and H. Eschapasse, Eds., International Trends in General Throracic Surgery, Saunders, Philadelphia, 1987, pp. 133-137.
[15] J. D. Cooper, F. G. Pearson, G. A. Patterson, et al., “Use of Silicone Stents in the Management of Airway Problems,” Annals of Thoracic Surgery, Vol. 3,No. 47, 1989, pp. 371-378. doi:10.1016/0003-4975(89)90375-5
[16] H. A. Gaissert, H. C. Grillo, D. J. Mathisen and J. C. Wain, “Temporary and Permanent Restoration of Airway Continuity with the Tracheal Tube,” Journal of Thoracic and Cardiovascular Surgery, Vol. 2, No. 107, 1994, pp. 600-606.
[17] K. Morshed, M. Szymanski and W. Golabek, “The Use of Tracheostomy T-Tube in the Treatment of Tracheal Stenosis,” Polish Otolaryngology, Vol. 3, No. 59, 2005, pp. 361-364.
[18] H. C. Liu, K. S. Lee, C. J. Huang, C. R. Cheng, W. H. Hsu and M. H. Huang, “Silicone T-Tube for Complex Laryngotracheal Problems,” European Journal of Cardiothoracular Surgery, Vol. 2, No. 21, 2002, pp. 326-330. doi:10.1016/S1010-7940(01)01098-3
[19] A. J. Maniglia, “Tracheal Stenosis: Conservative Surgery as a Primary Mode of Management,” Otolaryngologic Clinics of North America, Vol. 4, No. 12, 1979, pp. 877-892.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.