Montgomery tracheal t-tube stenting as a single first-line treatment in postintubation laryngotracheal stenosis

M. Ekram Osman, M.M. Roushdy, A.K. Abdel-Haleem, M.O. Ramadan

The Egyptian Journal of Otolaryngology 2018 34(4):293-300

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.

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