Hostname: page-component-6766d58669-kn6lq Total loading time: 0 Render date: 2026-05-20T12:30:01.362Z Has data issue: false hasContentIssue false
  • English
  • Français

Extra-long Montgomery T tube in major airway stenosis

Published online by Cambridge University Press:  03 November 2008

Y-H Liu ,
Y-C Wu ,
M-J Hsieh ,
Y-K Chao ,
C-J Wang ,
P-J Ko  and
H-P Liu
Y-H Liu
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
Y-C Wu
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
M-J Hsieh
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
Y-K Chao
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
C-J Wang
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
P-J Ko*
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
H-P Liu
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan Shiang, Taoyuan, Taiwan, Republic of China
*
Address for correspondence: Dr Po-Jen Ko, Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fushing Street, Gueishan Shiang, Taoyuan, Taiwan 333, ROC. Fax: 886 3 3285818 E-mail: l571011l@cgmh.org.tw
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

We evaluated the efficacy and safety of the extra-long Montgomery T tube for the management of major airway obstruction in tertiary care patients in Taiwan.

Method:

Eleven patients with major airway stenosis treated with an extra-long Montgomery T tube between April 2004 and December 2006 were retrospectively reviewed. Five patients had tracheostomy stenosis, two had intubation stenosis, one had traumatic stenosis, one had corrosive stenosis, one had laser burn stenosis and one had tubercular stenosis. All patients underwent three-dimensional airway reconstruction and endoscopic evaluation of airway stenosis. After determining the severity and location of airway stenosis, rigid bronchotherapy and Montgomery T tube placement were performed by rigid bronchoscopy.

Results:

The overall procedural success rate was 100 per cent. Three (27 per cent) patients were weaned from artificial ventilation, and all patients exhibited improved respiratory and functional status. No major post-operative complications or mortality were observed. At follow up (mean, 21.5 months), the decannulation rate was 27 per cent, and eight (73 per cent) patients had stable T tube ventilation. In four patients, granulation over the end of the T tube was controlled by endoscopic procedures. Three patients with stents above the vocal folds showed aspiration and required further intervention (i.e. one nasogastric feeding tube for nutrient supplement, one feeding jejunostomy and one stent shortening to decrease aspiration).

Conclusion:

The extra-long Montgomery T tube is an effective and safe method for treating major airway obstruction in the supra-glottic to lower tracheal region.

Keywords

TracheaStenosisOtorhinolaryngologic Surgical Procedures

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 772 - 777
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1 Grillo, HC, Donahue, DM. Postintubation tracheal stenosis. Chest Surg Clin North Am 1996;6:725–31Google ScholarPubMed
2 Wood, DE, Liu, YH, Vallieres, E, Karmy-Jones, R, Mulligan, MS. Airway stenting for malignant and benign tracheobronchial stenosis. Ann Thorac Surg 2003;76:167–72; 173–64CrossRefGoogle ScholarPubMed
3 Lu, MS, Liu, YH, Ko, PJ, Wu, YC, Hsieh, MJ, Liu, HP et al. Preliminary experience with bronchotherapeutic procedures in central airway obstruction. Chang Gung Med J 2003;26:240–9Google ScholarPubMed
4 Wu, CY, Liu, YH, Hsieh, MJ, Wu, YC, Lu, MS, Ko, PJ et al. Airway stents in management of tracheal stenosis: have we improved? A N Z J Surg 2007;77:27–32CrossRefGoogle ScholarPubMed
5 Cavaliere, S, Venuta, F, Foccoli, P, Toninelli, C, La Face, B. Endoscopic treatment of malignant airway obstructions in 2,008 patients. Chest 1996;110:1536–42CrossRefGoogle Scholar
6 Montgomery, WW. T-Tube tracheal stent. Arch Otolaryngol 1965;82:320–1CrossRefGoogle ScholarPubMed
7 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;107:600–6CrossRefGoogle ScholarPubMed
8 Liu, HC, Lee, KS, Huang, CJ, Cheng, CR, Hsu, WH, Huang, MH. Silicone T-tube for complex laryngotracheal problems. Eur J Cardiothorac Surg 2002;21:326–30CrossRefGoogle ScholarPubMed
9 Liu, YH, Wu, YC, Hsieh, MJ, Ko, PJ, Liu, HP, Lin, PJ. Montgomery T-tube insertion using a rigid bronchoscope under direct observation. A N Z J Surg 2006;76:853–4CrossRefGoogle ScholarPubMed
10 Dumon, JF. A dedicated tracheobronchial stent. Chest 1990;97:328–32CrossRefGoogle ScholarPubMed
11 Gaissert, HA, Grillo, HC, Wright, CD, Donahue, DM, Wain, JC, Mathisen, DJ. Complication of benign tracheobronchial strictures by self-expanding metal stents. J Thorac Cardiovasc Surg 2003;126:744–7CrossRefGoogle ScholarPubMed
12 Levine, PA, Sasaki, CT, Kirchner, JA. The long tracheostomy tube. Alternative management of distal tracheal stenosis. Arch Otolaryngol 1978;104:108–10CrossRefGoogle Scholar
13 Wu, CY, Liu, YH, Hsieh, MJ, Ko, PJ. Use of the Montgomery T tube in ventilator-dependent patients. Eur J Cardiothorac Surg 2006;29:122–4CrossRefGoogle Scholar
14 Couraud, L, Jougon, JB, Velly, JF. Surgical treatment of nontumoral stenoses of the upper airway. Ann Thorac Surg 1995;60:250–9; 259–60CrossRefGoogle ScholarPubMed
15 Hsieh, MJ, Liu, YH, Yueh, YS, Ko, PJ. Use of microdebrider in glottic stenosis following airway stenting. Eur J Cardiothorac Surg 2006;30:388–90CrossRefGoogle ScholarPubMed
16 Lunn, W, Garland, R, Ashiku, S, Thurer, RL, Feller-Kopman, D, Ernst, A. Microdebrider bronchoscopy: a new tool for the interventional bronchoscopist. Ann Thorac Surg 2005;80:1485–8CrossRefGoogle ScholarPubMed
17 Zalzal, GH, Collins, WO. Microdebrider-assisted supraglottoplasty. Int J Pediatr Otorhinolaryngol 2005;69:305–9CrossRefGoogle ScholarPubMed