Publication:

Role of Montgomery T-tube in laryngotracheal stenosis

Background The purpose of this retrospective study was to evaluate the outcome of laryngotracheal stenosis in patients undergoing Montgomery T-tube insertion in our institution. This study also throws light on the indications and complications of Montgomery T-tube insertion.

Methods 39 patients who presented with laryngotracheal stenosis in the Department of Otorhinolaryngology at the JSS Medical College, Mysore, India during period of January 2012-December 2015.Out of which, 32 patients underwent stenting by  Montgomery T-tube through an external approach. The follow-up period ranged from 6-24 months.The T-tube was removed after a minimum period of 6–12 months.

Results The most common cause of laryngotracheal stenosis was prolonged intubation as seen in 89.7% patients, majority of patients (41%) in this study were in the 3rd decade. In this study all the patients underwent tracheostomy prior to treatment for stenosis. Out of 32 patients, decannulation was not possible in four (12.5%). The most common complication seen was surgical emphysema in 21 patients (50%) followed by crusting in 13 patients (40.6%), granulations at the upper of end in 1 patient (3.1%), and granulations around the stoma in 4 patients (12.5%).

Conclusions Laryngotracheal stenosis (LTS) has always been and will remain a challenge to the otolaryngologist and a multidisciplinary approach is required to tackle it. Stenting remains a relatively conservative treatment, is successful in a proportion of cases. Although there are complications associated with the T tube it is always easily manageable and are not usually life threatening.