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Duration of stenting with Montgomery T-tubes in severe laryngotracheal stenosis: does it matter?

Published online by Cambridge University Press:  19 November 2021

M Muraleedharan ,
A S Ramavat ,
J Bakshi ,
S Mohindra ,
G Nayak  and
A Goel
M Muraleedharan
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
A S Ramavat*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
J Bakshi
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
S Mohindra
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
G Nayak
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
A Goel
Affiliation:
Department of Medicine, Dr B R Ambedkar State Institute of Medical Sciences, Sahibzada Ajit Singh Nagar, India
*
Author for correspondence: Dr A S Ramavat, Department of Otorhinolaryngology, Post Graduate Institute of Medical Education and Research, Madhya Marg, Sector 12, Chandigarh160012, India E-mail: ramavatanu@gmail.com
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Abstract

Objective

Laryngotracheal stenosis management remains largely discretionary in surgical practice. Duration of stenting remains variable following open reconstruction procedures in absence of clearly established differences. The current study evaluates successful decannulation after short-term periods compared with longer periods.

Method

A comparative study over 18 months evaluated differences in successful decannulation between short- and long-term stent groups. Patients with grade II, III or IV laryngotracheal stenosis were placed on Montgomery T-tube for a short-term period (n = 15), and decannulation rates were compared with age-, sex- and diagnosis-matched patients (n = 15) from historical cases with long-term stent placement.

Results

Thirty patients were included. There was no difference between the two groups at baseline. Nine patients (30 per cent) were successfully decannulated, and there was no difference in rates of decannulation between the two groups (p = 0.8). Granulations at the proximal end of tube (38.7 per cent), superior migration of tube (16.1 per cent) and dysphonia (12.9 per cent) were common complications.

Conclusion

Decannulation was not more successful after placing Montgomery T-tubes for longer periods of time when compared with removal within the first three months. Early removal after proper case selection and planning may be considered for a successful outcome in laryngotracheal stenosis.

Keywords

StenosisTracheostomyStents
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 4 , April 2022 , pp. 354 - 359
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr A S Ramavat takes responsibility for the integrity of the content of the paper

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