Treatment of secondary benign airway stenosis after tracheotomy with Montgomery T-tube.

Abstract

Objective: With the improvement of surgical operation, increasing incidence of secondary benign airway stenosis, as a complication of long-term tracheal intubation and tracheotomy, leads to significant increases in morbidity and mortality. Previous treatment of secondary benign airway stenosis was mainly based on surgical resection and reconstruction. There is an urgent need for new treatment methods except surgery, especially for those inoperable patients. Methods: This study retrospectively reviewed 20 patients who had treatments of secondary benign airway stenosis after tracheotomy with Montgomery T-tube. The clinical data including clinical features, efficacy, complications and prognosis were retrospectively evaluated. Results: Complete airway obstruction was 12/20, partial stenosis was 8/20, combined with airway granuloma and endoscopic granulation resection was 16/20, combined with scar stenosis and endoscopic balloon dilatation was 18/20. Plugging successfully was 19/20. Complications included mucous accumulation (20/20), secondary granulation tissue formation (13/20), subcutaneous soft tissue infection (1/20), and T-tube re-implantation (3/20). Conclusions: Montgomery T-tube implantation under rigid bronchoscopy is a safe, feasible and effective tracheal forming method with well tolerance for patients with benign airway stenosis. Secondary benign airway stenosis after tracheal intubation and tracheotomy is an indication of Montgomery T-tube implantation. Compared with the traditional tracheotomy, the advantage of Montgomery T-tube implantation is easy to make the patient phonate, significantly improving the quality of life of patients. T-tube implantation is safe, and the postoperative complications include mucous accumulation and formation of secondary T-tube granulation tissue.