Montgomery T tube in a management of inoperable tracheal stenosis
Authors:
J. Votruba 1; Z. Šestáková 1; M. Lukeš 2; P. Michálek 2,3
Authors‘ workplace:
1. klinika tuberkulózy a respiračních nemocí, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice v Praze
1; Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice v Praze
2; Department of Anaesthetics, Antrim Area Hospital, Antrim, Spojené království
3
Published in:
Anest. intenziv. Med., 30, 2019, č. 2, s. 68-71
Category:
Overview
Surgically untreatable tracheal stenosis is a very serious condition that requires repeated interventions of the interventional bronchologist and has an uncertain prognosis. This case report describes the definitive solution of tracheal stenosis, following long-term unsuccessful dilatations and stenting, by the insertion of the Montgomery T tube. The procedure requires close cooperation between the interventional bronchologist and the anaesthetist, using a combination of rigid and flexible bronchoscopes and high-frequency jet ventilation. In this patient, the insertion of the Montgomery T tube provided a significant improvement in the quality of life, maintaining patency of the airways, enabling phonation, and reducing the risk of acute choking.
Keywords:
tracheal stenosis – Montgomery T tube – jet ventilation
Sources
1. D'Andrilli A, Venuta F, Rendina EA. Subglottic tracheal stenosis. J Thorac Dis. 2016;8:S140–S147.
2. Auchincloss HG, Mathisen DJ. Tracheal stenosis – resection and reconstruction. Ann Cardiothorac Surg. 2018;7:306–308.
3. Hu H, Zhang J, Wu F, Chen E. Application of the Montgomery T-tube in subglottic benign tracheal stenosis. J Thorac Dis. 2018;10:3070–3077.
4. Montgomery WW. T-tube tracheal stent. Arch Otolaryngol. 1965;82:320–321.
5. Montgomery WW, Montgomery SK. Manual for use of Montgomery laryngeal, tracheal, and esophageal prostheses: update 1990. Ann Otol Rhinol Laryngol. 1990;150:S2–S28.
6. Ramaswamy AH, Kurdi MS, Sindhupriya M. TIVA – a promising approach to anaesthetic management of Montgomery T tube insertion. J Clin Diagn Res. 2015;9:UD03–UD04.
7. Agrawal S, Payal YS, Sharma JP, et al. Montgomery t-tube: anaesthetic management. J Clin Anesth. 2007;19:135–137.
8. Michálek P, Závada J, Brožek T. Specifika intervenční bronchologie z pohledu anesteziologa. Anest intenziv Med. 2016;27:207–213.
9. Dhillon VK, Akst LM, Best SR, Hillel AT. Voice outcomes in laryngotracheal stenosis: impact of the Montgomery T tube. Clin Surg. 2018;3:1855.
10. Bayan S, Hoffman HT. Indications and outcomes for use of Montgomery cannulas. JAMA Otolaryngol Neck Surg. 2015;141:142–147.
Labels
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2019 Issue 2
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