Forgotten Montgomery T–tube stent: A case reports and Review of literature

Abstract

Background: Airway stenting is one of the many methods of managing complex laryngotracheal stenosis. The silicone T- tube described by Montgomery WW is widely used for stenting the stenotic segment. The ideal duration of stenting with this tube is not known.
Objective: To understand the clinical presentation and outcome of two cases of long forgotten Montgomery T- tube stenting. Method: Clinical case reports of laryngotracheal stenosis who presented to us after 11 years and 9 years of initial stenting with Montgomery T- tube. Results: T- tube removal and successful closure of tracheostomy was done in one case. Due to persistent stenosis at the subglottis T- tube had to be reinserted in the second case. Conclusion: Silastic T-tubes are relatively well tolerated, safe to use in definitive management of laryngotracheal stenosis. They can possibly be used for prolonged period of time and can be safely reused in the same patient after sterilisation. To the best of our knowledge this is the first report of the changes that would take place in a long standing T- tube. Though these two cases did not receive medical care in the interim period, we recommend biannual review and regular follow up for patient who are stented with T-tube.