Summary
Objectives
To describe voice and airway outcomes and complications experienced by patients with
laryngotracheal stenosis following Montgomery T-tube placement.
Methods
Retrospective chart review of all patients with laryngotracheal stenosis and Montgomery
T-tube placement treated at a tertiary referral center from 2012 to 2021.
Results
Eighteen patients met criteria with laryngotracheal stenosis, seven including the
level of the glottis and 11 without glottal involvement. Eleven were completely aphonic
before T-tube placement and the remainder had severe dysphonia. There was improvement
of Voice Handicap Index-10, Reflux Symptom Index, and GRBAS grade following T-tube
placement in patients compared to their preoperative values. Improvement of grade
was greater in patients without glottal involvement. Complications of chronic indwelling
T-tube included granulation in 14 patients (78%), tracheitis in two patients (11%),
and mucus plugging in three patients (17%) with one T-tube related mortality. Five
patients were eventually decannulated, six returned to tracheostomy tube, and seven
retained the T-tube at last follow-up (average: 30 months, range: 4-80 months).
Conclusions
Montgomery T-tube placement improves voice in patients with severe dysphonia secondary
to laryngotracheal stenosis with and without glottal involvement though the degree
of improvement is greater in patients without glottal involvement. T-tube can help
reestablish long-term laryngotracheal continuity in patients with no other surgical
options. The potential benefits in phonation should be weighed against the possibility
of rare but serious adverse events.
Key Words
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Article info
Publication history
Published online: July 17, 2022
Accepted:
June 8,
2022
Publication stage
In Press Corrected ProofFootnotes
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. No financial interests of authors to report.
Meetings: Presented as poster virtually during 101st Annual Meeting of the American Broncho-Esophagological Association, occurring virtually with the Combined Otolaryngology Spring Meetings (COSM) April 7-8, 2021.
Identification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
