Saravanam Prasanna Kumar1, Arunachalam Ravikumar2, Kannan Senthil3, Lakshman Somu4, Mohd Ismail Nazrin5. 1. Department of E.N.T. Head & Neck Surgery, Sri Ramachandra Medical College & Research Institute, Porur, Chennai 600116, India. Electronic address: sprasannakumar10@gmail.com. 2. Department of E.N.T. Head & Neck Surgery, Sri Ramachandra Medical College & Research Institute, Porur, Chennai 600116, India. Electronic address: ravi_1954@hotmail.com. 3. Department of E.N.T. Head & Neck Surgery, Sri Ramachandra Medical College & Research Institute, Porur, Chennai 600116, India. Electronic address: drsenthilk@yahoo.co.in. 4. Department of E.N.T. Head & Neck Surgery, Sri Ramachandra Medical College & Research Institute, Porur, Chennai 600116, India. Electronic address: somu_l1496@yahoo.com. 5. Resident in Otorhinolaryngology, Sri Ramachandra Medical College & Research Institute, Porur, Chennai 600116, India. Electronic address: nazsams@gmail.com.
Abstract
OBJECTIVE: To identify the indications, complications and outcome of patients of LTS managed with Montgomery T-tube stenting and review the current literature about the role of stenting in LTS. METHODS: Retrospective chart reviews of 39 patients of laryngotracheal stenosis managed by T-tube stenting for temporary or definitive treatment during the period 2004-2011 were considered. The data on indications for stenting, type of stent, problems/complications of stenting, duration of stenting, additional intervention and outcome of management were collected, tabulated and analyzed. RESULTS: Of the 51 cases of laryngotracheal stenosis 39 patients were treated by Montgomery T-tube stenting. There was no mortality associated with the procedure or stenting. 82% of the patients were successfully decannulated. The problems and complications encountered were crusting within the tube in 44% and granulation at the subglottis in 33%. Two patients had complication due to T-tube itself: One patient developed tracheomalacia and the other had stenosis at both ends of the T-tube. CONCLUSION: Stenting still has a role in management of inoperable or in some deadlock situations where resection anastomosis is not feasible. It is easier to introduce the stent and to maintain it. Complications are minor and can be managed easily. It is safe for long term use. We emphasize that the treating surgeon needs to use prudence while treating stenosis using stents.
OBJECTIVE: To identify the indications, complications and outcome of patients of LTS managed with Montgomery T-tube stenting and review the current literature about the role of stenting in LTS. METHODS: Retrospective chart reviews of 39 patients of laryngotracheal stenosis managed by T-tube stenting for temporary or definitive treatment during the period 2004-2011 were considered. The data on indications for stenting, type of stent, problems/complications of stenting, duration of stenting, additional intervention and outcome of management were collected, tabulated and analyzed. RESULTS: Of the 51 cases of laryngotracheal stenosis 39 patients were treated by Montgomery T-tube stenting. There was no mortality associated with the procedure or stenting. 82% of the patients were successfully decannulated. The problems and complications encountered were crusting within the tube in 44% and granulation at the subglottis in 33%. Two patients had complication due to T-tube itself: One patient developed tracheomalacia and the other had stenosis at both ends of the T-tube. CONCLUSION: Stenting still has a role in management of inoperable or in some deadlock situations where resection anastomosis is not feasible. It is easier to introduce the stent and to maintain it. Complications are minor and can be managed easily. It is safe for long term use. We emphasize that the treating surgeon needs to use prudence while treating stenosis using stents.
Authors: Paula Duarte D'Ambrosio; Paulo F Guerreiro Cardoso; Priscila Loria da Silva; Paulo Manoel Pêgo Fernandes; Hélio Minamoto Journal: J Bras Pneumol Date: 2022-03-14 Impact factor: 2.624