Combined 'trache-stent': a useful option in the treatment of a complex case of subglottic stenosis.
The authors describe the adaptation of a Montgomery T-tube laryngo-tracheal stent to incorporate an uncuffed fenestrated Shiley tracheostomy tube in the management of a complex case of subglottic stenosis. The combined 'trache-stent' provided a secure, unobstructed airway and optimal phonation. The presence of a removable inner tube facilitated cleaning and reduced patient anxiety regarding the perceived risks of stent obstruction with dried secretions. The combined 'trache-stent' was upsized at four weeks with minimal evidence of local granulation formation. The device was removed entirely six weeks later after direct laryngoscopy reconfirmed the above findings. Almost two years later the patient retains a good voice and airway using a simple fenestrated tracheostomy tube and speaking valve. The subglottic area is stable and the patient has returned to full-time employment.
Morris
D P
DP
Department of Otolaryngology, Hope Hospital, Salford and The Royal Manchester Children's Hospital, Pendlebury, UK. dp_morris@yahoo.co.uk
Malik
T
T
Rothera
M P
MP
D001294:Attitude to Health; D006801:Humans; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D014135:Tracheal Stenosis / Q000601:surgery*; D014139:Tracheostomy / Q000009:adverse effects