A Case of Idiopathic Subglottic Stenosis That Was Treated Under Positive Pressure Ventilation by Intubation Through a Montgomery T-Tube

Abstract

Montgomery T-tubes are used for treating of subglottic or tracheal stenosis. Products marketed by Koken Co., Ltd. in Japan are easy to use in such patients. Due to the structure of the T-tube, however, positive pressure ventilation via the T-tube while maintaining safe anesthesia and ventilation is difficult.

We report the case of a 59-year old woman who presented to us with stridor, in whom we performed tracheostomy. The patient was clinically diagnosed as having idiopathic subglottic stenosis. Her stenotic scar was removed via an external tracheal incision and a T-tube was placed under general anesthesia. Positive pressure ventilation was continued by placement of “a RAE (Ring-Adair-Elwyn) tube within the T-tube”.

We used a T-tube (inner diameter of the side arm 9 mm and the main arm 10 mm/outer diameter 12 mm) manufactured by Koken Co., Ltd. and a Shiley oral RAE tracheal tube with a TaperGuard cuff (inner diameter 5.5 mm/outer diameter 7.6 mm) manufactured by Covidien Japan Co., Ltd. We conclude that treatment of idiopathic subglottic stenosis under general anesthesia by placement of “a RAE tube within a T-tube” is safe if it is possible to obtain tubes of suitable sizes.