Abstract
Seven laryngotracheal stenosis patients were treated by inserting a silicone tracheal T tube with a longer intratracheal portion than the standard T tube (long T tube). The cause of airway stenosis was tuberculosis in one patient, relapsing polychondritis in one patient, tracheal invasion of bronchogenic carcinoma in 2 patients, tracheal invasion of esophageal carcinoma in 3 patients. Two patients with benign disease had stenosis extending from the larynx to the lower trachea and 5 patients with malignancy had stenosis in the lower trachea. All patients complained of dyspnea and intubation or tracheostomy was performed before the T tube insertion. In patients who were intubated before tracheostomy, T tube was inserted when tracheostomy was performed. In other patients a tracheostomy tube was inserted before T tube insertion. In the patient with relapsing polychondritis the T tube moved distally and caused ulceration of the carina. In a patient with esophageal carcinoma the distal end of the T tube moved into the right main bronchus. In these cases, the distal limb was shortened and the long T tube was reinserted. There were no other troubles concerning the long T tube. A long T tube had been in place for 56 months before permanent extubation in a tuberculosis patient and one has been in place for 26 months in the relapsing polychondritis patient. All 5 patients with malignancy died within 10 months after insertion of the long T tube. In all the patients, phonation and expectoration of sputum were possible. The quality of life in patients with the long T tube was maintained at a good level and no major trouble concerning the long T tube was experienced.
