A 20-year audit of the outcomes of stenting with the Montgomery Safe-T-Tube at a tertiary hospital in South Africa

• Published in: Journal of laryngology and otology 2023-06, Vol.137 (6), p.697-703
• Main Authors: Klopper, G J, Adeniyi, O V
• Format: Article
• Language: English
• Subjects: Cartilage; Clinical outcomes; Epidemiology; Etiology; Females; Gender; Guillain-Barre syndrome; Hospitals; Intubation; Main Article; Ostomy; Patients; Restenosis; Success; Survival analysis; Tracheotomy; Trauma
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215122002298

This study aimed to describe the epidemiology of laryngotracheal stenosis within a resource-constrained setting, whilst exploring the outcome correlates unique to Montgomery Safe-T-Tube stented laryngotracheoplasty. A retrospective cross-sectional study of patients who underwent Montgomery Safe-T-Tube stented laryngotracheoplasty between January 2000 and December 2019 was performed. Amongst 75 patients, most lesions were iatrogenic (78.7 per cent) and high-grade in severity (84 per cent). Following 101 laryngotracheoplasties, 57 patients (76 per cent) were successfully decannulated. Young age (84.6 per cent; = 0.009), low-grade stenosis (100 per cent; = 0.034) and airway-framework structural integrity (79.3 per cent; = 0.004) were significant correlates of success. Restenosis ( = 43; 57.3 per cent), occurring at a median of 9.37 weeks following decannulation, was predominantly associated with antecedent dilatation (96.3 per cent; < 0.001). Demographic and clinical profiles play a pivotal role in the outcomes and complications of Montgomery Safe-T-Tube stented laryngotracheoplasty. The success rate validates the procedure within a resource-limited setting. There exist critical periods following both surgery and decannulation when the occurrence of adverse events is most likely.