Montgomery T-tube for management of tracheomalacia: Impact on voice-related quality of life.
Aged
Airway Obstruction
/ prevention & control
Bronchoscopy
/ methods
Case-Control Studies
Female
Humans
Intubation, Intratracheal
/ adverse effects
Male
Middle Aged
Minimally Invasive Surgical Procedures
/ methods
Mucus
/ physiology
Quality of Life
Speech Sound Disorder
/ etiology
Stents
/ adverse effects
Suction
/ methods
Trachea
/ surgery
Tracheomalacia
/ therapy
Tracheostomy
/ adverse effects
Montgomery T-tube
bronchoscopy
tracheomalacia
tracheostomy
voice-related quality of life
Journal
The clinical respiratory journal
ISSN: 1752-699X
Titre abrégé: Clin Respir J
Pays: England
ID NLM: 101315570
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
26
12
2018
revised:
03
09
2019
accepted:
11
10
2019
pubmed:
18
10
2019
medline:
24
10
2020
entrez:
18
10
2019
Statut:
ppublish
Résumé
Tracheostomy is a common procedure for management of tracheomalacia. However, the limitation to speak related to tracheostomy cannula could affect the quality of life. we reported a new minimally invasive procedure to replace tracheostomy cannula with Montgomery T-tube to improve the ability of speaking. This is a single center study including all consecutive patients undergoing the replacement of standard tracheostomy cannula with T-tube for management of tracheomalacia. The end-points were to evaluate (a) the changes in Voice-related quality of Life (V-RQOL) before and after T-tube placement; and (b) the complications related to T-tube. Eleven patients were included in the study. T-tube was placed using flexible bronchoscopy and laryngeal mask airway. A suture was inserted through the proximal end of T-tube. Once the stent was introduced with a clamp into the trachea, a traction was applied on the suture to facilitate the alignment of the upper end of the stent. The comparison of V-RQOL values before and after T-tube insertion showed a significant improvement in social/emotional (39.2 ± 6.1 vs 66.8 ± 1.9; P = .0001); physical functioning (21 ± 5.7 vs 56.4 ± 5.3; P = 0.0001) and total V-RQOL scores (33.9 + 5.4 vs 61.3 + 6.1; P = 0.0001). No complications were seen during the insertion of the stent. In two patients, T-tube was obstructed by mucus that resolved with aspiration using flexible bronchoscopy (mean follow-up: 18 ± 10 months). Our technique is simple and safe, not needing specific skills and/or cumbersome devices. The replacement of tracheostomy cannula with T-tube seems to improve the quality of voice without adding major complications.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
40-46Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
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