The aim of the study was evaluation of the use of
tracheostomy T-tube in patients with
tracheal stenosis. The advantages of closed T-tube over open
tracheotomy are: 1/ normal breathing through the nose, 2/ normal speech without necessity to close the tube with a finger, 3/ no spitting during
cough.
Silicone tracheostomy T-tube was used in 12 patients with
tracheal stenosis. The
stenosis resulted in 7 patients from prolonged intubation, in 4 patients from defective
tracheostomy and in one patient from failure of tracheal resection. In all the patients rigid tracheoscopy and/or flexible bronchoscopy revealed the length of the
stenosis and the distance from vocal cords. T-tube was placed under
local anesthesia. The patients used to wear closed T-tube from 1-12 years. The tube was exchanged every 2-4 years. The only adverse effect was recurrent granulation around
tracheostomy in two patients. 7 of 12 patients were decannulated with good result in 3 months - 5 years follow up. In two decannulated patients
stenosis recurred. One patient was retracheostomized and in another patient
stenosis was resected with end to end anastomosis. Three patients were not decannulated.
Tracheostomy T-tube can be used temporary in patients with
tracheal stenosis before planned
stenosis resection or as a sole treatment with good chances for successful decannulation. When
stenosis resection is not possible, T-tube can be placed for long time.