Improved technique for inserting a T tube in patients with subglottic stenosis

A simplified insertion technique for tracheal T-tube

“…Cooper and colleagues 2 demonstrated the use of a suture tied around the proximal end of the T-tube and withdrawn through the upper airway to pull the proximal end through the stenosis. Other authors used a coneshape dilatator 3 or an endotracheal tube 4 fixed to the proximal end of the T-tube to get it through the stenosis.…”

T-tube insertion for sclerotic subglottic stenosis

“…Firstly, insertion was attempted employing Kato's method (Figure 4). 5 A Rob-Nel catheter was advanced and pulled through the oral cavity, but the proximal limb of the T-tube could not be advanced into the stenotic region due to airway stenosis with severe sclerosis. Thus, predilatation of the stenotic region was performed by inserting Hegar dilators.…”

“…A T-tube with a 10-mm outer diameter was then inserted using Kato’s method (Figure 3E). 5 Briefly, before the procedure, a cone-shaped dilator was made from a 10 F Rob-Nel catheter (Argyle, Sherwood, Shizuoka, Japan; Figure 4A). The wider end of the catheter was cut to match the external diameter of the T-tube, and the narrower end was cut so as to allow another catheter to be pulled through its lumen.…”

“…We previously reported Kato's method of T-tube insertion for subglottic stenosis, and have applied this method in many patients in our department, using a Rob-Nel catheter. 5 Thereafter, we designed additional safe and reliable T-tube insertion methods for various types of subglottic stenosis. Herein, we describe our treatment of a case of sclerotic subglottic stenosis due to relapsing polychondritis, including modifications of the original procedure for T-tube insertion.…”

Fracture of silicone tracheal T-tube: A rare complication

“…The patient underwent fiberoptic bronchoscopic dilation. A 10-mm T-tube (Koken Laboratories, Tokyo, Japan; proximal portion of the vertical limb, 2 cm; distal portion of the vertical limb, 4 cm; horizontal limb, 5.5 cm) was inserted with difficulty via the tracheal stoma according to a previously described method 1 and with the help of the bronchofiberscope. The proximal portion of the vertical limb of the silicone T-tube was positioned across the stenotic segment, and only a slight kink (less than 90°) between the proximal portion of the vertical limb and the horizontal limb was observed using the bronchofiberscope.…”