Airway recanalization followed by montgomery T-tube placement for severe subglottic stenosis in an adolescent: a case report
- 1Department of Respiratory and Critical Care Medicine, Ganzhou Fifth People’s Hospital, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute for Prevention and Treatment of Respiratory Diseases, Ganzhou, Jiangxi, China
- 2School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
- 3Department of Otolaryngology, Ganzhou Fifth People’s Hospital, Ganzhou Key Laboratory of Respiratory Diseases, Ganzhou Institute for Prevention and Treatment of Respiratory Diseases, Ganzhou, Jiangxi, China
Abstract
BackgroundPost-intubation subglottic stenosis (SGS) in adolescents is a progressive acquired airway disorder that can substantially impair quality of life. Both surgical and interventional airway therapies are effective treatment options for SGS; however, each carries considerable technical demands, procedural risks, and potential complications. Interventional airway therapy relieves airway obstruction, maintains airway patency, restores airway and phonatory function, and has a less invasive profile, positioning it as a key treatment modality for SGS.Case presentationA 15-year-old girl sustained a traumatic brain injury following a motor vehicle accident. She received endotracheal intubation and mechanical ventilation in the intensive care unit for two weeks, followed by tracheostomy. After cognitive and motor function recovered, attempted complete occlusion of the tracheostomy tube provoked dyspnea. Subsequent bronchoscopic examination revealed subglottic stenosis.DiagnosisBronchoscopic examination demonstrated approximately 98% subglottic airway stenosis involving a segment of roughly 2 cm with a funnel-shaped morphology, consistent with acquired post-intubation SGS.InterventionsA multidisciplinary team developed an individualized treatment strategy that included rigid bronchoscopy-assisted respiratory support, airway recanalization, Montgomery T-tube placement, perioperative pulmonary hygiene management, and surveillance for procedure-related adverse events.ResultsAirway recanalization, including electrocautery incision, laser ablation, and balloon dilation, was performed successfully with rigid bronchoscopic support, restoring the tracheal lumen to approximately 1 cm in diameter. After the airway mucosa had stabilized, a Montgomery T-tube was implanted. Following T-tube placement, the patient regained phonatory function and experienced marked improvement in dyspnea. Computed tomography confirmed appropriate positioning of the Montgomery T-tube. Follow-up bronchoscopy demonstrated a patent lumen without significant secretion retention or granulation tissue formation.
Related
- Trans-cuff budesonide delivery and its effects on endotracheal intubation-induced subglottic injury
- When Postextubation Stridor Is Not Edema: Bilateral Lateral Subglottic Mucosal Tears.
- Laryngeal Hypersensitivity is Correlated With Subglottic Stenosis
- Factor Structure and Symptom Profiles of the Montgomery–Åsberg Depression Rating Scale (MADRS): A Meta-Analytic Mean and Covariance Structure Analysis
- Geographic Clustering of Idiopathic Subglottic Stenosis in North America: An Ecological Cohort Study
BibTeX
@article{lu2026airway,
title = {{Airway recanalization followed by montgomery T-tube placement for severe subglottic stenosis in an adolescent: a case report}},
author = {Yiyi Lu and Jinbo Li and Qian Chen and Miaomiao Yuan and Kaiwang Cui and Xiaohua Lu and Gaohua Chen and Xiangwen Gong},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1987862},
url = {https://doi.org/10.3389/fmed.2026.1987862},
note = {CC BY},
}
RIS
TY - JOUR
TI - Airway recanalization followed by montgomery T-tube placement for severe subglottic stenosis in an adolescent: a case report
AU - Yiyi Lu
AU - Jinbo Li
AU - Qian Chen
AU - Miaomiao Yuan
AU - Kaiwang Cui
AU - Xiaohua Lu
AU - Gaohua Chen
AU - Xiangwen Gong
PY - 2026
DA - 2026/10/28
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1987862
UR - https://doi.org/10.3389/fmed.2026.1987862
AB - BackgroundPost-intubation subglottic stenosis (SGS) in adolescents is a progressive acquired airway disorder that can substantially impair quality of life. Both surgical and interventional airway therapies are effective treatment options for SGS; however, each carries considerable technical demands, procedural risks, and potential complications. Interventional airway therapy relieves airway obstruction, maintains airway patency, restores airway and phonatory function, and has a less invasive profile, positioning it as a key treatment modality for SGS.Case presentationA 15-year-old girl sustained a traumatic brain injury following a motor vehicle accident. She received endotracheal intubation and mechanical ventilation in the intensive care unit for two weeks, followed by tracheostomy. After cognitive and motor function recovered, attempted complete occlusion of the tracheostomy tube provoked dyspnea. Subsequent bronchoscopic examination revealed subglottic stenosis.DiagnosisBronchoscopic examination demonstrated approximately 98% subglottic airway stenosis involving a segment of roughly 2 cm with a funnel-shaped morphology, consistent with acquired post-intubation SGS.InterventionsA multidisciplinary team developed an individualized treatment strategy that included rigid bronchoscopy-assisted respiratory support, airway recanalization, Montgomery T-tube placement, perioperative pulmonary hygiene management, and surveillance for procedure-related adverse events.ResultsAirway recanalization, including electrocautery incision, laser ablation, and balloon dilation, was performed successfully with rigid bronchoscopic support, restoring the tracheal lumen to approximately 1 cm in diameter. After the airway mucosa had stabilized, a Montgomery T-tube was implanted. Following T-tube placement, the patient regained phonatory function and experienced marked improvement in dyspnea. Computed tomography confirmed appropriate positioning of the Montgomery T-tube. Follow-up bronchoscopy demonstrated a patent lumen without significant secretion retention or granulation tissue formation.
SN - 2296-858X
ER -