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

An improved method for inserting a silicone T tube through a tracheostomy stoma in patients with subglottic stenosis is presented. A silicone T tube is pulled into the trachea with a catheter that is inserted into the tracheostomy stoma, advanced through the stenotic subglottic space, and pulled out the mouth. A cone-shaped dilator is placed beforehand at the proximal end of the vertical limb of the T tube to facilitate the passage of that end through the stenotic subglottic space. This method was used in 4 patients with good results. We suggest this technique be tried when attempts to insert a T tube by the usual method fail, as it can be performed under local anesthesia without special instruments and is technically easy.