[The Montgomery tracheal prosthesis: actual solution for tracheal stenosis]

Area of Science:

• Pulmonology and Respiratory Medicine
• Gastroenterology and Hepatology
• Otolaryngology

Context:

• Tracheal stenosis diagnosis is challenging, often identified only when significant airway obstruction (≥50%) causes symptomatic dyspnea.
• Severe obstruction (>70%) constitutes an endoscopic emergency due to decompensation risks from secretions and bleeding.
• Malignancy is a primary cause, necessitating palliative endoscopic techniques to restore airway patency.

Purpose:

• To review the technical aspects, indications, benefits, drawbacks, and effective placement techniques for tracheal stents.
• To highlight the continued relevance and efficacy of the Montgomery stent, particularly in resource-constrained healthcare systems.
• To present a clinical case with video documentation of tracheal stent placement by an interdisciplinary team.

Summary:

• Endoscopic management is vital for compromised central airways, enabling optimal conditions for curative treatment.
• Stenting is mandatory post-intervention to maintain airway patency, with various stent types available, including traditional silicone and newer metallic/hybrid options.
• The Montgomery stent, despite its age, remains a viable and cost-effective option with proven results, especially in public health systems with limited budgets.

Impact:

• Provides essential information for clinicians managing tracheal stenosis, emphasizing endoscopic solutions.
• Offers insights into cost-effective airway management strategies, particularly relevant for developing healthcare economies.
• Contributes to the understanding of tracheal stenting procedures through a documented clinical case and procedural video.