Description
The Montgomery Laryngeal Keel is an innovative medical device specifically designed to aid in the surgical repair of laryngeal conditions such as anterior subglottic stenosis and glottic stenosis. Developed by Montgomery, this device plays a crucial role in maintaining the separation of vocal cords during the healing process, thereby preventing restenosis and the migration of granulation tissue into the larynx.
Key Features
- Material: Crafted from soft implant-grade silicone, the keel features a non-adherent smooth surface, ensuring minimal irritation and optimal compatibility with laryngeal tissues.
- Size Options: Available in three sizes—12 mm, 14 mm, and 16 mm—to accommodate varying anatomical needs.
- Visibility: Offered in both clear and radiopaque materials, providing flexibility for different surgical requirements.
- Design: The flat keel design allows for easy endoscopic placement and is secured to the thyroid laminae with a figure-of-eight suture.
- Sterility: Each keel is supplied sterile, with one keel per carton, ready for immediate use.
Clinical Applications
The Montgomery Laryngeal Keel is particularly beneficial following the removal of a laryngeal stent or after hemilaryngectomy, where it helps in forming a sharp anterior commissure and prevents the reformation of laryngeal webs. It is also advantageous in cases where laser surgery is not feasible, allowing for early mobilization of the vocal cords without the need for round stents or endotracheal tubes.
Placement and Duration
Typically, the keel is placed endoscopically and recommended to remain in situ for 2 to 3 weeks. This duration is crucial to ensure effective healing and prevention of restenosis. Following removal, if necessary, a tracheostomy may remain for an additional 5 days to secure the airway.
Benefits
- Healing Support: By covering the thyrotomy repair and maintaining separation between the vocal cords, the keel supports optimal healing conditions.
- Ease of Use: The device requires no specific maintenance and is simply removed after the designated healing period, aligning with standard clinical protocols.
The Montgomery Laryngeal Keel stands out as a vital tool in otolaryngology, offering surgeons a reliable solution to complex laryngeal repairs and significantly enhancing patient outcomes through its thoughtful design and functionality.
