The use of a silicone T-tube to treat tracheal stenosis in a llama.

A female llama was presented at 4 days of age with severe dyspnea resulting from bilateral choanal atresia. A tracheostomy was performed before surgical treatment of the airway obstruction. Although the choanal atresia was successfully corrected, tracheal stenosis secondary to mucosal necrosis, malacia of the cartilage rings, and proliferation of intraluminal granulation tissue at and distal to the tracheal stoma developed. The affected segment of the trachea was resected and an end-to-end anastomosis was performed, but the lumen again became obstructed by granulation tissue. A silicone "T-tube" was placed in the trachea to provide a patent airway and intraluminal support. The llama has done well for 12 months with this prosthesis, and the complications that are often seen with long-term use of traditional tracheostomy tubes have not developed.