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This procedure is typically performed using a rigid bronchoscope under general anesthesia. However, a major limitation of this approach is the requirement for neck hyperextension, which is not feasible in patients with cervical spine injuries. This report details a complex case of subglottic stenosis in a patient with a cervical spinal cord injury and incomplete paraplegia, in whom conventional Montgomery T-tube tracheal stent placement was difficult to achieve. We performed Montgomery T-tube tracheal stent implantation under conscious sedation with oxygen support provided by high-flow nasal cannula, minimizing the risks of general anesthesia and cervical manipulation. The successful outcome suggests that the combination of conscious sedation and high-flow nasal cannula may represent a safe and practical strategy for treating carefully selected complex airway cases. Although this case highlights a promising pathway, further studies are required to confirm the efficacy of this strategy and define its clinical indications in larger patient populations.<\/jats:p>","DOI":"10.1177\/03000605251411746","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T05:11:26Z","timestamp":1770268286000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Montgomery T-tube tracheal stent implantation with high-flow nasal oxygen under conscious sedation: A case report"],"prefix":"10.1177","volume":"54","author":[{"given":"Danqian","family":"Su","sequence":"first","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenyu","family":"Yang","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Yuan","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-2974","authenticated-orcid":false,"given":"Daxiong","family":"Zeng","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-6710","authenticated-orcid":false,"given":"Junhong","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital of Soochow University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"e_1_3_10_2_2","first-page":"2145560","article-title":"Clinical analysis of 32 cases of subglottic benign airway stenosis treated with Montgomery T silicone stent","volume":"2024","author":"Yang Z","year":"2024","unstructured":"Yang Z, Zhou X, Pan W, et\u00a0al. 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