The constant bathing by saliva to the tissues altered by surgery, infection, or radiation therapy is a prime factor in retarding the progress of healing and fistula closure.

The Montgomery^® Salivary Bypass Tube directs the saliva into the distal esophagus and allows for spontaneous closure of the fistula, or at least permits the tissue to recover sufficiently to be an improved recipient for more formidable measures such as repair using pedicled skin flap tissue. A feeding tube may be inserted through the salivary bypass tube. Impending fistulae and strictures may be prevented by tube placement alone or following bougienage dilation.