• BMJ case reports · Nov 2013

    Case Reports

    Novel modification of tracheostomy tube to allow speech and manage tracheal stenosis.

    • Michael de la Cruz, Shaheen Islam, and Rebecca Cloyes.
    • Department of Pulmonary Critical Care, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
    • BMJ Case Rep. 2013 Nov 22; 2013.

    AbstractMid-tracheal, postintubation stenosis can be managed with an extended length tracheostomy tube to bypass the stenotic area. However these extra-long tracheostomy tubes are not fenestrated, and when the stenotic tracheal lumen sits against the tracheostomy tube, phonation is not possible as there is no translaryngeal airflow. A 59-year-old man developed distal tracheal stenosis following a prolonged intubation and tracheostomy after a motorcycle accident. He eventually required an extra-long tracheostomy tube to bypass the stenotic region. We modified a silicone tracheostomy tube by creating a fenestration on its posterior wall. This relieved the obstruction while still allowing phonation and speech.

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