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CASE REPORT
Novel modification of tracheostomy tube to allow speech and manage tracheal stenosis
  1. Michael de la Cruz1,
  2. Shaheen Islam2,
  3. Rebecca Cloyes2
  1. 1Department of Pulmonary Critical Care, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  2. 2Department of Interventional Pulmonology, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  1. Correspondence to Dr Michael de la Cruz, Michael.delaCruz{at}OSUMC.edu

Summary

Mid-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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