title: Novel modification of tracheostomy tube to allow speech and manage tracheal stenosis.
abstract: 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.
authors.affiliation: Department of Pulmonary Critical Care, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: de la Cruz
authors.forename: Shaheen
authors.initials: S
authors.lastname: Islam
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cloyes
mesh_terms: D001999:Bronchoscopy; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013060:Speech / Q000502:physiology*; D014135:Tracheal Stenosis / Q000628:therapy*; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods