Different types of tracheostomy tubes
A tracheostomy tube keeps the hole in your neck open to aid breathing. This hole or opening is called a tracheostoma or stoma and allows air to pass directly into the lungs, bypassing the nose and mouth. Your medical team will determine the type of tracheostomy tube that is best suited to meet your needs. Most tracheostomy tubes people wear at home have two tubes called cannulas. The outer cannula is the main body of the tracheostomy tube and stays in place within the trachea. The inner cannula fits inside the outer cannula and can be removed as needed for cleaning. Inner cannulas can be cleaned and reused or disposed of after each use. Tubes come in various sizes, lengths, and materials, and can have additional features like cuffs, fenestrations, or subglottic suction lines.
Cuffed tracheostomy tubes
Some tracheostomy tubes have a cuff, which is an inflatable balloon around the outer cannula that seals your airway to prevent air from escaping around the tube. When inflated, the cuff can reduce secretions entering the lungs and forms a seal for ventilator use. Some cuffed tubes have a subglottic suction line to remove additional secretions that collect above the cuff. Typically, the cuff is inflated right after surgery. Once stable, your medical team will decide if deflating the cuff or switching to a cuffless tube is appropriate.
Uncuffed (cuffless) tracheostomy tubes
If you do not need a ventilator and have no major issues with swallowing or managing secretions, a cuffless tracheostomy tube is usually suitable. With a cuffless tube, you can breathe through the tube while air also moves around the tube to the upper airway.
Fenestrated tracheostomy tubes
A fenestrated tracheostomy tube has openings or holes on the bend of the outer and/or inner cannula, which allows air you breathe out to pass through the fenestration up to the vocal cords. This increases air movement to the upper airway, which may improve speech and sensation.
Outer cannula: Main body of the tube that stays in the trachea until the tube is changed.
Neck flange: The flat part that rests against the neck, securing the tube. Contains manufacturer’s name, tube size, and presence of a cuff and/or fenestration.
Eyelets: Holes on the sides of the neck flange where ties are inserted to secure the tube.
Cuff: An inflatable balloon at the end of the outer cannula used to seal the space between the tube and wall of the trachea.
Fenestration: Opening(s) or hole(s) in a cannula.
Pilot balloon: Indicates cuff inflation and serves as a port for inflating/deflating the cuff. When the cuff is inflated, the pilot balloon is also inflated.
Inner cannula: A removable tube inside the outer cannula for cleaning.
