Tracheostomy is a procedure to create an opening in the neck leading directly to the trachea. A fenestrated trach tube is a form of tubing inserted into the opening to assist with breathing.
A fenestrated trach tube consists of an outer cannula, an inner cannula, an obturator, a cuff and a plug.
A fenestrated trach tube has openings, or fenestrations, in the outer cannula. These holes allow air from the lungs to pass through the vocal chords and into the mouth and nose. This enables normal breathing and the ability to speak or cough through the mouth.
A fenestrated trach tube is often used as the final step before trach tube removal. It permits the patient to speak and cough on their own, providing an experimental trial for life after the trach tube.
To take advantage of the fenestrations, one must deflate the cuff, remove the inner cannula and plug the outer cannula. The air passing through the fenestrations will now allow the patient to speak and breathe normally.
Some doctors believe using fenestrated trach tubes may cause fibrous tissue to develop along the tracheal wall near the fenestrations.