Cuffed tracheostomy tube Cuffed tube with an adjustable flange
Fenestrated tracheostomy tube (Portex) Metal tracheostomy tube
The opening was closed to allow hand-free with speaking valve.
phonation in this patient who had
intermittent airway obstruction
due to myasthenia gravis.
Fenestration on dorsal asoect of tracheostomy tube to allow
air stream upwards and enable phonation in a functioning glottis.
Tracheostomy position as depicted in sagittal CTscan showing its course ending in tracheal lumen.
A chest X-ray showing a tracheostomy in-situ in a patient having pneumonia with pleural effusion.
This add-on accessory serves to filter, moisten and maintain the temperature of air that the patient breathe (the normal nasal functions deprived by having tracheostomy tube). It may help to reduce spread of infection as well if the patient cough out infected phlegm or tracheal secretions without wearing tracheostomy bibs or tracheal stopper/cap. Other modification include oxygen inlet port (if required - not shown here). [HME - heat and moisture exchange device, arrow - tracheostomy tube with inner cannula in-situ].
Significant goitre (2,3) obstructing tracheostomy tube placement which need to be divided and transfixed. (1- anterior tracheal wall, S - superior towards chin, I - inferior towards chest, R - right side, L - left side)
Large external jugular vein (V) directly facing the midline area where tracheostomy to be performed.
The vein be separated and prepared to be ligated and cut.
Figure shows peri-stomal granulations and internally towards tracheal lumen. [black dots- peristomal granulations, stars- endotracheal granulations]
Endoluminal trachea suprastomal granulation (+).
Close-up view of the granulation (+) with the tracheostomy tube located just below its inferior edge.
in a functional larynx. The tube need to be changed as it will becomes dirty after prolonged use and potentially harbour microrganisms and bofilm
to cause tracheitis and granulations.
The TRACOE smart Cuff Manager monitors and regulates the internal pressure of Higj Volume Low Pressure cuffs of tracheostomy tubes as well as endotracheal tubes. The pressure is continuously held between 20 cm HO and 30 cm HO.
Rusch polyflex stent Dumont silicone stent
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