TRACHEOSTOMY

There are different types of tracheostomy tubes available in the market. Basically there are metallic and non metallic tubes. Metallic tubes have different shapes and sizes. Fuller's metallic tube has an inner tube and an outer tube. Inner tube is longer than the outer tube to prevent crusting. It has an opening on its shoulder for phonation. The outer tube is bi- phalanged.The purpose of phalanges is that the tube can be easily inserted by pinching the phalanges. The advantage of this metallic tube is that its insertion is easy. Secondly if inner tube is removed for cleaning purposes, the outer tube remains in the trachea to maintain respiration.Another advantage is phonation. The patient can learn to close the opening of tracheostomy tube with the finger and phonate as the inner tube has an opening for phonation.The disadvantage is that ventilators are difficult to connect with these tubes. Secondly these can cause pressure necrosis of trachea and the tube can itself get erroded and fall in the trachea causing a foreign body in airway.