A tracheotomy tube is a device that is surgically placed into the trachea low in the neck, with its tip well inside the trachea and its other end anchored to a faceplate that sits on the surface of the neck. A tracheotomy tube allows an individual to breathe directly from the neck opening into the trachea as an alternative to normal breathing through the nose and/or mouth. “Trach” is the colloquial term used by clinicians to refer to a tracheotomy tube.
Tracheotomy (1 of 4)
This woman was gravely ill and intubated longterm. A tracheotomy was required. Now she wants the tube removed.
View below vocal cords (2 of 4)
The tip of the scope has been taken below the vocal cords. Note the fenestrated tracheotomy tube within the high trachea.
Fenestra (3 of 4)
When the patient plugs her trach tube with a finger, air comes into the distal tip of the tube (dark circle within the tube), passes up and out of the fenestra (window) and can power the vocal cords which are above our view. The trachea surrounds the tube as a whole without any "blow-by". If there were no fenestra, the patient would be unable to speak.
Patient post-trach (4 of 4)
After tracheal resection and re-anastomosis, the tracheotomy is no longer needed. The circular scar is at the dotted line. The M denotes overlying mucus. The patient now breathes normally.