A tracheostomy tube is necessary to keep the tracheostoma open to help you breathe. There are a variety of different tubes that range in size, materials, whether it has a cuff (balloon-like feature), and other characteristics. Some tubes can even be customised to specific needs.
A medical team will help determine what type of tracheostomy tube is best for each patient. Most tracheostomy tubes have two tubes, one inside of another. They are also referred to as cannulas. The outer cannula typically stays in place for a longer period of time and the inner cannula can be removed for cleaning.
Tracheostomy tubes are available in two basic types: cuffed or uncuffed (cuffless).
The cuff is like a balloon that seals against the inside walls of your trachea/windpipe. When the cuff is inflated, it can reduce the risk of secretions from entering the lower portion of the airway and/or form a seal if you need to use a ventilator. The cuff is typically inflated right after surgery to prevent any postoperative blood and/or secretions from entering the lungs. Once stabilised, the medical team will determine when it is appropriate to begin deflating the cuff or possibly changing to a cuffless tracheostomy tube if indicated.
When you can breathe on your own and don’t have any problems with swallowing or managing your secretions, you can usually have a cuffless tracheostomy tube. If you have a cuffless tracheostomy tube, you will breathe in and out of the tube. Air may also pass around the tube up to the upper airway allowing for improved speech.
A fenestrated tracheostomy tube means that there are openings on the curve of the tube to allow for air to more efficiently move up to the vocal cords. This can allow for a stronger voice.
As a result of the tracheotomy, there is a new way of breathing where breathing through your mouth and nose is either reduced or completely bypassed. This means that the inhaled air you breathe may no longer be heated, moisturised, and/or filtered, and the sense of smell can be affected. This may result in more coughing, mucus production, and a greater risk of infection. Since the amount of exhaled air moving up through your vocal cords is either stopped or reduced, your voice is also affected. The type of tube you have will dictate how much this will be affected.