ENT Tracheostomy tubes types classification Fuller Jackson cuff flange Fenestra Obturator What is

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Tracheostomy tubes for adults. Various types available are:
1. Uncuffed and cuffed tubes.
2. Double cuff tube. Each cuff can be inflated alternately to prevent pressure necrosis at one site.

3. Fenestrated tube. Single or multiple holes are situated at the upper curvature. The hole(s) help in speech production
or in weaning from tracheostomy. Fenestrated tube is used in children for decannulation.

4. Adjustable flange long tube. Extra length tracheostomy tubes are used when pretracheal tissues are thick or swollen
or to by-pass a growth or stenosis in trachea. Flange in these cases is movable and fixed at a desired place according
to the thickness of tissues of the neck.

5. Single lumen tube. There is no inner cannula
6. Double lumen tube. They have an inner cannula inside an outer cannula. It is easier to remove, clean and replace
the inner cannula, keeping outer cannula in place for breathing.

7. Suction-aid tracheostomy tubes. They have a small tube ending above the cuff to suck out pharyngeal secretion
and prevent their aspiration.

8. Tracheostomy with speaking valve. A valve is fitted at the outer end of tracheostomy tube. It allows ingress of air
when breathing in but closes when breathing out. In the latter situation air finds its way to vocal cords to produce
sound. It is used in long-term treatment of bilateral abductor paralysis or laryngeal stenosis. Digital closure of tracheostomy
tube to speak is thus avoided.
Classification of tubes according to the material
1. Silver. An alloy of silver, copper and phosphorus, e.g. Fuller, Negus or Jackson’s tube.
2. PVC (polyvinyl chloride). They are disposable, single use tubes and thermolabile, and thus adjust to tracheal lumen.
3. Silicone. Bacteria and secretions do not adhere to the tube and there is minimum of crusting.
4. Siliconized PVC. It has the properties of both PVC and silicon, i.e. it is thermolabile and adjusts to tracheal wall while silicon prevents crusting.
5. Silastic. It is soft and nonirritating, and minimizes crusting.
6. Armoured tubes. They are plastic tubes reinforced by a spiral or rings of stainless steel. They are not easily kinked(wont bend)
Fuller’s tracheostomy tube
Jackson’s tracheostomy tube.
Cuffed tracheostomy tube.
Cuffed suction - aid tracheostomy tube.

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