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December 7, 1970

A Fenestrated Tracheostomy Tube

JAMA. 1970;214(10):1886. doi:10.1001/jama.1970.03180100076018

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To the Editor.—  When a decision is made to remove the tracheostomy tube from a patient, decannulation is performed in one of two ways.In the first, the tracheostomy tube is corked for one or more days while the patient is ambulatory. If the patient remains comfortable during this period and the need to uncork the cannula does not arise, the tube is removed and the stoma is covered with a dry dressing. While this method maintains a patent stoma during the trial period, the cannula inside the trachea will reduce the functional airway as the patient has to breath around it.In the second, the tube is removed without corking and the stoma is covered with a dry dressing. This is usually done after substituting successively smaller cannulae. While there is no encroachment on the airway, the stoma rapidly heals after decannulation. Premature decannulation may require another operation.The