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November 1989

Food for Thought: Are Tracheostomy Tubes Redundant?

Author Affiliations

Nagoya, Japan

Arch Otolaryngol Head Neck Surg. 1989;115(11):1389. doi:10.1001/archotol.1989.01860350123031

To the Editor.—Tracheostomy was described as early as 100 BC by the Greek physician, Asclepaides. Since then, it has proven to be one of the mainstays of securing and maintaining an airway. Its many uses cannot be overemphasized. However, tracheostomy after-care is beset with a number of problems, not the least of which because of the cannula itself. Although the tube is a must for airway maintenance in certain situations such as overcoming an extremely low respiratory obstruction1 (Koenig's tube), prevention of aspiration of fluids (if the cuff is inflated), maintaining airway patency in laryngeal muscular spasms, and in the facilitation of speech, the overwhelming list of complications that results due to the tube per se, such as decannulation difficulties, tube occlusion and/or displacement, laryngotracheal trauma, and life-threatening hemorrhage due to erosion of the innominate artery, raises the important question of whether routine use of a tracheal

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