Custom biopsy punch fenestrations of tracheostomy tubes in clinic for tracheal stenosis: a case series

OBJECTIVE: To present a novel method for creating custom fenestrations in tracheostomy tubes in the clinic setting, to aid in the decannulation of patients with tracheal stenosis. METHODS: A retrospective case series was performed of six adult patients with tracheal stenosis who received custom fenestrated tracheostomy tubes due to failed capping trials. RESULTS: Six of six patients were initially decannulated. Three patients required replacement of their tracheostomy tube. One patient developed granulation tissue at the site of the fenestration. CONCLUSION: Custom-made fenestrations in tracheostomy tubes in the clinic allow for immediate evaluation and modification of the fenestration. This allows for capping trials and subsequent decannulation in patients with tracheal stenosis. Further studies comparing this technique to commercial fenestrated tracheostomy tubes can help delineate its efficacy.