ABSTRACT
Considerable differences exist between a standard and custom tracheotomy tube. The standard tracheotomy (Fig. 6, upper) tube length is 67-79mm and a fenestration at 30mm. The second tube (Fig. 6, lower) is a custom tracheotomy tube for a 75-year-old patient with severe OSA and CHF caused by a compressive inoperable thyroid goiter. The tube length is 92mm and the fenestration distance is 61mm. This patient recovered, became ambulatory and continues wearing the same size custom tracheotomy for the past 4 years. OSA patients with tracheal compression, tracheal stenosis, or large necks who cannot be treated successfully with surgical methods are ideal candidates for a custom tracheotomy.
