Medical Oncologist
CION Cancer Clinics
The parts of a tracheostomy tube, explained for families | CION Cancer Clinics
A tracheostomy tube usually has an outer tube that stays in the neck, a flat plate that rests on the skin, and a removable inner tube, the inner cannula, that slides out for cleaning. Some tubes also have a cuff, a guide for insertion and a connector for valves or filters. Knowing each part makes daily care calmer and emergencies quicker to handle. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What are the parts of a tracheostomy tube?
- What does each part do?
- What should be kept next to the bed?
- How is the inner tube taken out and put back?
- Which words describe the type of tube?
- What mistakes do families make with the tube?
- What can this page not tell you about your own tube?
- Common questions about tracheostomy tube parts
The short answer
What are the parts of a tracheostomy tube?
Most tracheostomy tubes have an outer tube that stays in the neck, a flat plate that rests on the skin, and a removable inner tube that slides in and out for cleaning. Some also have a small balloon called a cuff, a guide used to insert the tube, and a connector for a valve or filter.
Why it helps to know the parts
When you go home, you and your family become the people who look after the tube. Knowing which part does what makes daily care less frightening. It also matters in an emergency. If breathing through the tube becomes hard, the first step is usually to take out the inner tube, and you can only do that quickly if you already know which part it is.
Not every tube has every part
Tubes come in plastic, silicone and metal, and in many designs. A metal tube often has an inner tube that locks in place. Many plastic tubes used soon after surgery have a cuff. Some tubes have no inner tube at all. Before discharge, ask the nurse to name every part on your own tube and write down its type and size.
The size and type are usually printed on the flat plate of the tube. Take a photo of it and keep it on your phone.Part by part
What does each part do?
These are the parts you are most likely to handle. Your own tube may have only some of them.
Outer tube
The curved main tube that sits inside the windpipe and keeps the opening open. It stays in place between planned changes and should not be taken out at home unless you have been trained.
Flange or neck plate
The flat wings on the outside that rest against the neck. The ties pass through its holes, and it stops the tube slipping in too far or out.
Inner tube, or inner cannula
A thinner tube that fits inside the outer one. Phlegm collects on it, so it is removed and cleaned or replaced, leaving the outer tube and the airway undisturbed.
Remember
- Remove it first if the tube seems blocked
- Put it back promptly after cleaning
Cuff and pilot balloon
The cuff is a soft balloon near the tip that seals the windpipe when filled with air. A thin line leads to a small outside balloon that shows whether the cuff is filled.
Only fill or empty the cuff as your team has instructed.Obturator, or introducer
A smooth, rounded guide that sits inside the tube while it is being inserted, then is pulled out straight away. Keep it by the bed with the spare tube.
Connector and caps
The opening of the tube, sized to fit a filter, a speaking valve, an oxygen mask or a cap. Some inner tubes carry this connector.
Not sure whether this applies to you?
Ask an oncologistAlways within reach
What should be kept next to the bed?
- A spare tube of the same size, with its introducer
- A spare tube one size smaller
- A clean spare inner tube, if your tube uses one
- Suction machine and suction catheters that fit
- Spare ties, dressings and scissors with rounded tips
- The emergency card and the helpline number
The part you handle most
How is the inner tube taken out and put back?
Prepare
Wash your hands well. Have the clean or spare inner tube ready before you remove the one in use, so the gap is short.
Steady the plate
Hold the flange gently with one hand so the outer tube does not move. Unlock the inner tube if it has a lock or twist fitting.
Slide it out along the curve
Draw the inner tube out following its curve, down and towards you. Put in the clean one the same way and lock it if needed.
Clean the used one
Clean it exactly as your nurse showed you, or discard it if it is a single-use type. Never use sharp brushes that could scratch it.
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On the packet
Which words describe the type of tube?
- Cuffed or uncuffed
- Whether the tube has a balloon near the tip. Cuffed tubes are common soon after surgery.
- Fenestrated
- The tube has a small window in its curve that lets air pass up to the voice box, which can help speech.
- Plain or fenestrated inner tube
- Inner tubes can come with or without that window, to match the outer tube and the stage of recovery.
- Metal tube
- A silver or steel tube, often used for longer-term tracheostomies, that is cleaned and reused.
- Heat and moisture exchanger
- A small foam filter that clips onto the tube and warms and moistens the air you breathe.
Commonly believed
What mistakes do families make with the tube?
"The inner tube can stay out while we clean it slowly."
The inner tube is what stops phlegm building up on the outer tube. Clean it and put it back promptly, or fit the spare while you clean the used one.
"Any tube of the same size will do."
Tubes of the same size from different makers can differ in length and curve, and inner tubes are not interchangeable between brands. Buy replacements that match exactly what the team fitted.
"If the balloon on the line looks flat, we should pump it up."
Some people are meant to have the cuff empty, especially when using a speaking valve. Filling it with a valve on can stop breathing. Follow your team's instructions only.
"The introducer is just packaging."
It is needed to put a tube back in safely. Keep it clean, with the spare tube, where you can find it in a hurry.
Being straight with you
What can this page not tell you about your own tube?
This page describes tubes in general. It cannot tell you which design you have, how often your inner tube should be cleaned or changed, whether your cuff should be filled, or when it is safe to use a speaking valve. Those depend on why the tube was placed and how you are recovering.
Who should not rely on this page alone
If you have gone home with a newly placed tube, a cuffed tube, or a tube that has never been changed, the instructions from your own team come first. The same is true for anyone who breathes through a laryngectomy stoma rather than a tracheostomy, because the equipment and emergency steps are different.
Questions to ask before discharge
What is the type and size of my tube? Does it have an inner tube and a cuff? How often should each part be cleaned or changed? Where can we buy matching spares in Hyderabad or our district? Who do we call if a part breaks or goes missing?
Ask to practise taking out and putting back the inner tube on the ward, more than once, with the nurse watching.Questions we are asked
Common questions about tracheostomy tube parts
What is an inner cannula for?
The inner cannula is the removable tube that sits inside the outer tube. Phlegm sticks to it rather than to the outer tube. Taking it out to clean or replace it keeps the airway clear without disturbing the tube in the neck. It is also the first thing to remove if breathing through the tube becomes hard.
How often should the inner tube be cleaned?
It depends on the type of tube and how much phlegm there is. Some families clean it several times a day at first, and less often as things settle. Some inner tubes are disposable and simply replaced. Follow the schedule your nurse gives you, and clean it sooner whenever breathing sounds noisy.
What does the small balloon on the thin line show?
That is the pilot balloon. It is connected to the cuff inside the windpipe. When the cuff is filled, the pilot balloon feels firm. When it is empty, the pilot balloon is soft and flat. It is a guide only. Do not add or remove air unless your team has taught you to.
Why is there a spare tube one size smaller?
If the tube comes out and the opening starts to narrow, a same-size tube may not slide back in. A smaller tube is easier to insert and keeps the airway open until help arrives. Your nurse will show you when and how to use it.
Can I use a speaking valve with any tube?
No. A speaking valve lets air in through the tube but sends it out past the tube through the voice box. That only works if air can get around the tube, so a cuff must be fully empty. Use a valve only after your team says it is safe for your tube.
Are metal tubes better than plastic ones?
Neither is better for everyone. Metal tubes are durable and reusable, and are common for long-term use. Plastic and silicone tubes are lighter, can have a cuff, and are often used soon after surgery. Your team chooses based on your airway and care needs.
What should I do if a part cracks or is lost?
Use the spare straight away, and do not try to repair a cracked inner tube or connector with tape. Then call your treating team or the helpline to arrange a matching replacement. This is why keeping the type and size written down matters.
Are tube parts covered by Aarogyasri or insurance?
The first tube is usually included with the operation under approved cancer treatment. Aarogyasri, CGHS, ECHS, EHS and most cashless insurers are accepted at CION. Spare tubes, inner tubes and filters for home are often not covered. Call the helpline to check your own cover.
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Sources
- NHS — Tracheostomy
- Macmillan Cancer Support — Head and neck cancer
- Cancer Research UK — Laryngeal cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Cleaning the Inner TubeStep-by-step care for the part you handle mostCuffed vs Uncuffed TubesWhat the cuff does and when it is let downBlocked Tube: The Emergency Every Family Must KnowWhy the inner tube comes out firstTracheostomy Supplies and Cost in HyderabadBuying matching spares and what they costTracheostomyEvery page in this guide
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