A New System Enabling Both Speech and Artificially Aided Ventilation

A new system that enables both speech and artificially aided ventilation is reported. The system consists of 1) BiPAP® (Respitronics Inc., USA), an extracorporeal artificial ventilator of the flow-triggered type, small size and light weight ; 2) a nasal pressure mask ; and 3) a fenestrated tracheotomy tube (FEN type, Shiley Inc.). These instruments were applied to a 42-year-old female patient with progressive spinal muscular atrophy. She had been suffering from chronic respiratory failure, but showed no bulbar palsy. She was artificially ventilated by the BiPAP® which was connected to the inner tube of the tracheotomy tube when she was at rest. When she wished to speak, the pressure mask was firmly fixed on her nose with a rubber belt and connected to the BiPAP®, the inner tracheotomy tube was extracted and the outer tracheotomy tube was inserted.After these procedures, she could speak with a very good voice and articulation using passively expirated air through the fenestration of the tracheotomy tube.