Direct comparison
Fenestrated vs Non-Fenestrated Trach: Differences
Fenestrated vs non-fenestrated trach tubes: opening design, Shiley models and inner cannula pairing, plus what a 2024 crossover trial found on airflow.
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How do Fenestrated tracheostomy tube, Non-fenestrated tracheostomy tube compare side by side?
The table below compares Fenestrated tracheostomy tube, Non-fenestrated tracheostomy tube across 11 procurement-relevant dimensions, from defining feature through source.
Side-by-side comparison
| Dimension | Fenestrated tracheostomy tube | Non-fenestrated tracheostomy tube |
|---|---|---|
| Defining feature | An opening (fenestration) in the wall of the outer cannula. | No opening in the outer cannula wall. |
| Air path when the tube opening is capped or unobstructed | Air can pass through the fenestration as well as around the tube, if the fenestration is unobstructed. | Air passes only around the tube. |
| Stated design purpose | Medtronic describes its Shiley adult fenestrated tubes as having an opening that allows increased airflow, so the patient can breathe through the upper airway. | No fenestration, so there is no designed airflow opening through the outer cannula wall. |
| Trial evidence on airflow | In a randomised crossover trial of 28 adults (Australian Journal of Otolaryngology, 2024), a fenestrated inner cannula did not change peak expiratory flow, FEV1 or maximum phonation time compared with a non-fenestrated inner cannula (P=0.66, 0.93, 0.66). The tube was an uncuffed fenestrated outer cannula with the opening corked, in head and neck surgical patients. | The comparison condition in that trial: the non-fenestrated inner cannula, inside the same outer cannula. |
| Fit of the fenestration | Fenestration malposition was seen in 71% of participants (90% of males, 25% of females); half of those were partial and half complete obstruction by the tracheal wall. The authors note fenestrated tubes often fit poorly. | No fenestration, so fenestration position does not apply. |
| Shiley model codes | DFEN (cuffed, disposable inner cannula), DCFN (cuffless, disposable inner cannula), FEN (cuffed, reusable inner cannula), CFN (cuffless, reusable inner cannula). Medtronic lists four configurations in total. | Shiley DCT and DCFS are listed with the standard disposable inner cannula (DIC). |
| Inner cannula compatibility (Shiley disposable) | The fenestrated disposable inner cannula (DICFEN) is listed for DFEN and DCFN only. The standard DIC is also listed for DFEN and DCFN. | The standard DIC is listed for DCT, DCFS, DFEN and DCFN. |
| Inner cannula formats | DICFEN has a snap-lock, green colour-coded connector; sizes 4, 6, 8, 10; 10 per box; sterile, single use. The reusable inner cannula has a 15 mm twist-lock connector and, per Medtronic, may be cleaned and reused up to 29 days on a single patient. | The standard DIC is sterile and single use, and is not made with natural rubber latex (Medtronic). |
| Sizes and supply facts (Shiley fenestrated tubes) | Jackson sizes 4, 6, 8 and 10; sterile, individually packaged; optional high-volume, low-pressure cuff; not made with natural rubber latex. | Confirm model-specific details in the manufacturer directions for use. |
| When each is chosen | The care team may choose it when an opening in the outer cannula is wanted. Because the cannula part must match the tube model, order the inner cannula listed for that model. The trial above found no airflow gain in its population, so this is a clinical decision, not a purchasing one. | The care team may choose it when no opening is wanted. The standard DIC is listed for all four Shiley families above. Selection is a clinical decision; this page gives no medical advice. |
| Source | Medtronic Shiley adult fenestrated tracheostomy tube product page (read 2026-10-31); Pryor et al., Australian Journal of Otolaryngology 2024, doi 10.21037/ajo-23-15 (read 2026-10-31). | Medtronic Shiley disposable inner cannula product page (read 2026-10-31); same AJO article for the definition. |
Common questions
Common questions about Fenestrated tracheostomy tube vs Non-fenestrated tracheostomy tube
What is a fenestrated tube tracheostomy?
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It is a tracheostomy tube whose outer cannula has an opening, called a fenestration, in its wall. If the opening lines up with the airway and is unobstructed, air can pass through it as well as around the tube; a non-fenestrated tube allows air only around it (Pryor et al., Australian Journal of Otolaryngology, 2024). Manufacturers such as Medtronic describe the opening as allowing increased airflow so the patient can breathe through the upper airway. Whether a fenestrated tube is used is a decision for the patient's care team.
Going deeper
