(Soft) tube and button
If the skin does not (yet) tolerate any plaster, a flexible soft tube (22 mm connection) or button may be used, which is placed into the stoma.
So-called buttons are available also. These buttons have a raised rim that keeps them in place in the tracheostoma. They provide airtight closure of the stoma during talking and prevent the tracheostoma from shrinking. Such buttons unfortunately do not fit in each stoma.
If stoma lumen is maintained, the periods that no tube or button is warn are slowly increased, as individual situations permit.
During and immediately after irradiation, the stoma frequently tends to shrink. A cannula or button can be used to prevent this.
Filter cassettes and hands-free speech valves can be placed both in the buttons and in the soft tubes.
Tubes and buttons are available in various types and sizes. The nurse, speech therapist or ENT physician can assess whether such tubes or buttons are suitable devices for the patient.