Combitube®: A New Proposal for a Confusing Nomenclature

We used the esophageal tracheal Combitube® (Kendall-Sheridan Catheter Corp., Argyle, NY) in a study designed to test some of its properties. During the preliminary phase of the study, we found that its original nomenclature is confusing. It has been described by Frass et al. (1–4) as a double-lumen and a double-cuffed tube, as follows:FIGURE 1FIGURE 2Figure 1: Original nomenclature of esophageal tracheal Combitube® (4).Figure 2: New proposed nomenclature of the esophageal tracheal Combitube®. 1. A proximal lumen, also referred as an esophageal lumen, with perforations at the pharyngeal site and the distal end sealed. This lumen is never opened to the esophageal lumen, and it is always related to the pharyngeal lumen. 2. A distal lumen, also referred as a tracheal lumen, with the distal end opened, which can be inserted into the trachea or the esophagus. 3. A pharyngeal balloon, to seal the pharynx. 4. A distal cuff, to seal the esophagus or trachea. In an article by Krafft et al. (5), describing a redesigned Combitube™, the esophageal lumen was referred as the pharyngeal lumen. We propose renaming the esophageal lumen the “pharyngeal lumen,” the tracheal lumen the “tracheoesophageal lumen,” and the distal cuff the “tracheoesophageal cuff.” We consider the term “pharyngeal balloon” appropriate. This would lead to a better understanding of Combitube™ characteristics and functions.