We have devised a technique for performing pulmonary function testing on patients with permanent tracheostomy stomas. A device consisting of a modified rubber mouthpiece and a peristomal patch is cemented to the patient's neck, directly over the stomal site. The patient is instructed to keep his mouth closed, and his nose is sealed by a nasal clip. Pulmonary function testing equipment is then attached to the device, and testing proceeds in the usual manner. With this method, no air leaked during testing, as it often does when tracheostomy tubes are used, and we were able to obtain reproducible flow-volume loops. No local anesthesia was required, and we have had no reports of adverse dermatologic reactions to the materials. We have used this technique successfully on more than 20 patients and have had no patient on whom we could not perform the desired spirometry.
