A 93-year-old man with a 73-year-old tracheostoma presented with rest dyspnea caused by bilateral pleural effusions because of chronic pulmonary hypertension (PAPsystol~50 mmHg). He had received the tracheostoma in 1931 in our hospital as an “ultima ratio therapy” for severe chronic dyspnea because of upper airway obstruction from bilateral recurrent nerve injury following goiter surgery in 1930. After the tracheostomy he developed good phonation, developed a normal lifestyle, established a family with three children and even became important in his community for one election period. For 73 years his self-management of tube change and sterilization was excellent. He never suffered severe local or pulmonary infections, although he was chronically exposed to dust in his job as a carpenter, and never used devices for warm humidification of the inspired air. From our point of view, this patient is an encouraging example for all children and patients with chronic tracheostomy for a positive mindset concerning their future life management.
