Abstract: A talking tracheostomy tube according to the teachings of the present invention is shown in the preferred embodiment as including an inner cannula removably received within an outer cannula. The tracheostomy tube further includes, in the preferred embodiment, a first cuff for sealing between the outer cannula and the trachea for substantially preventing air introduced through the inner cannula to escape from the trachea through the larynx. In the preferred embodiment, air is introduced into the trachea above the first cuff by ports directionally drilled through the outer cannula and in fluid communication with a secondary passageway formed by and between the inner and outer cannulas. The inner end of the secondary passageway is formed by a sealing obstruction integrally formed in the inside surface of the outer cannula adjacent the inner end for the sealing receipt of the inner cannula.