It is hard to speak with a tracheostomy tube in situ. There are certain tracheostomy tube accessories that enables the patient to speak with the tube in place. One such accessory is the speaking valve. It is a button like equipment placed on the outer hub of the tracheostomy tube. These valves are one-way valves that can be attached to the outer end of the tracheostomy tube. These valves allow air to enter through the tube and exit through the mouth and nose.
This is a bayonet shaped instrument with a very sharp trocar like tip. The tip is guarded at some distance to ensure that the tip does not prevent too deep into the tissue. In quinsy drainage the sharp tip is used to pierce the bulge of the swelling with the forceps in closed position. Then after successful piercing it is opened like a sinus forceps to facilitate drainage of pus.