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Tracheotomy is often successfully used to manage tracheal stenosis, as a temporizing measure prior to definitive treatment or a long-term remedy. In some patients, where a sizeable portion trachea is stenotic, the fixed arm of an ordinary tracheotomy tube may not be of sufficient length to satisfactorily maintain the distal tracheal lumen, and commercially available adjustable tubes may not be at hand in certain clinical settings. Herein, we describe a simple method of constructing a temporary tracheotomy tube with an adjustable distal arm, allowing custom fit at the patient bedside.