The Speech Cannula allows ventilator dependent patients to speak regardless of cuff inflation or ventilator manipulation. It does so with a flap valve and bubble valve. The flap valve opens during inhalation allowing the bubble valve to expand into the fenestration sealing it. The flap valve will close during exhalation allowing the bubble valve to collapse and unblock the fenestration. When the fenestration is unblocked the air is directed up through the fenestration to the vocal cords allowing speech. The Speech Cannula can only be used with the Blom Fenestrated Cuffed Tube.