HI. Thanks for your query. This patient has been on tracheostomy - a tube kept in the trachea for a proper respiration. ( indication not noted by you). It looks the tube has eroded through the posterior ( back) of the trachea and entered into the esophagus. This is caled TOF= Tracheo-oesophageal Fistula. This means there is a connection between the trachea ( windpipe ) and oesophagus ( food pipe). Further process definitely is surgical correction . The fistulous tract is excised and both the tubes are repaired to keep them separate as they were. Being the most difficult area and a typical blood supply as well as the typical functions , the surgery can be done at a super-specialist center by an exprienced surgeon or a TEAM of surgeons. The patient s fitness is very important for the outcome of such procedure. The hemoglobin, proteins in the body have to be really optimum and needs a great preparation. With the advent of stents these procedures have been giving better results.