This case study was undertaken to describe the use and limitations of glossopharyngeal breathing (GPB) by a ventilator-dependent, tracheotomized patient after cervical tumor resection. A 6-yr, 8-mo-old, tracheotomized, ventilator-dependent boy, after cervical tumor resection, learned GPB on his own and used it for ventilator-free breathing. Over the next 16 yrs, his GPB efficacy improved to the point that, with a vital capacity of 670 ml, his GPB maximum single-breath capacity increased to 3300 ml. This was limited by the fact that at 2.9 l of lung volume, air began to leak around the tracheostomy tube walls and out of the stoma. Still, GPB permitted up to 12 hrs/day of ventilator-free breathing. Measurements of assisted peak cough flow and GPB lung insufflations exceeding vital capacity are the main measures that demonstrate adequate tube fit to permit effective GPB in the presence of an indwelling tracheostomy tube.