Tracheal tube systems may include first and second tubes and an inflatable balloon. The first tube may be flexible and hollow and have first and second open ends. The inflatable balloon may be affixed to and circumferentially surround a portion of the first tube. The inflatable balloon may include an indentation sized and positioned to accommodate a portion of a second tube positioned therein, when the inflatable balloon is inflated. The second tube may be hollow and have a multiplicity of holes along a sidewall not in contact with the balloon. The second tube may be configured to be coupled to a suction device that creates a negative pressure in the second tube. When the tracheal tube system is inserted in a patient's trachea, the negative pressure in the second tube may act to remove, or suction out, fluids and other matter from the trachea.