The Hans Rudolph Metro Seal™ is a disposable, medical adhesive and thermoplastic elastomer, tube securement device intended to hold securely in place on the patient’s face an accessory tube which is routed under a face mask and to thus enable a seal between the mask, tube and patient’s skin.The Metro Seal is intended to be used with any size Hans Rudolph oro-nasal mask when it is necessary to pass and secure an accessory tube (12 to 18 French) under the mask to the patient’s nasal or oral orifices from somewhere outside of the mask. The accessory tubes involved may include but are not limited to nasogastric tubes and esophageal balloon catheters. The associated masks involve applications for single and bilevel CPAP, Non-Invasive Ventilation, and other clinical or research settings by individuals that have received at least minimal instruction or training on the use of the Metro Seal as well as the device and system with which the Metro Seal is associated.