Abstract
Post-laryngectomy heat and moisture exchanger (HME) use is known to have a beneficial effect on tracheal climate, pulmonary symptoms and related aspects. This study aims to investigate differences in clinical effects between the first and second generation Provox HMEs. The second generation (Provox XtraHME) has better humidification properties than the first generation (Provox HME), and has been shown to further improve tracheal climate. Forty-five laryngectomized patients, who were already using an HME, participated in a prospective, randomized cross-over clinical study in which each HME was used for 6 weeks. Results showed that for most parameters studied, the second generation HME performed equally well or better than the first generation HME. The improvement in tracheal climate translated into patients reporting significantly less tracheal dryness with the second generation than with the first generation (p = 0.039). Using an HME with better humidification properties is related to a reduction in tracheal dryness in our study population.
Similar content being viewed by others
References
Togawa K, Konno A, Hoshino T (1980) A physiologic study on respiratory handicap of the laryngectomized. Arch Otorhinolaryngol 229(1):69–79
Ackerstaff AH, Hilgers FJ, Meeuwis CA, Knegt PP, Weenink C (1999) Pulmonary function pre- and post-total laryngectomy. Clin Otolaryngol Allied Sci 24(6):491–494
Griffith TE, Friedberg SA (1964) Histologic changes in the trachea following laryngectomy. Ann Otol Rhinol Laryngol 73:883–892
Ackerstaff AH, Hilgers FJ, Aaronson NK, Schouwenburg PF, van Zandwijk N (1990) Physical and psychosocial sequelae of total larynx extirpation and the use of a heat and moisture exchanger. Ned Tijdschr Geneeskd 134(50):2438–2442
Ackerstaff AH, Hilgers FJ, Balm AJ, Tan IB (1998) Long-term compliance of laryngectomized patients with a specialized pulmonary rehabilitation device: provox Stomafilter. Laryngoscope 108(2):257–260
Ackerstaff AH, Hilgers FJ, Aaronson NK, Balm AJ, van Zandwijk N (1993) Improvements in respiratory and psychosocial functioning following total laryngectomy by the use of a heat and moisture exchanger. Ann Otol Rhinol Laryngol 102(11):878–883
Ackerstaff AH, Hilgers FJ, Aaronson NK et al (1995) Heat and moisture exchangers as a treatment option in the post-operative rehabilitation of laryngectomized patients. Clin Otolaryngol Allied Sci 20(6):504–509
Scheenstra RJ, Muller SH, Vincent A, Ackerstaff AH, Jacobi I, Hilgers FJ (2011) A new heat and moisture exchanger for laryngectomized patients: endotracheal temperature and humidity. Respir Care 56(5):604–611
Lorenz KJ, Maier H (2009) Pulmonary rehabilitation after total laryngectomy using a heat and moisture exchanger (HME). Laryngorhinootologie 88(8):513–522
Zuur JK, Muller SH, de Jongh FH, van Zandwijk N, Hilgers FJ (2006) The physiological rationale of heat and moisture exchangers in post-laryngectomy pulmonary rehabilitation: a review. Eur Arch Otorhinolaryngol 263(1):1–8
Keck T, Durr J, Leiacker R, Rettinger G, Rozsasi A (2005) Tracheal climate in laryngectomees after use of a heat and moisture exchanger. Laryngoscope 115(3):534–537
Zuur JK, Muller SH, Vincent A, Sinaasappel M, de Jongh FH, Hilgers FJ (2009) The influence of a heat and moisture exchanger on tracheal climate in a cold environment. Med Eng Phys 31(7):852–857
Scheenstra RJ, Muller SH, Hilgers FJ (2011) Endotracheal temperature and humidity in laryngectomized patients in a warm and dry environment and the effect of a heat and moisture exchanger. Head Neck 33(9):1285–1293
Scheenstra RJ, Muller SH, Vincent A, Sinaasappel M, Hilgers FJ (2010) Influence of breathing resistance of heat and moisture exchangers on tracheal climate and breathing pattern in laryngectomized individuals. Head Neck 32(8):1069–1078
Herranz Gonzalez-Botas J, Suarez T, Garcia CB, Martinez MA (2001) Experience with the HME-Provox stomafilter in laryngectomized patients. Acta Otorrinolaringol Esp 52(3):221–225
Bien S, Okla S, van As-Brooks CJ, Ackerstaff AH (2010) The effect of a heat and moisture exchanger (Provox HME) on pulmonary protection after total laryngectomy: a randomized controlled study. Eur Arch Otorhinolaryngol 267(3):429–435
Hilgers FJ, Aaronson NK, Ackerstaff AH, Schouwenburg PF, van Zandwikj N (1991) The influence of a heat and moisture exchanger (HME) on the respiratory symptoms after total laryngectomy. Clin Otolaryngol Allied Sci 16(2):152–156
Hilgers FJ, Ackerstaff AH, Balm AJ, Gregor RT (1996) A new heat and moisture exchanger with speech valve (Provox stomafilter). Clin Otolaryngol Allied Sci 21(5):414–418
Ackerstaff AH, Fuller D, Irvin M, Maccracken E, Gaziano J, Stachowiak L (2003) Multicenter study assessing effects of heat and moisture exchanger use on respiratory symptoms and voice quality in laryngectomized individuals. Otolaryngol Head Neck Surg 129(6):705–712
Acknowledgments
The authors would like to acknowledge Atos Medical for providing the HMEs used in this study free of charge.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Herranz, J., Espiño, M.A. & Morado, C.O. Pulmonary rehabilitation after total laryngectomy: a randomized cross-over clinical trial comparing two different heat and moisture exchangers (HMEs). Eur Arch Otorhinolaryngol 270, 2479–2484 (2013). https://doi.org/10.1007/s00405-013-2493-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-013-2493-1