A prospective observational study of care after total laryngectomy – effect of a "new generation" of heat and moisture exchangers (HME) in HME-experienced patients

Objectives The aim of this prospective observational study is to evaluate the effects of a new generation of heat and moister exchangers (NG-HMEs) on the pulmonary rehabilitation, quality of life and patient satisfaction.

Materials and methods A prospective study on HME-experienced laryngectomised patients. Patients were interviewed at three time periods, at inclusion, after 6 and 12 weeks after the use of NG-HMEs. For each interview, two validated questionnaires, CASA-Q (Cough and Sputum Assessment Questionnaire) and EQ-5D (European Quality of Life 5 Dimensions) Index Score and Visual Analog Scale, were used to determine pulmonary complaints and quality of life. Usage tendencies and patient satisfaction were reported using study specific questionnaires.

Results 23 patients with an average age of 65.7 ± 6.8 years (87% (n=20) male) were examined, those patients underwent total laryngectomy before 33.7 ± 35.3 months on average. NG-HMEs were used for a mean of 22 ± 5 hours/day (p= 0.34). After 12 weeks of use, patients report an upward trend in 3 of the 4 domains of the CASA-Q: cough symptom (+5; p= 0.66), sputum symptom (+8; p= 0.13) sputum impact (+3; p= 0.54). The EQ-5D index score increased (+0.024; p= 0.92) as well the EQ-5D VAS (+0.8; p= 0.27). Average number of expectorations per day decreased from 9.2 to 7.2 (p= 0.073). All patients (n =23) reported satisfaction with their experience with the NG-HMEs rating it with ≥ 3 out of 5. The patients with the longest duration of use benefitted the most (CASA-Q: cough symptom (+11; p= 0.11), cough impact (+8; p= 0.13), sputum symptom (+10; p= 0.16), sputum impact (+10; p= 0.08).

Conclusion The NG-HMEs demonstrate positive clinical effects on the pulmonary rehabilitation after total laryngectomy.

Publication History

Article published online:
12 May 2023