An Exploratory Study on the Efficacy of a New Heat and Moisture Exchanger (Provox® LifeTM) for Laryngectomized Patients

Objective: After a total laryngectomy, patients lose various physiological functions of the upper airway. To address these issues, an artificial nose (heat and moisture exchanger (HME)) has been developed. However, the current HMEs do not provide sufficient physiological upper airway function. We prospectively investigated the efficacy of a new type of HME and compared it with that of the current type.

Methods: This was a pre- and post-comparative study comparing the efficacy of the current HME and the new HME using a questionnaire (physiological upper airway function, skin complications, and adherence, especially for nocturnal HME). Patients who underwent laryngectomy were asked to use the new type of HME for six weeks and to complete questionnaires three days before and six weeks after starting the use of the new HME. The values for each question were statistically compared using paired t-tests.

Results: A significant decrease in the number of coughs per day was observed (before use: 6.89, after use: 3.16; p = 0.049). The degree of dyspnea significantly improved (before use: 7.77 cm, after use: 9.28 cm; p = 0.013). The number of days of nocturnal HME use improved significantly from 0 days to 33.32/42 days after the use of the new HME (p <0.0001).

Conclusion: To the best of our knowledge, for the first time in Japan, we showed that the new HME can improve respiratory symptoms, such as the number of coughs per day, degree of breathlessness, and nocturnal HME use.