Montreal's experience with Cyranose heat and moisture exchanger use in 15 laryngectomized patients.

Abstract

Objective: Evaluate the effects of the improvement of filtration, heating and humidification of inspired air with Cyranose heat and moisture exchanger (HME) on voice quality, breathing, and secretion handling in laryngectomized patients.

Design: Prospective study.

Setting: Fifteen laryngectomized patients, mean age 68, ages ranging from 50 to 91 years.

Methods: Information was given to patients through video and brochures. Patients were selected if they had minimal understanding, permanent decanulization, no tumour progression or bronchopulmonary infections, and received no recent radiation therapy treatment. They were given the prosthesis and a starter kit. They were then evaluated by a speech pathologist with a structured questionnaire after one week, one month, and three months.

Main outcome measures: The outcomes measured were comfort, breathing, secretions, and ease of use of the prosthesis as well as its effect on voice. Impressions of patients on humidification, filtration, and heating of inspired air were also recorded.

Results: At conclusion of trial, 75% of patients wore the prosthesis on a daily basis and they all found it easy to use. All patients who completed the trial found breathing and handling of secretions easier as they thought humidification and filtration of air had improved. Quality of voice improved for 50% while remaining unchanged for 37%. The positive effect of the prosthesis progressed throughout the trial. Seven patients dropped out of the trial, mainly because of adhesive-related issues.

Conclusion: Laryngectomized patients from the Montreal area could benefit from Cyranose artificial nose following an adaptation period during our cold winter.