Randomised, multi-centre study of the usefulness of the heat and moisture exchanger (Provox HME) in laryngectomised patients

Dassonville, Olivier; Mérol, Jean; Bozec, Alexandre; Swierkosz, François; Santini, José; Chaïs, André; Marcy, Pierre; Giacchero, Paul; Chamorey, Emmanuel; Poissonnet, Gilles
November 2011
European Archives of Oto-Rhino-Laryngology;Nov2011, Vol. 268 Issue 11, p1647
Academic Journal
This study included 60 patients (30 in Nice and 30 in Reims), who were randomised between a control group that used no device of this type and a group equipped with the Provox HME. After 3 months of using the device, a notable improvement was found which was statistically significant with regard to cough ( P = 0.00174) and to bronchorrhoea ( P = 0.0031), and very close to achieving significance with regard to breathing effort. An overall improvement in the prosthetic (tracheo-oesophageal) voice was found in the 21 patients using the HME and a voice prosthesis for all of the parameters studied. The device was used daily by 80% of the patients of whom 42% used it day and night at the end of the 3 months. Seven patients suffered from minor cutaneous intolerance (of whom 6 had received radiation therapy), which did not require the use of the HME to be abandoned (PC). After 3 months, patients were asked the following questions: 'Do you feel any improvement?': 92% of affirmative answers; 'Are you breathing better?': 88% of affirmative answers; 'Are you speaking more easily?': 81% had experienced speech improvement. The general adaptation to the device was judged to be satisfactory for 95% of the patients after 3 months. The results of this randomised study show an improvement in the pulmonary symptoms and in the prosthetic voice after 3 months of using Provox HME. This light and easy-to-use device appears to us to afford a significantly improved quality of life for laryngectomees and should be offered systematically during functional rehabilitation of these patients.


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