title: Multicenter study assessing effects of heat and moisture exchanger use on respiratory symptoms and voice quality in laryngectomized individuals.
abstract: OBJECTIVE
  A multicenter study based in the United States assessed the heat-moisture exchanger effect on respiratory symptoms and "voice quality" of laryngectomees. PATIENTS AND MEASURES: The study group consisted of 81 consecutive laryngectomees (62 men and 19 women; mean age, 66 years; age range, 45 to 89 years), with a median follow-up of 3.5 years (range, 0.5 to 24 years). A structured questionnaire was used to assess 3-month results, and tally sheets recorded the frequency of cough-expectoration during first and last trial weeks.
  
  
  RESULTS
  Compliance was 73% (n = 59); decrease in coughing, 68%; sputum production, 73%; forced expectoration, 60%; and need for stoma cleaning, 52% of these 59 patients. Regarding daily cough-expectoration frequency, a statistically significant decrease (P < 0.0001) was found between the first and last trial weeks. Regarding influence on voice quality, 46% of regular users reported improvement in intelligibility, 30% in loudness, 37% in fluency, and 40% in telephone intelligibility. Fourteen patients (19%) reported skin irritation, with discontinuation of 7 patients.
  
  
  CONCLUSIONS
  The observed decrease in pulmonary symptoms and improvement in voice quality confirm earlier reports from the Netherlands, United Kingdom, and Spain indicating improvement in postlaryngectomy quality of life.
authors.affiliation: The Netherlands Cancer Institute, Amsterdam, The Netherlands. a.ackerstaff@nki.nl
authors.forename: Annemieke H
authors.initials: AH
authors.lastname: Ackerstaff
authors.forename: D
authors.initials: D
authors.lastname: Fuller
authors.forename: M
authors.initials: M
authors.lastname: Irvin
authors.forename: E
authors.initials: E
authors.lastname: Maccracken
authors.forename: J
authors.initials: J
authors.lastname: Gaziano
authors.forename: L
authors.initials: L
authors.lastname: Stachowiak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006875:Hydrotherapy / Q000009:adverse effects / Q000295:instrumentation*; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000295:instrumentation*; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012120:Respiration Disorders / Q000209:etiology / Q000628:therapy*; D012138:Respiratory Therapy / Q000009:adverse effects / Q000295:instrumentation*; D014833:Voice Quality