IMPROVEMENTS IN RESPIRATORY AND PSYCHOSOCIAL FUNCTIONING FOLLOWING TOTAL LARYNGECTOMY BY THE USE OF A HEAT AND MOISTURE EXCHANGER

A prospective clinical study in 61 patients was undertaken to investig ate the subjective and objective influence of a heat and moisture exch anger (HME) on the respiratory and psychosocial problems following tot al laryngectomy. Although statistical comparisons failed to detect sig nificant differences between the experimental and the control groups, there was a clear trend toward-improvements in respiratory and psychos ocial functioning in the experimental group. Analyses of differences o ver time within the HME user group showed significant reductions in th e incidence of coughing, the mean daily frequency of sputum production , forced expectoration, and stoma cleaning. Significant improvements w ere also found in shortness of breath, fatigue and malaise, sleep prob lems, levels of anxiety and depression, and perceived voice quality. P ulmonary function tests showed significant improvements in inspiratory flow and volume values following use of the HME. This objective impro vement in inspiratory pulmonary function reflects the decrease in sput um production reported by the patients.