Using a Heat and Moisture Exchanger (Provox XtraHME)

Purpose of the XtraHME

After laryngectomy the function of the nose and upper airways is lost because you are breathing through your tracheostoma instead of your nose. The air you breathe in is not heated and humidified. Cold, dry air is inhaled directly into the lungs which often results in undesirable pulmonary side effects such as increased coughing and sputum production, sleeplessness and other social implications.

The heat and moisture exchanger (HME) heats and moisturizes inhaled air. The foam inside the HME cassette traps heat and moisture from the exhaled air. This heat and moisture is then returned to the inhaled air. Consistent HME users, who use the HME day and night (24/7) often experience fewer problems with coughing and mucus production. This also may improve sleep and quality of life. The lid on the HME helps with stoma occlusion.

The Provox XtraHME is available in two versions:
XtraMoist HME has capacities close to normal nasal function. The humidification is improved and the XtraMoist is still keeping the good airflow for easy breathing. XtraMoist is recommended for patients who have recently undergone a total laryngectomy, and for accustomed users.

XtraFlow HME is focusing on having superior airflow. XtraFlow is great to use when exercising and when adapting to the breathing resistance after having been without an HME for a longer time.

Benefits of using an HME

1. Respiratory Health
Research has shown that consistently wearing an HME often reduces coughing and sputum production.

2. Hygiene
With an HME your hands have less direct contact with your stoma helps keeping both your hands and stoma cleaner.

3. Appearance
Wearing an HME covers the stoma and allows a more discreet appearance.

4. Voice
Users of a voice prosthesis report improved voice quality. Another benefit is that the stoma is reportedly easier to occlude, which also makes speaking easier.

5. Quality of Life
Research has shown that consistent users of an HME often report better sleep and less fatigue.

References:
Ackerstaff, A.H., Fuller, D., Irvin, M., MacCracken, E., Gaziano, J., & Stachowiak, L. (2003). Multi-center study assessing effects of heat and moisture exchanger use on respiratory symptoms and voice quality in laryngectomized individuals. Otolaryngology Head and Neck Surgery, 129, 705-712.
Ackerstaff, A.H., Hilgers, F.J.M., Balm, A.J.M., & Tan, I.B. (1998). Long term compliance of laryngectomized patients with a specialized pulmonary rehabilitation device, Provox Stomafilter. Laryngoscope, 108, 257-260.
Herranz Gonzalez-Botas, J., Suarez, T., Garcia Carreira, B., & Martinez Moran, A. (2001). Experiencia con el uso del HME-Provox Stomafilter en pacientes laringuectomizados (Experience with the HME-Provox Stomafilter in laryngectomized patients). Acta Otorrinolaringol Española, 2001, 221-225.
Masson AC, Fouquet ML, Gonçalves AJ. (2008). Tracheostoma humidifier: influence on secretion and voice of patients with total laryngectomy. Pro Fono, 20(3), 183-9.
Van As, C.J., Hilgers, F.J., Koopmans-van Beinum, F.J., & Ackerstaff, A.H. (1998). The influence of stoma occlusion on aspects of tracheoesophageal voice. Acta Otolaryngol, 118, 732-738.