• Cindy van den Boer, Jonathan H Vas Nunes, Sara H Muller, Vincent van der Noort, Michiel W M van den Brekel, and Frans J M Hilgers.
• Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
• Otolaryngol Head Neck Surg. 2014 Jun 1; 150 (6): 999-1004.

ObjectiveAfter total laryngectomy, patients suffer from pulmonary complaints due to the shortcut of the upper airways that results in decreased warming and humidification of inspired air. Laryngectomized patients are advised to use a heat and moisture exchanger (HME) to optimize the inspired air. According to manufacturers' guidelines, these medical devices should be replaced every 24 hours. The aim of this study is to determine whether HMEs still function after 24-hour tracheostoma application.Study DesignAssessment of residual water uptake capacity of used HMEs by measuring the difference between wet and dry core weight.SettingTertiary comprehensive cancer center.Subjects And MethodsThree hygroscopic HME types were tested after use by laryngectomized patients in long-term follow-up. Water uptake of 41 used devices (including 10 prematurely replaced devices) was compared with that of control (unused) devices of the same type and with a control device with a relatively low performance.ResultsAfter 24 hours, the mean water uptake of the 3 device types had decreased compared with that of the control devices. For only one type was this difference significant. None of the used HMEs had a water uptake lower than that of the low-performing control device.ConclusionThe water uptake capacity of hygroscopic HEMs is clinically acceptable although no longer optimal after 24-hour tracheostoma application. From a functional point of view, the guideline for daily device replacement is therefore justified.© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

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