For patients who need a cannula to stabilize the stoma, a special cannula system (the Provox LaryTube) has been developed, allowing the use of an HME without the necessity to use an adhesive (see figure below to the right). A very practical feature of this system is that for those patients who only use a cannula during the night, there is a LaryTube version containing a blue ring that fits in any of the Provox Adhesives (see figure right). This enables the patient to wear the HME in the usual Adhesive base plate during the day, and at night time allows the use of the cannula without the need to remove the Adhesive, if this is still properly glued in place. A LaryTube with a blue ring inserted in an Adhesive is also useful for combination with the Provox FreeHands HME. The cannula in the trachea stabilizes the automatic valve during voicing, which decreases the pressure on the adhesive even further, and potentially increases the time an airtight seal can be kept. Another advantage of the LaryTube cannula is that it enables the patient to use an HME during the postoperative radiation period, when the use of adhesives is often not recommended by most physicians, even not the hydrocolloid version (OptiDerm). Also in case of an irritated skin, when the use of adhesives is (temporarily) not possible, patients can still wear an HME, by using a LaryTube cannula.
The LaryTube is available in a fenestrated version, which is ready for use in patients with a voice prosthesis. There is also a fenestration punch (see figures below to the right) for individualized fenestration of the standard LaryTube (with or without the blue ring).