Conclusions

The results of these studies suggest that the use of an HME can effectively reduce the physical and psychosocial problems after total laryngectomy. Continuous use of the HME, both day and night, is advisable to obtain an optimal pulmonary rehabilitative effect. With the availability of the Provox HME early post-operative pulmonary hygiene and voicing is improved. The short and long-term compliance with the use of this HME by laryngectomized patients, not always optimal in the past, is also clearly improved, because digital stoma occlusion is greatly facilitated by its valve mechanism. This device undoubtedly can improve the vocal prosthetic and pulmonary rehabilitation of laryngectomized patients, especially of those individuals who have too limited dexterity to handle a handsfree valve. It should be emphasized that an HME is a medical device. Optimal results can be expected only with better awareness of the medical team of the respiratory symptoms and the related psychosocial problems, and with proper patient education.