Takeda Hiroko, Shinomiya Hirotaka, Fujiwara Hajime, Furukawa Tatsuya, Teshima Masanori, Nibu Ken-Ichi
Department of Otolaryngology-Head and Neck Surgery, Kobe University Hospital, Kobe, JPN.
Cureus. 2024 Nov 8;16(11):e73279. doi: 10.7759/cureus.73279. eCollection 2024 Nov.
After a total laryngectomy, patients lose various physiological functions of the upper airway. To address these issues, an artificial nose (heat and moisture exchanger (HME)) has been developed. However, the current HMEs do not provide sufficient physiological upper airway function. We prospectively investigated the efficacy of a new type of HME and compared it with that of the current type.
This was a pre- and post-comparative study comparing the efficacy of the current HME and the new HME using a questionnaire (physiological upper airway function, skin complications, and adherence, especially for nocturnal HME). Patients who underwent laryngectomy were asked to use the new type of HME for six weeks and to complete questionnaires three days before and six weeks after starting the use of the new HME. The values for each question were statistically compared using paired -tests.
A significant decrease in the number of coughs per day was observed (before use: 6.89, after use: 3.16; p = 0.049). The degree of dyspnea significantly improved (before use: 7.77 cm, after use: 9.28 cm; p = 0.013). The number of days of nocturnal HME use improved significantly from 0 days to 33.32/42 days after the use of the new HME (p <0.0001).
To the best of our knowledge, for the first time in Japan, we showed that the new HME can improve respiratory symptoms, such as the number of coughs per day, degree of breathlessness, and nocturnal HME use.
全喉切除术后，患者会丧失上呼吸道的多种生理功能。为解决这些问题，已研发出人工鼻（热湿交换器（HME））。然而，目前的热湿交换器无法提供足够的上呼吸道生理功能。我们前瞻性地研究了一种新型热湿交换器的疗效，并将其与当前类型进行了比较。
这是一项前后对照研究，使用问卷（上呼吸道生理功能、皮肤并发症和依从性，尤其是夜间热湿交换器的使用情况）比较当前热湿交换器和新型热湿交换器的疗效。接受喉切除术的患者被要求使用新型热湿交换器六周，并在开始使用新型热湿交换器前三天和六周后完成问卷。每个问题的值使用配对检验进行统计学比较。
观察到每日咳嗽次数显著减少（使用前：6.89次，使用后：3.16次；p = 0.049）。呼吸困难程度显著改善（使用前：7.77厘米，使用后：9.28厘米；p = 0.013）。使用新型热湿交换器后，夜间使用热湿交换器的天数从0天显著增加到33.32/42天（p <0.0001）。
据我们所知，在日本首次表明新型热湿交换器可改善呼吸症状，如每日咳嗽次数、呼吸困难程度和夜间热湿交换器的使用情况。
