# Comparison of functional aspects and quality of life before and after using the heat and moisture exchange in total laryngectomy patients

## TL;DR

This study found that using a heat and moisture exchange filter improved sleep quality and cough-related quality of life in total laryngectomy patients over time.

## Contribution

The study provides longitudinal evidence of functional improvements in laryngectomy patients using a heat and moisture exchange filter.

## Key findings

- Sleep quality improved significantly after 2 weeks of using the filter.
- Cough-related quality of life improved and was maintained after 4 weeks.
- Voice handicap scores showed a trend toward improvement but were not statistically significant.

## Abstract

To compare self-assessment of voice handicap, sleep quality, and quality of life related to coughing and swallowing before and after using a heat and moisture exchange filter in total laryngectomized patients.

This was a prospective longitudinal study whose participants completed the Voice Handicap Index (VHI), Pittsburgh Sleep Quality Index (PSQI), Leicester Cough Questionnaire (LCQ), and MD Anderson Dysphagia Inventory (MDADI) at three times: (T1) before starting to use the heat and moisture exchange filter, (T2) 2 weeks after using it, and (T3) 4 weeks after using it.

14 participants (12 men) with a mean age of 66.4 ± 5.8 years. The medians of the total VHI score at T1, T2, and T3 were, respectively, 65.5 (47.5-86.3), 55.5 (39.5-71.3), and 44.5 (39-72), p=0.085. The medians of the PSQI score at T1, T2, and T3 were, respectively, 6.5 (4.25-11.8), 4.5 (2.25-10.8), and 3.0 (2.0-5.75), p=0.010. The medians of the total MDADI score at T1, T2, and T3 were, respectively, 78.6 (69.1-92.7), 76.3 (73.3-92.6), and 85.7 (72.7-94), p=0.571. The medians of the total LCQ score at T1, T2, and T3 were, respectively, 16.7 (13.1-18.5), 19.1 (17.4-19.4), and 19.0 (17.3-19.9), p=0.002.

The total laryngectomized patients participating in this study self-assessed an improvement in the emotional domain of voice handicap, sleep quality, and cough-related quality of life after 2 weeks of using a heat and moisture exchange filter. They also maintained the perception of improvement after 4 weeks of using the device.

Comparar a autoavaliação da desvantagem vocal, da qualidade do sono e da qualidade de vida relacionadas à tosse e à deglutição antes e após o uso do filtro permutador de calor e umidade em laringectomizados totais.

Estudo prospectivo longitudinal, no qual os participantes foram submetidos à aplicação dos instrumentos Índice de Desvantagem Vocal (IDV), Índice de Qualidade do Sono de Pittsburgh (PSQI), Leicester Cough Questionnaire (LCQ) e Inventário de Disfagia MD. Anderson (MDADI) em três momentos: (T1) antes do início do uso do filtro permutador de calor e umidade, (T2) após duas semanas e (T3) após quatro semanas de uso do dispositivo.

14 participantes (12 homens), com média de idade de 66,4±5,8 anos. As medianas do escore total do IDV em T1, T2 e T3 foram, respectivamente, 65,5(47,5-86,3), 55,5(39,5-71,3) e 44,5(39-72), p=0,085. As medianas do escore do PSQI em T1, T2 e T3 foram, respectivamente, 6,5(4,25-11,8), 4,5(2,25-10,8) e 3,0(2,0-5,75), p=0,010. As medianas do escore total do MDADI em T1, T2 e T3 foram, respectivamente, 78,6(69,1-92,7), 76,3(73,3-92,6) e 85,7(72,7-94), p=0,571. As medianas do escore total do LCQ em T1, T2 e T3 foram, respectivamente, 16,7(13,1-18,5), 19,1(17,4-19,4) e 19,0(17,3-19,9), p=0,002.

Os laringectomizados totais participantes deste estudo apresentam percepção de melhora do domínio emocional da autoavaliação da desvantagem vocal, da qualidade do sono e da qualidade de vida relacionada à tosse após duas semanas de uso de filtro permutador de calor e umidade. Ademais, estes participantes mantêm a percepção de melhora após quatro semanas de uso do dispositivo.