{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T13:57:39Z","timestamp":1782655059456,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T00:00:00Z","timestamp":1550620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Supporting infrastructure for research within the department"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to compare the relative compliance and the dermatological and pulmonary outcomes when the Provox Luna system (Atos Medical, Malm\u00f6, Sweden) is added during the night to the usual tracheastoma care of laryngectomized subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter randomized crossover trial conducted in the Netherlands Cancer Institute, Erasmus Medical Center, and Maastricht University Medical Center in The Netherlands. The study included 46 laryngectomized subjects with prior heat and moisture exchanger (HME) and adhesive experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant improvement in the number of compliant individuals was found: Luna: n\u2009=\u200943 of 45 (96%); usual care: n\u2009=\u200935 of 46 (76%), <jats:italic>P<\/jats:italic> =\u20090.02. The Luna period was associated with longer intervals of daily HME use (Luna 23.2\u2009hours [range: 15.6\u201324.0\u2009hours], usual care [UC]: 21.5\u2009hours [range: 6.0\u201324.0\u2009hours], <jats:italic>P<\/jats:italic> =\u20090.003) and an increased frequency of skin improvement overnight (Luna 3.9\u2009days [standard deviation (SD)]: 7.0\u2009days), Usual Care: 8.1\u2009days ([SD: 10.8\u2009days], <jats:italic>P<\/jats:italic> =\u20090.008). Fifty\u2010six percent (n\u2009=\u200926) of participants wanted to continue using the Provox Luna system at the conclusion of the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An improvement in compliance and skin recovery overnight was observed when the Provox Luna was added to the usual adhesive and HME use. Therefore, there is utility in supplementing the usual post\u2010total laryngectomy care with the Provox Luna system at night, particularly in the setting of compliance concerns and in subjects who desire dermatological relief overnight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>1b<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:2354\u20132360, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27839","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T23:09:16Z","timestamp":1550704156000},"page":"2354-2360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multicenter randomized crossover trial evaluating the provox luna in laryngectomized subjects"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5188-9124","authenticated-orcid":false,"given":"Chathura B.B.","family":"Ratnayake","sequence":"first","affiliation":[{"name":"University of Auckland  Auckland New Zealand"},{"name":"Netherlands Cancer Institute  Amsterdam New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renske","family":"Fles","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute  Amsterdam New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Bing","family":"Tan","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute  Amsterdam New Zealand"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura W.J.","family":"Baijens","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Maastricht University Medical Center  Maastricht The Netherlands"},{"name":"School for Oncology and Developmental Biology\u2013GROW Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walmari","family":"Pilz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Maastricht University Medical Center  Maastricht The Netherlands"},{"name":"School for Oncology and Developmental Biology\u2013GROW Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees A.","family":"Meeuwis","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline H.E.","family":"Janssen\u2010van Det","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"van Son","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute  Amsterdam New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel W.M.","family":"Van den Brekel","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute  Amsterdam New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000021514"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100049690"},{"key":"e_1_2_6_4_1","unstructured":"van denBoerC. 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