{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:45:01Z","timestamp":1789501501676,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Permanent tracheostomy because of total laryngectomy surgery entails significant consequences for patients regarding respiratory physiopathology, such as the loss of the filtering, humidifying, and heating of air by the nose. The use of special stomal filters can provide adequate protection of the tracheal\u2013bronchopulmonary system with a reduction in respiratory pathologies. In fact, in most cases, laryngectomy patients are first cigarette smokers who for this reason also already have respiratory diseases such as chronic obstructive pulmonary disease (COPD). Despite the availability of tracheal filters, as reported in the literature, patients often tend to limit their use due to reported breathing difficulties, especially in conditions of intense breathing. Methods: The objective of this clinical study was to evaluate the most suitable stomal filter for laryngectomy patients during physical activity. The filters studied were an INHEALTH device (Blom-Singer SpeakFree HME); two ATOS devices (Provox\u00ae Life\u2122 Energy HME and Provox\u00ae Life\u2122 Home HME); and an FAHL device (Laryvox HME Sport). Results: For this purpose, the performances of 31 laryngectomy patients, subjected to medium\u2013high physical effort, were analyzed through a standardized pneumological test, the Six Minute Walking Test (6MWT), which involves a sustained walk lasting six minutes, with an evaluation of heart rate, oxygen saturation, and meters traveled every 60 s; furthermore, we examined two subjective indices, namely, the basal and final dyspnea index and the initial and final muscular fatigue index. Conclusions: The multidisciplinary approach of the laryngectomee patient must also take pulmonary rehabilitation into consideration. It is the task of the medical team and speech therapy support to help the patient in the correct choice of HME filters taking into account daily needs.<\/jats:p>","DOI":"10.3390\/jcm13113137","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T09:33:31Z","timestamp":1716802411000},"page":"3137","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quality of Life and Respiratory Performance in the Laryngectomized Patient: Role of the HME Filters during Physical Activity"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5081-1552","authenticated-orcid":false,"given":"Massimo","family":"Mesolella","sequence":"first","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, University Federico II of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4312-4711","authenticated-orcid":false,"given":"Salvatore","family":"Allosso","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, University Federico II of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Mormile","sequence":"additional","affiliation":[{"name":"Autonomic Service of Pneumology, Policlinical University Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Quaremba","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Errante","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, University Federico II of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"D\u2019Aniello","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, University Federico II of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Motta","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Mental and Physical Health and Preventive Medicine, University Luigi Vanvitelli, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Catalano","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, University Federico II of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Motta","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Mental and Physical Health and Preventive Medicine, University Luigi Vanvitelli, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Salerno","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, University Federico II of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1002\/ijc.21855","article-title":"Trends in laryngeal cancer mortality in Europe","volume":"119","author":"Bosetti","year":"2006","journal-title":"Int. J. Cancer."},{"key":"ref_2","first-page":"870","article-title":"The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: The MD Anderson Dysphagia Inventory","volume":"127","author":"Chen","year":"2001","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/lary.29027","article-title":"Health-Related Quality of Life Following Total Laryngectomy: A Systematic Review","volume":"131","author":"Wulff","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1002\/lio2.381","article-title":"Interaction of functional and participation issues on quality of life after total laryngectomy","volume":"5","author":"Leemans","year":"2020","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"106184","DOI":"10.1016\/j.jcomdis.2022.106184","article-title":"Characteristics associated with communicative participation after total laryngectomy","volume":"96","author":"Dahl","year":"2022","journal-title":"J. Commun. Disord."},{"key":"ref_6","first-page":"3191","article-title":"Sport in the rehabilitation of patients after total laryngectomy","volume":"36","author":"Besser","year":"2016","journal-title":"Anticancer Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.anorl.2011.02.010","article-title":"Quality of life in patients treated for advanced hypopharyngeal or laryngeal cancer","volume":"128","author":"Guibert","year":"2011","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mesolella, M., Allosso, S., D\u2019aniello, R., Pappalardo, E., Catalano, V., Quaremba, G., Motta, G., and Salerno, G. (2023). Subjective Perception and Psychoacoustic Aspects of the Laryngectomee Voice: The Impact on Quality of Life. J. Pers. Med., 13.","DOI":"10.3390\/jpm13030570"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1590\/S2179-64912011000100017","article-title":"Modifications and evaluation of smell and taste functions in total laryngectomy: Systematic review","volume":"23","author":"Caldas","year":"2011","journal-title":"J. Soc. Bras. Fonoaudiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"546","DOI":"10.5935\/1808-8694.20130099","article-title":"Gustatory and olfactory dysfunction in laryngectomized patients","volume":"79","author":"Caldas","year":"2013","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/S0194-59980301595-X","article-title":"Multicenter Study Assessing Effects of Heat and Moisture Exchanger Use on Respiratory Symptoms and Voice Quality in Laryngectomized Individuals","volume":"129","author":"Ackerstaff","year":"2003","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E865","DOI":"10.1002\/lary.28517","article-title":"Secondary Tracheoesophageal Puncture After Laryngectomy Increases Complications With Shunt and Voice Prosthesis","volume":"130","author":"Scherl","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_13","first-page":"1391","article-title":"Adult height and head and neck cancer: A pooled analysis within the INHANCE Consortium","volume":"36","author":"Leoncini","year":"2014","journal-title":"Head Neck."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00405-005-0969-3","article-title":"The physiological rationale of heat and moisture exchangers in post-laryngectomy pulmonary rehabilitation: A review","volume":"263","author":"Zuur","year":"2006","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1055\/s-0029-1225619","article-title":"Pulmonale rehabilitation nach totaler laryngektomie durch die verwendung von HME (Heat Moisture Exchanger)","volume":"88","author":"Lorenz","year":"2009","journal-title":"Laryngorhinootologie"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1177\/000348940111000709","article-title":"Airflow resistance of airflow-regulating devices described by independent coefficients","volume":"110","author":"Verkerke","year":"2001","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1097\/00005537-199706000-00017","article-title":"An efficiency comparison of four heat and moisture exchangers used in the laryngectomized patient","volume":"107","author":"Grolman","year":"1997","journal-title":"Laryngoscope"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","article-title":"American Thoracic Society ATS Statement: Guidelines for the Six-Minute Walk Test","volume":"166","author":"Issues","year":"2002","journal-title":"Am. J. Respire Crit. Care Med."},{"key":"ref_19","unstructured":"Borg, G. (1998). Borg\u2019s Perceived Exertion and Pain Scales, Human Kinetics."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3539","DOI":"10.1007\/s00405-014-3396-5","article-title":"Pathohistological changes of tracheal epithelium in laryngectomized patients","volume":"272","author":"Rosso","year":"2015","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1080\/00016480802572517","article-title":"Prospective controlled study of microbial colonization of the trachea in tracheotomized and laryngectomized patients with HME (heat and moisture exchanger)","volume":"129","author":"Kramp","year":"2009","journal-title":"Acta Otolaryngol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s00106-020-00905-1","article-title":"Tracheostoma valves and their associated risks","volume":"69","author":"Kress","year":"2021","journal-title":"HNO"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1177\/000348941312200602","article-title":"Long-term use of heat and moisture exchangers among laryngectomees: Medical, social, and psychological patterns","volume":"122","author":"Brook","year":"2013","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"739","DOI":"10.3109\/00016480903382790","article-title":"Short-term endotracheal climate changes and clinical effects of a heat and moisture exchanger with an integrated electrostatic virus and bacterial filter developed for laryngectomized individuals","volume":"130","author":"Scheenstra","year":"2010","journal-title":"Acta Otolaryngol."},{"key":"ref_25","first-page":"301","article-title":"Quality of life with voice prosthesis after total laryngectomy","volume":"33","author":"Massaro","year":"2021","journal-title":"Iran. J. Otorhinolaryngol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S48","DOI":"10.1016\/j.ijsu.2014.05.055","article-title":"Current therapeutic prospectives in the functional rehabilitation of vocal fold paralysis after thyroidectomy: CO2 laser aritenoidectomy","volume":"12","author":"Testa","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jcomdis.2015.06.008","article-title":"The multidimensional impact of total laryngectomy on women","volume":"56","author":"Cox","year":"2015","journal-title":"J. Commun. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1136\/bjsports-2015-094684","article-title":"The impact of physical activity on health-related fitness and quality of life for patients with head and neck cancer: A systematic review","volume":"50","author":"Capozzi","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mesolella, M., Allosso, S., Salerno, G., and Motta, G. (2023). Sport in the Laryngectomized Patient: A Literature Review and Single Case Presentation. J. Pers. Med., 13.","DOI":"10.3390\/jpm13060982"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Schwartz, A.L., and Terry, C.M. (2021). Returning to sport: Female athletes living with and beyond cancer. Int. J. Environ. Res. Public Health, 18.","DOI":"10.20944\/preprints202105.0783.v1"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/j.1399-6576.1990.tb03112.x","article-title":"Performance evaluation of six heat and moisture exchangers according to the Draft International Standard (ISO\/DIS 9360)","volume":"34","author":"Eckerbom","year":"1990","journal-title":"Acta Anaesthesiol Scand."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.otc.2015.04.010","article-title":"Quality of Life After Conservation Surgery for Laryngeal Cancer","volume":"48","author":"Sadoughi","year":"2015","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"913S","DOI":"10.1177\/0145561320929941","article-title":"Voice Quality, Function, and Quality of Life for Laryngeal Cancer: A Prospective Longitudinal Study Up to 24 Months Following Radiotherapy","volume":"100","author":"Tuomi","year":"2021","journal-title":"Ear Nose Throat J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1002\/lary.29857","article-title":"Health-Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy","volume":"132","author":"Wulff","year":"2022","journal-title":"Laryngoscope"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"03000605211014784","DOI":"10.1177\/03000605211014784","article-title":"Neuroendocrine carcinoma of the larynx with Lambert-Eaton myasthenic syndrome: A rare case report and literature review","volume":"49","author":"Mesolella","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"144 e9","DOI":"10.1016\/j.jvoice.2020.11.017","article-title":"Acoustic Characterization of the Voice with a Tracheoesophageal Speech in Laryngectomized Patients. Similarities and Differences with the Laryngeal Voice","volume":"37","year":"2023","journal-title":"J. Voice"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s00520-003-0516-y","article-title":"Implementation of the Vienna Hydrotherapy Group for Laryngectomees\u2014A pilot study","volume":"11","author":"Crevenna","year":"2003","journal-title":"Support. Care Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"873","DOI":"10.6004\/jnccn.2020.0031","article-title":"Head and neck cancers, version 2.2020","volume":"18","author":"Pfister","year":"2020","journal-title":"J. Natl. Compr. Cancer Netw."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3137\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:48:59Z","timestamp":1760107739000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,27]]},"references-count":38,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13113137"],"URL":"https:\/\/doi.org\/10.3390\/jcm13113137","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,27]]}}}