The use of tracheostoma humidification by people with total laryngectomy
in the UK: a cross-sectional survey.
Objectives: To investigate the use of tracheostoma humidification by
people with total laryngectomy (PTL) in the UK and explore influencing
factors. Design: National cross-sectional survey and case note review.
Setting: 26 UK National Health Service (NHS) centres providing care to
PTL. Participants: PTL reviewed by speech and language therapy (SLT)
between March and September 2020. Methods: Secondary analysis of data
collected during a national multi-centre audit of PTL completed in
response to the Covid-19 pandemic. Data were collected on type of
humidification used by PTL and demographic information. Type of
humidification was dichotomised as ‘HME’ (closed-system heat moisture
exchanger) or ‘non-HME’ (alternative stoma cover or no stoma cover).
Univariable analysis was performed to determine the association with
several potential explanatory variables including gender, age, living
circumstances, distance from treatment centre, communication method and
time elapsed since laryngectomy. A backwards selection procedure was
used to determine the final model for multiple regression analysis.
Results: Data were obtained from 1216 PTL from 26 centres across the UK;
information on type of tracheostoma humidification used was available
for 1097 PTL. Most PTL (69%) used an HME. Following multiple regression
analysis, time elapsed since laryngectomy (p=<0.001), living
circumstances (p=0.002) and communication method (p=<0.001)
were statistically significant factors in HME use. Conclusion: In the
UK, most PTL follow recommendations to use a closed-system HME, though
there is marked variability across centres. HME use is influenced by
time elapsed since laryngectomy, living circumstances and communication