Without HME 



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Laryngectomized patients have lost their respiratory functions of the nose since they breath through their tracheostoma in the neck. Figure 1.5 illustrates the problem that laryngectomees encounter. During expiration, a relatively high amount of the heat and moisture contained in the expired air is lost. During inhalation, relatively cool and dry ambient air enters the tracheobroncheal tree.

The trachea and conducting airways are now highly involved in the air conditioning process. Consequently, the mucus composition becomes more viscous decreasing the escalator transport. This process has clearly been demonstrated in animal studies.68,69

Many laryngectomized patients complain about excessive amounts of phlegm production. This can partly be explained by the lost air conditioning and filtering that has occurred as well as the epithelial changes due to the years of smoking that most of these patients have done.

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Copyright 1998 Medical Illustrations
Last modified: January 07, 1999

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