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The use of tracheostoma humidification by people with total laryngectomy in the UK: a cross-sectional survey.
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  • Jane Dunton,
  • Joanne Patterson,
  • Carol Glaister,
  • Kate Baker,
  • Sarah Woodman,
  • Elizabeth Rowe,
  • Roganie Govender
Jane Dunton
Guy's and St Thomas' Hospitals NHS Trust
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Joanne Patterson
University of Liverpool
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Carol Glaister
Birmingham City University

Corresponding Author:[email protected]

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Kate Baker
Royal Marsden NHS Foundation Trust
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Sarah Woodman
South Tees Hospitals NHS Foundation Trust
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Elizabeth Rowe
Chesterfield Royal Hospital NHS Foundation Trust
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Roganie Govender
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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 method.