Attachment systems

Attachment of HME, Freehands HME and Provox Micron HME
The HME devices can be attached to the tracheostoma in two different ways: peristomally (base plate) or intraluminally (laryngectomy tube or stoma button).

For peristomal attachment the Provox HME can be attached into a variety of available Provox adhesives (Provox Optiderm, Regular, Flexiderm, or XtraBase). Additionally, some patients may require the use of Provox Silicone Glue to improve the seal of the adhesive to the skin. Other products that are required for proper application of the adhesive are Remove (to remove glue from the skin) and SkinPrep (to protect the skin against adhesive and glue and prevent skin irritation).

For intraluminal attachment the HME device can be attached into a LaryTube or a LaryButton. The primary goal of using a LaryTube or LaryButton is usually to maintain stoma patency, although more recently a LaryButton has also shown to be beneficial in combination with a hands-free speaking valve.

The Provox LaryTube
The Provox LaryTube is a so-called laryngectomy tube or tracheostoma tube. Many laryngectomized patients require a laryngectomy tube to maintain stoma patency, especially in the early postsurgical days and during postoperative radiotherapy (Ward, Acton, & Morton, 2006). Some patients experience permanent problems with stoma patency, requiring permanent use of a laryngectomy tube (Ward et al., 2006). The Provox LaryTube is the only laryngectomy tube available that holds an HME. The LaryTube can hold a Provox HME or Provox Freehands HME. The LaryTube is held in place with a tubeholder (necktie) or it can be clicked into a baseplate (model with Blue Ring). For patients using a voice prosthesis, a fenestrated LaryTube is available. Laryngectomy tubes are considered a necessary part of laryngectomy care. A stoma that is too small causes difficulties in breathing and changing the voice prosthesis. There are no studies available on LaryTube or laryngectomy tubes in general.

The Provox LaryButton
The Provox LaryButton is a so-called laryngectomy button or stoma button. A stoma button is primarily used in stoma’s that are shrinking and that have a tight ‘lip’ or ‘rim’ that holds the button in place (Ward et al., 2006). The LaryButton holds and HME or Freehands HME. Studies have shown that the use of a stoma button increases successful use of a hands-free speaking valve (Lewin et al., 2000). The LaryTube is stoma and patient friendly in design (rounder edges, softer materials) and that it can be held in place by using an additional neck tie or LaryClips (small adhesives combined with Velcro-attached hooks). These additional features enlarge the number of patients that is able to use the device. The need for a tight ‘lip’ or ‘rim’ to hold the button in place is less important. The LaryButton and LaryClips were only recently developed and a study that is still in press (Hilgers & Ackerstaff, 2006) demonstrated that the system was appreciated by the majority of the patients and that its use led to increased usage of hands free speaking valves.