Rehabilitation of Olfaction After Laryngectomy by Means of a Nasal Airflow-Inducing Maneuver

Abstract

A LTHOUGH deterioration of olfaction after total laryngectomy is reported by the majority of patients,1 this unpleasant side effect has not received widespread attention. Moreover, olfactory rehabilitation has been given much less consideration than other more obvious sequelae of this operation, ie, vocal and pulmonary rehabilitation.2 In several overviews on the "total rehabilitation of laryngectomees," olfactory problems as a consequence of the laryngectomy were not even mentioned.3-5 It was thought that the anosmia, noted immediately after the operation, was an inevitable result of the laryngectomy and that no return of olfactory acuity occurred as long as 8 years after operation.6,7 Others, however, have reported improvement in olfaction during the first 6 months after surgery8 and the presence of a relatively normal sense of smell in some laryngectomees.9,10 A recent study in our clinic showed that patients who have undergone laryngectomy could be divided into 2 groups on the basis of an odor detection and/or an odor differentiation test, ie, "smellers" and "nonsmellers."10 These tests were performed without artificial devices to generate a nasal airflow. The results of these "natural" tests indicated that one third of the patients could be classified as smellers. This category of patients reported not only a better sense of smell than the nonsmellers but also a better sense of taste and appetite.