Olfaction following total laryngectomy

Abstract

Total laryngectomy (TL) results in the complete disconnection of the upper and lower respiratory tract, ceasing orthonasal airflow. Hence, olfaction and olfactory acuity are negatively impacted. Prior to the late 1990s, impaired olfaction was simply accepted as a negative consequence of TL surgery. However, a growing body of research conducted within this past decade has demonstrated that rehabilitation is possible with a simple and effective behavioral technique. The current review outlines the literature supporting the negative impact of altered olfaction on quality of life, details of known best practice methods for olfactory assessment both for research and clinical use, and outlines the evidence for interventions known to improve olfactory performance in the TL population. Intervention for olfactory impairment should be part of a holistic, evidence-based rehabilitation process for patients post-laryngectomy. Optimized content for mobile and hand-held devicesHTML pages have been optimized of mobile and other hand-held devices (such as iPad, Kindle, iPod) for faster browsing speed. Click on [Mobile Full text] from Table of Contents page. This is simple HTML version for faster download on mobiles (if viewed on desktop, it will be automatically redirected to full HTML version)

Rehabilitation of olfaction post‐laryngectomy: a randomised control trial comparing clinician assisted versus a home practice approach

“…Any participant identified as being anosmic was subsequently assessed using a laryngeal bypass device 4,6–9 to provide a clinical indication of upper airway patency and function of the olfactory epithelium. Of the 30 anosmic participants, five were unable to comfortably generate nasal airflow and bypass was discontinued.…”

“…The five sessions involved practise of the NAIM with clinician feedback to assist in refining the manoeuvre to maximise their air intake and minimise excessive jaw movements as detailed in van As‐Brooks et al. 4 The sessions also involved practice performing functional tasks such as smell identification of common smells (e.g. coffee, spices) which were presented during the session.…”

“…Therefore, the best method of instructing the patient was to ask them to yawn with their mouth closed, i.e., a ‘polite’ yawn. The learning of the manoeuvre was facilitated by supplying patients in both groups with visual biofeedback using a U‐tube manometer 4,11 . Details regarding U‐tube manometers for use in olfaction rehabilitation can be found reported elsewhere 4 …”

“…The primary and dominant mode of smell perception is via orthonasal olfaction, the process whereby odorants enter via the nostrils on inhaled air and travel to the receptors in the olfactory epithelium located on the ceiling of the nasal cavity 1,2 . The secondary means of smell perception occurs via retronasal olfaction, the process by which odorants are produced in the oral cavity during mastication of food, and travel up through the posterior pharyngeal space and into the nasal cavity 3,4 …”

Interferência das variáveis sexo e idade no olfato e no paladar em crianças com e sem rinite alérgica

“…The first and main is the orthonatal route, in which, through the inhalation of air, the odor molecules reach the olfactory epithelium, located in the nasal cavity. The second mode of olfactory perception occurs via retronasal route, in which the odors produced in the oral cavity, during chewing of food reach the posterior region of the pharynx up to the nasal cavity, reaching the olfactory epithelium (6,7) .…”