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Screening and Rehabilitation of Olfaction After Total Laryngectomy in Swedish Patients
Results From an Intervention Study Using the Nasal Airflow–Inducing Maneuver
Birgit Risberg-Berlin, SLP;
Riitta Ylitalo, MD, PhD;
Caterina Finizia, MD, PhD
Arch Otolaryngol Head Neck Surg. 2006;132:301-306.
Objectives To examine the olfactory function in patients with laryngectomy and to assess the results of the Nasal Airflow–Inducing Maneuver (NAIM) odor-rehabilitation technique.
Design A prospective intervention study.
Setting University hospital.
Patients Twenty-four patients, 21 men and 3 women, mean age 68 years, who underwent laryngectomy at least 5 months prior to intervention.
Intervention Speech therapists trained patients in the NAIM technique: simultaneous lowering of the jaw, floor of the mouth, tongue, base of the tongue, and soft palate while the lips are closed. Three interventions were given within 6 weeks.
Main Outcome Measure Olfactory testing with semistructured interview, the Questionnaire on Olfaction, Taste, and Appetite (QOTA), and the Scandinavian Odor-Identification Test (SOIT). Quality of life was measured with European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-H&N35 questionnaires. The patients were categorized as smellers or nonsmellers based on the SOIT results.
Results Before the treatment, 10 patients (42%) were smellers (ie, 6 had normosmia and 4 hyposmia), while 14 patients (58%) were nonsmellers (ie, all had anosmia). Thus, 18 patients had impaired olfaction. Using the NAIM technique, 13 (72%) of 18 patients with impaired olfaction showed improvement. Of the 14 nonsmellers, 7 converted to smellers after only 1 intervention session, giving us a success rate of 50% in anosmic patients after 1 session.
Conclusions Olfactory impairment is common in patients who underwent laryngectomy. The NAIM method is easy to learn and rapidly improves smell and taste. A single intervention session is sometimes sufficient, but many patients benefit from repeated training. The SOIT test is an effective and simple test for the assessment of olfaction acuity after laryngectomy.
Author Affiliations: Division of Logopedics and Phoniatrics, Sahlgrenska University Hospital, Göteborg (Dr Risberg-Berlin); Department of Otolaryngology, Karolinska Institute, Karolinska University Hospital, Stockholm (Dr Ylitalo); Department of Clinical Sciences–Otolaryngology, University of Umeå, Umeå (Dr Ylitalo); and Department of Otolaryngology, Sahlgrenska University Hospital Mölndal, Mölndal (Dr Finizia), Sweden.
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