Olfactory rehabilitation after total laringectomy

A Study on the Effects of Polite Yawning Technique on Rehabilitation of Olfaction After Total Laryngectomy

Background: Laryngeal cancer is one of the most common head and neck cancers for which total laryngectomy is the preferred treatment in advanced stages. Major disabilities of this surgical procedure include loss of voice and nasal function, swallowing difficulties, and psychological consequences. Objectives: This study aimed to investigate the effect of the Polite Yawning technique on olfactory quality in patients undergoing total laryngectomy. Methods: In this cross-sectional study, after total laryngectomy, the patients with olfactory dysfunction were enrolled and the quality of olfaction was evaluated by the Quick Odor Detection test before and after receiving the Nasal Airflow Inducing Maneuver technique training. Statistical analysis was performed using SPSS 21 software by the Wilcoxon or McNemar’s test. The significance level was considered for P ≤ 0.05. Results: A total of 40 patients were evaluated. The mean age was 55.98 ± 6.27 years. Eighty-five percent of the patients were male (n = 34). The difficulty score in learning maneuvering was 2.5 ± 1.3, and 90% had no problem with learning it. Before maneuver, none of the patients had normal olfaction and had hyposmia mostly (n = 32, 80%). Immediately after the maneuver, there was a sensation of smell in all patients and the rate of hyposmia in patients was reduced to 65% (P = 0.008). Normal olfactory status was reported in half of the patients one month after the maneuver (21 patients, 52.5%, P = 0.0001), and there was a sense of smell in all patients (P = 0.0001). Conclusions: The results proved that olfactory quality can be rehabilitated after laryngectomy by the nasal airflow-inducing maneuver (the “Polite Yawning” technique). It is a patient-friendly method; however, a single training session is probably insufficient and most patients may need more training sessions.

Alterações e avaliação das funções do olfato e do paladar em laringectomizados totais: revisão sistemática

O objetivo desse estudo foi rever de forma sistemática as alterações nas funções do olfato e do paladar em indivíduos submetidos à laringectomia total, bem como identificar na literatura os aspectos envolvidos na avaliação dessas funções nesta população. Foi realizada uma revisão sistemática a partir das bases de dados MedLine, LILACS e SciELO, tendo a busca de dados ocorrida em outubro/2010. Foram encontrados 84 artigos a partir da busca de descritores e termo livre, sendo 79 da Medline, via Pubmed, e cinco da LILACS e da SciELO. Destes, foram selecionados 16 artigos. A maioria dos estudos, nesta revisão, atestou diminuição das funções sensoriais do olfato e do paladar em indivíduos submetidos à laringectomia total e, embora haja consenso com relação aos prejuízos causados a essas funções pela interrupção do fluxo aéreo nasal, ainda não é possível evidenciar minuciosamente os mecanismos e estruturas envolvidas, principalmente no que se refere às alterações da mucosa olfatória