Smell Rehabilitation: Recovery of Olfactory Perception and Discrimination in Twelve Cases of Total Laryngectomy

Objective: Total laryngectomy (TL) is a surgical practice widely used in the therapy of advanced laryngeal cancer. Since TL provokes loss of both speech and smell functions, the aim of the present work was to evaluate the effect of a smell rehabilitation cycle in twelve total laryngectomized patients. Methods: Twelve laryngectomized patients were enrolled to undergo a smell rehabilitation cycle in addition to previously performed speech recovery. For this aim the Nasal Airflow-Inducing Maneuver (NAIM) was employed to allow air to reach the nasal cavities again. Both olfactory perception and olfactory discrimination of odorous substances were evaluated by numeric scores to assess the modifications induced by the smell rehabilitative intervention on the recovery of the olfactory functions. Results: Smell capability, as regards the olfactory perception, ameliorated in the group of patients already after the first week of the smell rehabilitation cycle. Subsequently also the olfactory discrimination was evaluated, both at the end of the rehabilitation cycle (day 28) and after a period of twelve months, and we observeda significant amelioration at the end of the rehabilitative intervention that was essentially maintained even after one year although without a constant assistance performed by speech therapists. Conclusions: Smell rehabilitation should be always considered after TL in addition to speech restoration. Recovered smell perception and discrimination could enhance the related taste sensitivity, therefore restored olfactory functions could also ameliorate significantly the quality of life in total laryngectomized patients.