Retronasal and Orthonasal Olfactory Ability After Laryngectomy

Abstract

To characterize orthonasal and retronasal olfactory ability in patients who have had a total laryngectomy (TL).Design: Prospective psychophysical evaluation of orthonasal and retronasal olfactory function.

Endoscopy findings affect subjective smell rehabilitation in post-laryngectomy patients using the nasal airflow-inducing manoeuvre

“…Therefore, patients who have completely lost their sense of smell may benefit more from the nasal airflow-inducing manoeuvre. 8,10 However, we did not find a significant relationship between the smell rehabilitation programme outcome and other nasal endoscopy findings. This could result from our small sample size or from differences in endoscopy findings for non-use rhinitis and neuroepithelial changes to the olfactory cleft, as claimed by Miani et al 6 Further studies with larger sample sizes are therefore needed to identify the effective elements of the nasal airflow-inducing manoeuvre.…”

“…[2][3][4][5] Separation of the airway passage from the nose prevents odorous particles reaching the olfactory cleft, leading to deterioration in the sense of smell and taste. [1][2][3][4][5][6][7][8] Olfactory epithelial damage is also reported to be a consequence of laryngectomy, 1,3,6,7,9 although this is controversial. 10 Much effort has been put into overcoming this problem, 4,5,11 but most attempts have been unsuccessful.…”

Acuidade olfatória e qualidade de vida após a laringectomia total

“…Some authors demonstrate the close relation between the olfaction and taste functions on the perception of food tastes and that these function alterations would result in nutritional losses, on the appetite and even influence on weight loss 10,11,14 .…”

“…The olfactory sense is extremely important, once it enables the perception of delightful scents such as perfumes and food, and it helps in potentially dangerous situations, in detecting spoilt food, gas leak and smoke, or even in the perception of the own body odor 7,10,11 .…”

Função olfatória e qualidade de vida após a reabilitação do olfato em laringectomizados totais

“…The permanent discontinuity between the upper and lower airways, with the removal of the larynx and the transfer of the nasal air current to a permanent tracheostoma, entails significant changes in pulmonary physiology as well as alterations in olfactory acuity (2,3) . Olfactory perception can occur in two main ways: the first and most important is the orthonasal olfaction, which occurs when odorant molecules are delivered to the olfactory epithelium via the nares; the second is the retronasal olfaction, which occurs when odorant molecules from the oral cavity, produced during mastication, are delivered via the nasopharynx and posterior choanae to the olfactory epithelium in the olfactory cleft (4)(5)(6) . Discontinuation of the airflow in the nasopharyngeal airways due to total laryngectomy prevents the odorant molecules from reaching the olfactory epithelium, precluding its stimulation and causing hyposmia or even anosmia (5,7,8) .…”