Olfactory rehabilitation via retronasal olfaction using atracheoesophageal voice prosthesis after total laryngectomy. German version

Abstract

Despite the variety of existing methods for olfactory rehabilitation after total laryngectomy, olfactory disability remains one of the main factors limiting quality of life for laryngectomees. Considering theneed for asocially acceptable rehabilitation method that is suitable for everyday use, this study sought to elucidate whether retronasal olfaction during phonation through atracheoesophageal voice prosthesis is possible. The odor identification of 22laryngectomees was assessed using the Sniffin' Sticks test battery (12 odors), while performing an established method of olfactory rehabilitation-"polite yawning"-or while transnasal expiration or phonation through the tracheoesophageal fistula (TF). To facilitate the latter, anovel Expiratory Nasal Airflow M‑Maneuver (ENAMM) was developed. All 21non-anosmic laryngectomees included in the study were able to identify odors retronasally. While only 6of 22patients (27.3%) could perform the nasal expiration through the TF, all patients could easily perform phonation using ENAMM after proper instruction. The odor identification scores with the ENAMM technique did not statistically differ from ones with "polite yawning" (5.4 ± 3.1 vs. 6.4 ± 3.2, p = 0.279). The ENAMM was easy to learn and showed atendency of increasing olfactory scores over time, possibly due to a learning effect. Study results show that retronasal olfaction using avoice prosthesis after total laryngectomy is possible and suggest the potential of ENAMM as amethod of olfactory rehabilitation for laryngectomy patients.