Olfactory Rehabilitation in Total Laryngectomy Patients

ABSTRACT

Patients who undergo total laryngectomy often experience difficulties with their voice, olfaction, and taste due to the lack of airflow through nasal and oral cavities. While voice rehabilitation is more commonly performed, olfactory rehabilitation has gained importance in recent times with the use of various techniques. Previous studies have shown that incidence of hyposmia or anosmia (partial or total loss of smell) after total laryngectomy ranges from 25% to 100%. However, after olfactory rehabilitation, there has been notable improvement in olfaction, ranging from 46% to 88% of the patients. There are two main techniques for olfactory rehabilitation. The first involves creating airflow for smelling purposes by connecting the oral or nasal cavity to the tracheostoma using prosthetic laryngeal bypass devices. The second technique involves orofacial musculature training, which includes a nasal airflow-inducing maneuver known as the “polite yawning technique.” This maneuver creates negative pressure in the oropharynx, resulting in the induction of nasal airflow and potentially improving olfaction. Additionally, rehabilitation through biofeedback can facilitate airflow in the nasal cavity, further enhancing the sense of smell. In this review, we will introduce the principles, pathogenesis, and various techniques of olfactory rehabilitation, as well as summarize the outcomes of olfactory rehabilitation efforts.