[Estimation of smell sense rehabilitation in patients after total laryngectomy]. / Ocena skutecznosci rehabilitacji wechu u osób po laryngektomii calkowitej.

The loss of sense of smell significantly decreases a quality of life after total laryngectomy. That is why this problem should be considered within a complex rehabilitation of laryngectomized patients. The smell exercises ought to start parallely to the speech rehabilitation. The aim of our study was to estimate the efficacy of smell rehabilitation after total laryngectomy. 59 persons after total laryngectomy attending the fourteen days long rehabilitation camp were examined. All the patients had the examination of three smells identification (lemon, mint and anise) made before the beginning of exercises. All the persons had also the efficacy of air aspiration through the nose measured. The control examination of those parameters was conducted after fourteen days of exercises of making the negative pressure in the throat and nasopharynx directing the air flow into the olfactory area of the nose. We confirmed a statistically significant differences between the smell identification and the force of aspiration before and after rehabilitation. We confirmed that patient's age and the time from laryngectomy have the influence into the efficacy of smell rehabilitation.

[Carbon granuloma--an unwanted effect of laryngeal laser microsurgery]. / Carbon granuloma--niepozadany skutek mikrochirurgii laserowej krtani.

Over recent twenty years, laser microsurgery has gained great recognition in the treatment of early carcinoma. From 1990 to 2004, more than 800 operations on the larynx were performed using laser microsurgery, including 167 chordectomies for squamous cell carcinoma. In 14 patients who were on the follow-up for 1 to 6 months, we observed a spherical, smooth structure (3-5 mm in diameter) in the middle part of the scar, which imitated local relapse of the neoplastic process. The lesion was removed with CO2 laser. Histopathologic examination revealed, in all cases, the presence of nonspecific, inflammatory process and development of granulation tissue. In only one patient in further follow-up, neoplastic growth recurred. Such lesions were not observed in other than chordectomy laser microsurgical procedures.

[Proposal of rehabilitation standard after total laryngectomy]. / Propozycje standardów postepowania rehabilitacyjnego po laryngektomii calkowitej.

The aim of the paper is to propose a standard program of rehabilitation in patients after total laryngectomy in preoperative, early postoperative period and after the end of laryngological and oncological procedures. During the process of complex rehabilitation the teaching of oesophageal voice mechanism, the improving of respiratory system function, the psychological procedure and the supply of technical equipment must be taken into account. The role of laryngectomee clubs and associations in psychological support is discussed. The authors express the opinion, that the introduction of a uniform in structure standard of rehabilitation may be helpful in improvement of medical care of laryngectomized patients in Poland.