Focusing on the olfactory rehabilitation after total laryngectomy

BACKGROUND: Most patients report a deterioration of the sense of smell after total laryngectomy. The loss of this sense is often underestimated and not rehabilitated. The aim of this study was to evaluate the efficacy of the olfactory rehabilitation, after total laryngectomy, by the NAIM (nasal airflow-inducing maneuver) technique, using the Sniff Sticks Extended (SSE) Test. METHODS: A retrospective analysis was performed at two different hospital settings, and only included patients that underwent olfactory rehabilitation with the NAIM technique and further evaluated by the SSE test. Included subjects have been evaluated from 2013 to 2021. The self-assessment questionnaire on quality of life (QoL), the EORTC QLQ-HN43, have been also administered to all subjects in order to assess the QoL perception. RESULTS: A total of 13 patients (11 males and 2 females) have been enrolled for this study. The mean SSE score before rehabilitation was 15.67 (SD±8.64) while the score after rehabilitation resulted increase to 29.53 (SD.±5.65) (P<0.001), therefore the NAIM technique can be considered effective in order to restore smell perception. Furthermore, considering together the results of the EORTC QLQ-HN43 questionnaire and the SSE outcomes, total laryngectomy patients were not aware of their olfactory disorder before starting the rehabilitation. CONCLUSIONS: Olfactory rehabilitation should be offered to all patients after total laryngectomy; the technique based on the NAIM maneuver have shown good results. In our opinion, further studies will be necessary particularly in order to clarify the correct timing for starting this treatment.