Clin. Otolaryngol. 2012, 37, 28–34
Objectives: To determine minimum airflow rate required for olfactory stimulation in successfully rehabilitated laryngectomised patients after learning the polite ...yawning technique (PYT) and to confirm the hypothesis that sense of smell is rehabilitated once the nasal airflow is re‐established.
Design: Prospective open interventional trial.
Setting: Tertiary academic hospital.
Participants: The study population comprised 100 laryngectomised patients. The control group consisted of 100 non‐laryngectomised patients of similar age and sex. Rhinomanometry was used to measure air flow in the right and left nostrils, respectively, while the Smell Diskettes Olfaction test (SDOT) was used to test each individual’s sense of smell.
Main outcome measures: The primary endpoint was increasing the airflow, while the secondary endpoint was improvement in the Smell Diskettes Olfaction test score after learning the polite yawning technique.
Results: The difference in the Smell Diskettes Olfaction test results before and after introducing the polite yawning technique was statistically significant (F = 53.077; P < 0.001). The number of accurately identified odours increased with each measurement. There was a significant difference among rhinomanometric measurements of airflow through the right (F = 65.002; P < 0.001) and left nostrils (F = 75.465; P < 0.001). Nasal airflow improved with each measurement. The minimum airflow required for olfactory stimulation in successfully rehabilitated patients was approximately 60 cm3/s. The control group had considerably better airflow in both nostrils than the laryngectomised group. The difference between the total number of rehabilitated (normosmic) patients (48%) in the laringectomised group and normosmic participants (56%) in the control group (z = 1.132; P = 0.129) was not statistically significant.
Conclusion: The number of odours identified by laryngectomised patients increased with the volume of nasal airflow. The number of patients with rehabilitated olfactory function approximated the percentage of normosmic individuals in the non‐laryngectomised population. These findings confirm the hypothesis that sense of smell is rehabilitated once the nasal airflow is re‐established.
The aim of the study was to determine the influence of swimming on postlaryngectomy olfactory rehabilitation. This prospective open interventional trial at a tertiary academic hospital included 100 ...laryngectomised patients; 17 were swimmers and 83 were nonswimmers. Participants practiced the polite yawning technique (PYT) for postlaryngectomy olfactory rehabilitation. Rhinomanometry was used to measure air quantity in the right and left nostrils, respectively; to test sense of smell, we applied the smell diskettes olfaction test (SDOT). Swimmers used swimming aids and swam only in a pool accompanied by another person trained in the rescue and resuscitation of a laryngectomee. Measures were made at three time points. Following PYT initiation, the number of accurately guessed odours was higher among swimmers (SDOT1 = 5.29, SDOT2 = 6.40, SDOT3 = 6.76) than nonswimmers (SDOT1 = 3.73, SDOT2 = 5.48, SDOT3 = 5.60) as were airflows through the left (swimmers: FL1 = 40.82, FL2 = 137.71, FL3 = 172.80; nonswimmers: FL1 = 13.05, FL2 = 104.63, FL3 = 113.00) and right nostrils (swimmers: FR1 = 46.82, FR2 = 115.41, FR3 = 145.40; nonswimmers: FR1 = 13.70, FR2 = 92.77, FR3 = 106.43). The number of odours identified by laryngectomised patients increased with the volume of nasal airflow, but this number and the efficiency of olfactory rehabilitation were higher in swimmers compared to nonswimmers. Swimming with a swimming aid improved the quality of life after surgery and may facilitate resocialisation of laryngectomised patients.
