Rehabilitation Improves Smell in Total Laryngectomy Patients

NEW YORK (Reuters Health) Apr 05 - An odor rehabilitation technique called the Nasal Airflow-Inducing Maneuver (NAIM) can improve smell and taste in patients who have undergone total laryngectomy, according to the results of a Swedish study.

The disconnection of the upper and lower airways that occurs with total laryngectomy results in a slew of problems, one of the most common being a loss of normal olfaction and taste. Until recently, however, relatively little clinical attention has been paid to these disturbances.

A few methods of improving smell have been proposed, but the techniques have been unproven or impractical for every day use, according to the report in the Archives of Otolaryngology: Head and Neck Surgery.

With NAIM, also known as the "polite yawning" technique, the patient is instructed to make an extended yawning movement, while keeping the mouth closed and lowering the jaw. This is intended to create negative pressure that draws air into the nose, allowing odorous substances to reach the olfactory epithelium. Rapid repetition of the technique apparently improves its effectiveness.

In the present study, Dr. Caterina Finizia, from Sahlgrenska University Hospital in Molndal, Sweden, and colleagues assessed the efficacy of NAIM in 24 patients who underwent laryngectomy. The subjects were instructed in NAIM by speech therapists during three sessions over 6 weeks.

At baseline, 14 of the patients had anosmia, 4 hyposmia, and 6 normosmia, the report indicates. Thirteen of the 18 patients with impaired olfaction experienced improvements with NAIM.

Seven of the 14 anosmic patients had some sense of smell restored after just one NAIM training session, the authors note.

"The NAIM rehabilitation method is easy to learn and rapidly improves the capacity to smell and taste," the researchers state. "We recommend that olfactory and gustatory rehabilitation be incorporated into routine rehabilitation program for patients with laryngectomy," Dr. Finizia's team concludes.

Arch Otolaryngol Head Neck Surg 2006;132:301-306.
Visit American Society of Clinical Oncology to see original article