title: Long-term results of olfaction rehabilitation using the nasal airflow-inducing ("polite yawning") maneuver after total laryngectomy.
abstract: OBJECTIVE
  To study the long-term results of the nasal airflow-inducing maneuver (NAIM) as an olfaction rehabilitation tool after laryngectomy and to investigate the effectiveness of a new, simpler odor detection test (ODT) called the smell disk test (SDT), or Zürcher Geruchstest.
  
  
  METHODS
  Intervention study.
  
  
  METHODS
  National cancer center.
  
  
  METHODS
  Forty-one laryngectomees who received olfaction rehabilitation training with the NAIM 4 months to 2 years earlier. This so-called polite yawning maneuver creates an "underpressure" in the oral cavity, which, in turn, generates a nasal airflow that enables odor molecules to again reach the olfactory epithelium.
  
  
  METHODS
  Olfaction acuity testing with a standard ODT, along with a questionnaire, providing a subjective olfaction score (present odor perception scale [POPS]), and the SDT, as well as assessment of the patients' correct execution of the NAIM by speech-language pathologists on video recordings made during odor testing and long-term assessment of olfaction acuity.
  
  
  RESULTS
  The correlation between the previously used ODT-POPS combination and the SDT was kappa = 0.56 (P<.001). Based on these results, we preferred to use the much simpler SDT instead of the laborious combination of the ODT-POPS. Based on the SDT results, 19 (46%) of the 41 laryngectomees were "smellers" and could be considered normosmic. There was a significant relationship (P =.03) between the patient's correct execution of the NAIM and whether or not the laryngectomee was a smeller according to the SDT.
  
  
  CONCLUSIONS
  The effectiveness of the NAIM, or so-called polite yawning technique, for the rehabilitation of olfaction in individuals who have undergone total laryngectomy was reconfirmed. Long-term olfaction rehabilitation was achieved in about 50% of the patients, but more intensified training may be needed to increase the percentage of successfully rehabilitated individuals. The SDT is an effective and simple test for the assessment of olfaction acuity after laryngectomy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands. fhilg@nki.nl
authors.forename: Frans J M
authors.initials: FJ
authors.lastname: Hilgers
authors.forename: Helma A
authors.initials: HA
authors.lastname: Jansen
authors.forename: Corina J
authors.initials: CJ
authors.lastname: Van As
authors.forename: Marianne F
authors.initials: MF
authors.lastname: Polak
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Muller
authors.forename: Frits S A M
authors.initials: FS
authors.lastname: Van Dam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000503:physiopathology; D000857:Olfaction Disorders / Q000209:etiology* / Q000534:rehabilitation*; D012903:Smell / Q000502:physiology; D013997:Time Factors