Considerations on postlaryngectomy olfaction rehabilitation

Rehabilitation of olfaction in laryngectomized individuals clearly belongs to the sphere of activities of the speech pathology profession, and should form an integral part of the postlaryngectomy rehabilitation program. From our studies it becomes clear that more intensified training is needed in many patients, in order to transform the NAIM into an automatism, and to integrate the maneuver in all every-day-life situations. It has to be stressed with the patient, that compensation for the lack of passive smelling is only possible to a certain extent, if the NAIM is applied in every change of environment or situation, e.g. entering a room, approaching other people, etc. This is also an important reason to try to make this maneuver as unobtrusive as possible, and this requires additional speech pathology efforts. In fact, the so-called ‘large’ movement, where the jaw is lowered substantially in order to increase the volume in the oral cavity, can be transformed into a ‘small’ movement, in which the position of the jaw is not changed and only the floor of mouth and tongue are lowered. By quick repetition of this ‘small’ movement, a large enough airflow is provoked to enable smelling again. The ‘small’ movement can be applied without drawing much attention, and patients who acquire this skill are more likely to use the NAIM regularly.

In conclusion: olfaction rehabilitation in laryngectomized individuals should form an integral part of the rehabilitation program, deserving as much attention of the speech pathologist as the other two postlaryngectomy fields of interest, i.e. speech and pulmonary rehabilitation. The nasal airflow inducing maneuver or ‘polite yawning’ technique forms an excellent ‘instrument’ for the speech pathologist to address this disturbing problem, resulting in a clear improvement not only in olfaction, but also in taste perception, and thus in an improved quality of life.