Research article

Effects of total laryngectomy on olfactory function, health-related quality of life, and communication: a 3-year follow-up study

Birgit Risberg-Berlin¹ , Anna Rydén² , Riitta Ylitalo Möller³ and Caterina Finizia⁴

¹Division of Logopedics and Phoniatrics, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden

²Health Care Research Unit, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden

³Karolinska Institute, Department of Otolaryngology B 53, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden

⁴Department of Otolaryngology, Sahlgrenska University Hospital Mölndal, SE-431 80 Mölndal, Sweden

author email corresponding author email

BMC Ear, Nose and Throat Disorders 2009, 9:8doi:10.1186/1472-6815-9-8

Published:	29 July 2009

Abstract

Background

As total laryngectomy results in loss of airflow through the nose, one of the adverse effects for a majority of patients is the reduced or complete loss of olfactory function. However, with the introduction of a new method, the Nasal Airflow-Inducing Maneuver (NAIM), an important technique is available for laryngectomized patients to regain the ability to smell. The purpose of the present study was to assess changes in olfaction, health-related quality of life (HRQL) and communication 3 years after NAIM rehabilitation.

Methods

18 patients (15 men and 3 women; mean age, 71 years) who had undergone laryngectomy and NAIM rehabilitation were followed longitudinally for 3 years. For comparison an age and gender matched control group with laryngeal cancer treated with radical radiotherapy was included. Olfactory function was assessed using the Questionnaire on Odor, Taste and Appetite and the Scandinavian Odor Identification Test. HRQL was assessed by: 1) the European Organization for Research and Treatment for cancer quality of life questionnaires; and 2) the Hospital Anxiety and Depression Scale. Communication was assessed by the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer. Descriptive statistics with 95% confidence interval were calculated according to standard procedure. Changes over time as well as tests between pairs of study patients and control patients were analyzed with the Fisher nonparametric permutation test for matched pairs.

Results

Thirty-six months after rehabilitation 14 of 18 laryngectomized patients (78%) were smellers. There were, with one exception (sleep disturbances), no clinically or statistically significant differences between the study and the control group considering HRQL and mental distress. However, statistical differences (p < 0.001) were found between the study and the control group concerning changes in communication.

Conclusion

Olfactory training with NAIM should be integrated into the multidisciplinary rehabilitation program after total laryngectomy. Our study shows that patients who were successfully rehabilitated concerning olfaction and communication had an overall good HRQL and no mental distress. Moreover, the EORTC questionnaires should be complemented with more specific questionnaires when evaluating olfaction and communication in laryngectomized patients.