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Rehabilitation of olfaction post‐laryngectomy: a randomised control trial comparing clinician assisted versus a home practice approach
Author(s) -
Ward E.,
Coleman A.,
Van AsBrooks C.,
Kerle S.
Publication year - 2010
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2009.02050.x
Subject(s) - medicine , laryngectomy , rehabilitation , randomized controlled trial , olfaction , visual acuity , physical therapy , surgery , larynx , neuroscience , biology
Clin. Otolaryngol. 2010, 35 , 39–45. Objectives: To determine (i) the prevalence of impaired olfaction in a group of individuals post‐laryngectomy, and (ii) whether intensive, clinician‐supported training of the Nasal Airflow Inducing Manoeuvre (NAIM) was more effective at improving olfactory acuity than intensive, home practice over a 6‐week period. Designs: Cohort study followed by a randomised control trial of two treatments over a 6‐week period with a 3‐month review. Participants: Olfactory acuity was evaluated in 43 laryngectomy patients. Results revealed 95% had impaired olfactory acuity (anosmic or hyposmic). From this group 40 eligible participants with reduced olfactory acuity were then randomly assigned into either the clinician‐supported or home practice treatment group. Main outcome measures: Olfactory acuity and functional impact measures relating to olfactory acuity (participation restriction, wellbeing/distress). Results: Although olfactory acuity significantly improved in both treatment groups following 6 weeks of therapy, results indicated significantly greater improvement in the clinician‐assisted group immediately post‐treatment. By 3 months, post‐treatment effects were maintained. Both modes of treatment improved levels of patient wellbeing, however, only the clinician‐assisted mode made a significant positive effect on levels of perceived participation restriction. Conclusion: Reduced olfactory acuity is prevalent post‐laryngectomy. Olfactory acuity can be significantly improved using either 6 weeks of clinician‐assisted or home practice using the NAIM manoeuvre, although the current data suggest that intensive clinician‐assisted treatment can assist patients to improve more rapidly and have a positive impact on functional state.