Reversal of hyposmia in laryngectomized patients

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Abstract
To assess the degree to which the olfactory deficit associated with laryngectomy is simply due to the loss of nasal airflow, 17 laryngectomees were fitted with a device (larynx bypass) which allowed them to produce approximately normal sniffs. Detection thresholds were determined for two odorants, vanillin (reportedly excites only the olfactory nerve) and ammonia (a strong trigeminal irritant). Without the bypass nine patients detected neither odorant. The others, who could manoeuver somewhat more vigorous nasal airflows, detected the odorants but only half had ‘normal’ thresholds. In this latter group there was a tendency for decreasing detection thresholds with increasing postoperative years. With the bypass all 17 patients achieved ‘normal’ ammonia thresholds whereas 10 achieved ‘normal’ vanillin thresholds. Thus, the loss of nasal airflow is a major contributor to the olfactory deficit of laryngectomy, and it may be the only contributor for trigeminal irritants like ammonia. On the other hand, for non-trigeminal stimuli like vanillin other factors seem to be involved.

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