Olfactory perception rehabilitation after total laryngectomy (OPRAT): proposal of a new protocol based on training of sensory perception skills



We aim to propose a new protocol for olfaction rehabilitation after total laryngectomy based on training of sensory perception levels using the Nasal Airflow-Inducing Maneuver.


This is a randomized clinical trial including patients undergoing total laryngectomy between March 2010 and March 2019. Patients with nasal or oral abnormalities, prior olfaction impairment, a muco-ciliary transport time higher than 30 min, positive history for feeding, and neurological disorders were excluded. Thirty-three patients were enrolled and were randomized into two groups: an Experimental group, submitted to the new protocol (olfactory perception rehabilitation after total laryngectomy-OPRAT) and a Control group that did not receive any treatment. Subjective Olfactometry, Chemosensory Complaints Score, and University of Washington Quality of Life version 4 questionnaires were used to assess the outcomes before and after treatment, and at 3-month, 6-month, and 10-month follow-up.


Among the 33 patients included (32 men and 1 woman; mean age, 67.94 ± 5.64 years), 17 were subjected to olfaction rehabilitation and 16 did not receive any treatment.

At baseline evaluation, there were not significant differences between the two groups. At the end of treatment, the rehabilitated group improved their olfaction capability significantly. Such improvement remained stable over time, and after 10 months, only the Experimental group had significant improvements in all outcome measures.


The OPRAT may guarantee excellent results in the short- and long-term time with positive effects on the Quality of Life.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by YL, CP, GDC, MEM, GM, and EC. YL wrote the first draft of the manuscript and all authors commented on the previous versions of the manuscript. GP, LD, and GCP supervised this research. All authors read and approved the final manuscript.

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Correspondence to Lucia D’Alatri.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Medical Ethics Committee of the Catholic University of the Sacred Heart and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Longobardi, Y., Parrilla, C., Di Cintio, G. et al. Olfactory perception rehabilitation after total laryngectomy (OPRAT): proposal of a new protocol based on training of sensory perception skills. Eur Arch Otorhinolaryngol 277, 2095–2105 (2020). https://doi.org/10.1007/s00405-020-05918-8

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  • Total laryngectomy
  • Rehabilitation
  • Olfaction
  • Quality of life
  • Head and neck surgery
  • Rhinology