Skip to main content
Log in

A comparison between sniffing and blowing for olfactory testing before and after laryngectomy

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Olfactory dysfunction occurs after laryngectomy due to the loss of nasal airflow and inability to sniff. However, the reason for the loss of olfactory function after laryngectomy is unclear on evaluation with sniffing type tests performed individually. It is expected that the sensorineural olfaction remains, and the results of the sniffing test would be negative, while that of the odour-blowing test would be positive. Therefore, the aim of this study was to investigate both tests and prove normal olfaction in the patients.

Methods

Patients who had undergone laryngectomy were evaluated using the T&T olfactometer for odour-sniffing tests, Jet Stream Olfactometer (JSO) for odour-blowing tests, and visual analogue scale (VAS). Evaluations were performed pre-operatively, and 1 month, 6 months, and 1-year post-laryngectomy.

Results

Thirty-two patients were included in the study. The median recognition thresholds using the T&T and JSO were 1.4 and 2.2 before surgery, 5.8 and 5.4 at 1 month, 5.8 and 5.2 at 6 months, and 5.8 and 5.0 at 1 year after surgery, respectively. Results of the olfactory threshold test in both T&T and JSO and VAS score were significantly worse after surgery compared to that before laryngectomy (p < 0.05). The degree of increase was significantly smaller with JSO than with T&T (p < 0.05).

Conclusion

While we could not prove normal olfaction in patients after laryngectomy, the odour-blowing test was superior to the odour-sniffing test in detecting patients with residual olfaction. Simply blowing a scent is insufficient to obtain good olfaction; active airflow is crucial for recognizing odours.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ackerstaff AH, Hilgers FJ, Aaronson NK, Balm AJ (1994) Communication, functional disorders and lifestyle changes after total laryngectomy. Clin Otolaryngol Allied Sci 19:295–300. https://doi.org/10.1111/j.1365-2273.1994.tb01234.x

    Article  CAS  PubMed  Google Scholar 

  2. Mumovic G, Hocevar-Boltezar I (2014) Olfaction and gustation abilities after a total laryngectomy. Radiol Oncol 48:301–306. https://doi.org/10.2478/raon-2013-0070

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mozell MM, Hornung DE, Leopold DA, Youngentob SL (1983) Initial mechanisms basic to olfactory perception. Am J Otolaryngol 4:238–245. https://doi.org/10.1016/s0196-0709(83)80065-9

    Article  CAS  PubMed  Google Scholar 

  4. Doty RL, Shaman P, Dann M (1984) Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav 32:489–502. https://doi.org/10.1016/0031-9384(84)90269-5

    Article  CAS  PubMed  Google Scholar 

  5. Cain WS, Gent JF, Goodspeed RB, Leonard G (1988) Evaluation of olfactory dysfunction in the Connecticut Chemosensory Clinical Research Center. Laryngoscope 98:83–88. https://doi.org/10.1288/00005537-198801000-00017

    Article  CAS  PubMed  Google Scholar 

  6. Riva G, Sensini M, Corvino A, Pecorari G, Garzaro M (2017) Smell and taste impairment after total laryngectomy. Ann Otol Rhinol Laryngol 126:548–554. https://doi.org/10.1177/0003489417709794

    Article  PubMed  Google Scholar 

  7. Caldas AS, Facundes VL, Cunha DA, Balata PM, Leal LB, da Silva HJ (2013) Gustatory and olfactory dysfunction in laryngectomized patients. Braz J Otorhinolaryngol 79:546–554. https://doi.org/10.5935/1808-8694.20130099

    Article  PubMed  Google Scholar 

  8. Risberg-Berlin B, Rydén A, Möller RY, Finizia C (2009) Effects of total laryngectomy on olfactory function, health-related quality of life, and communication: a 3-year follow-up study. BMC Ear Nose Throat Disord 9:8. https://doi.org/10.1186/1472-6815-9-8

    Article  PubMed  PubMed Central  Google Scholar 

  9. Fujii M, Fukazawa K, Hatta C, Yasuno H, Sakagami M (2002) Olfactory acuity after total laryngectomy. Chem Senses 27:117–121. https://doi.org/10.1093/chemse/27.2.117

    Article  PubMed  Google Scholar 

  10. Miwa T, Ikeda K, Ishibashi T et al (2019) Clinical practice guidelines for the management of olfactory dysfunction—secondary publication. Auris Nasus Larynx 46:653–662. https://doi.org/10.1016/j.anl.2019.04.002

    Article  PubMed  Google Scholar 

  11. Ohyama M, Furuta S, Furukawa M et al (1998) Clinical usefulness of a jet stream olfactometry. Jpn J Rhinol 37:26–34. https://doi.org/10.7248/jjrhi1982.37.1_26

    Article  Google Scholar 

  12. Okutani F, Hirose K, Kobayashi T, Kaba H, Hyodo M (2013) Evaluation of “Open Essence” odor-identification test card by application to healthy volunteers. Auris Nasus Larynx 40:76–80. https://doi.org/10.1016/j.anl.2012.02.007

    Article  PubMed  Google Scholar 

  13. McCormack HM, Horne DJ, Sheather S (1988) Clinical applications of visual analogue scales: a critical review. Psychol Med 18:1007–1019. https://doi.org/10.1017/s0033291700009934

    Article  CAS  PubMed  Google Scholar 

  14. Tsukatani T, Reiter ER, Miwa T, Costanzo RM (2005) Comparison of diagnostic findings using different olfactory test methods. Laryngoscope 115:1114–1117. https://doi.org/10.1097/01.MLG.0000163754.16475.43

    Article  PubMed  Google Scholar 

  15. Hummel T, Livermore A (2002) Intranasal chemosensory function of the trigeminal nerve and aspects of its relation to olfaction. Int Arch Occup Environ Health 75:305–313. https://doi.org/10.1007/s00420-002-0315-7

    Article  PubMed  Google Scholar 

  16. Schwartz DN, Mozell MM, Youngentob SL, Leopold DL, Sheehe PR (1987) Improvement of olfaction in laryngectomized patients with the larynx bypass. Laryngoscope 97:1280–1286. https://doi.org/10.1288/00005537-198711000-00006

    Article  CAS  PubMed  Google Scholar 

  17. Santos CG, Bergmann A, Coça KL, Garcia AA, Valente TC (2016) Olfactory function and quality of life after olfaction rehabilitation in total laryngectomees. [Função olfatória e qualidade de vida após a reabilitação do olfato em laringectomizados totais]. CoDAS 28:669–677. https://doi.org/10.1590/2317-1782/20162015255

    Article  PubMed  Google Scholar 

  18. Pekala K, Chandra RK, Turner JH (2016) Efficacy of olfactory training in patients with olfactory loss: a systematic review and meta-analysis. Int Forum Allergy Rhinol 6:299–307. https://doi.org/10.1002/alr.21669

    Article  PubMed  Google Scholar 

  19. Sinkiewicz A, Winiarski P, Mackiewicz H, Owczarzak H, Janicka-Beutch L, Betlejewski S (2006) Ocena skuteczności rehabilitacji wechu u osób po laryngektomii całkowitej [Estimation of smell sense rehabilitation in patients after total laryngectomy]. Otolaryngol Pol 60:33–36

    PubMed  Google Scholar 

  20. Karaca CT, Gültekin E, Yelken MK, Iğdem AA, Külekçi M (2010) Long-term histologic changes in nasal mucosa after total laryngectomy. Int J Otolaryngol 2010:137128. https://doi.org/10.1155/2010/137128

    Article  PubMed  PubMed Central  Google Scholar 

  21. Miani C, Ortolani F, Bracale AM, Petrelli L, Staffieri A, Marchini M (2003) Olfactory mucosa histological findings in laryngectomees. Eur Arch Otorhinolaryngol 260:529–535. https://doi.org/10.1007/s00405-003-0638-3

    Article  PubMed  Google Scholar 

  22. Veyseller B, Ozucer B, Aksoy F, Yildirim YS, Gürbüz D, Balikçi HH, Ozturan O (2012) Reduced olfactory bulb volume and diminished olfactory function in total laryngectomy patients: a prospective longitudinal study. Am J Rhinol Allergy 26:191–193. https://doi.org/10.2500/ajra.2012.26.3768

    Article  PubMed  Google Scholar 

  23. Kesimli MC, Kaya D, Aydemir L, Durmaz HÖ (2021) A simple method for olfactory rehabilitation following total laryngectomy. Eur Arch Otorhinolaryngol 278:4917–4921. https://doi.org/10.1007/s00405-021-06711-x

    Article  PubMed  Google Scholar 

  24. Okabe E (1989) A study on the mechanism of phleboid olfactory function. Nihon Jibiinkoka Gakkai Kaiho 92:111–120. https://doi.org/10.3950/jibiinkoka.92.111

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Contributions

YN: data collection and analysis and writing the original draft. EM: conceptualization, investigation, methodology, and complete project administration and supervision. TA: data analysis, investigation, and methodology. NT: data collection. HK: data collection. ES: supervision, review, and editing of the final manuscript. NO: supervision, review, and editing of the final manuscript.

Corresponding author

Correspondence to Yukio Nishiya.

Ethics declarations

Conflict of interest

None of the authors declare any conflict of interest financial or otherwise.

Ethics statement

This study was approved by the Jikei University School of Medicine (28–270) (8513). All participants provided informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nishiya, Y., Mori, E., Akutsu, T. et al. A comparison between sniffing and blowing for olfactory testing before and after laryngectomy. Eur Arch Otorhinolaryngol 279, 5009–5015 (2022). https://doi.org/10.1007/s00405-022-07343-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-022-07343-5

Keywords

Navigation