Deterioration of olfaction and gustation as a consequence of total laryngectomy

Introduction: After total laryngectomy the absence of a nasal airflow resul ts in a decrease in olfaction and perception of flavors, Materials and Meth ods: Odor perception was assessed in 63 laryngectomized patients with two d ifferent olfactory tests, The methods used by patients to smell were observ ed during olfactory testing. Patients' judgment about their olfaction and g ustation was assessed by means of a structured questionnaire, semistructure d interview, and self-rating Results: Based on the results of the olfactory tests, patients were categorized as "smellers" and "nonsmellers," Approxim ately one third of the patients were able to smell the odorous substances u sed in the olfactory tests. The smellers more often used a variety of metho ds to smell than the nonsmellers (P < .002); in most patients the method co nsisted of active use of facial muscles. Patients appeared well able to jud ge their own odor perception. Compared with the smellers, the nonsmellers j udged their odor perception as worse (P < .003) and reported a more severe decrease in gustation after the operation (P < .033). The results of this s tudy in laryngectomized patients confirm the interrelation between olfactio n and gustation: the nonsmellers reported a poorer gustation and a more sev ere decrease in gustation and appetite than both the smellers and a referen ce group of elderly persons (P < .05). Patients who reported a deterioratio n of olfaction and gustation tended to experience negative consequences suc h as the inability to smell smoke, leaking gas, or agreeable odors. Conclus ion: Olfaction and odor-related flavor sensation are seriously deteriorated after total laryngectomy.