Page 17 - Olfaction regained_Flipbook-subtitles

related decrease of the sense of smell is to be expected. Inhalation of harmful substances is harmful to the sense of smell and is also suggested as playing a role in the development of laryngeal carcinoma. There are more male than female laryngectomees and generally males have a poorer sense of smell than females. In summary, it can be stated that in laryngectomees a perceptual smelling disorder, apart from hyposmia based on the absence of nasal airflows, may commonly exist. Rehabilitation of olfaction Olfaction before and after laryngectomy Shortly after surgery, the loss of the sense of smell may for many laryngectomees be of less importance than other consequences of the total laryngectomy, such as the presence of a tracheostoma and changes in the voice. However, as described, the sense of smell plays an important role in many aspects of daily life. This is reason enough to give each laryngectomee, qualified to receive training, the attention this subject it deserves. In the past, some options have been suggested on how to improve olfaction after total laryngectomy. One of these suggestions was the use of a larynx-bypass (Mozell et al., 1983; Bosone, 1984; Tatchel et al., 1985; Mozell et al., 1986; Swartz et al., 1987; Knudson and Williams, 1989). A larynx-bypass is a tube between the tracheostoma and the mouth (see figures 7 and 14), re-establishing a connection between the upper and lower airways. This enables breathing in through the nose and thus allowing olfaction to take place in a more or less normal manner. However, this solution is not very practical; one must perform a number of actions before one can actually smell. Talking and eating are not easily combined with smelling in this way and consequently the use of a larynx-bypass does not improve the sense of taste. Since the larynx-bypass is not used throughout the entire day, but only when there is a reason to smell, its use does not restore the warning function of odour perception. Moreover, it is a rather eye-catching instrument. Nevertheless, the 16