Rajavel, M S P S (2016) Is rehabilitation of Olfaction necessary in patients undergoing Total Laryngectomy. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION : Laryngeal malignancy is the second most common malignancy in the upper aero-digestive tract. In India, the incidence rate is about 2.63% of all malignancy. 85 to 95 percentage of the laryngeal malignancy is the squamous cell carcinoma type, majority of which arises from the glottis. Hypopharyngeal malignancy is not very common. It accounts for 4% of all head and neck malignancy and 7% of all upper aero-digestive tract malignancy. 95% of the malignancy is squamous cell carcinoma and pyriform sinus being the most common site involved. The treatment of choice for the carcinoma of the larynx and hypopharynx depends on the stage at the time of presentation. Early stage of disease is managed by Radiotherapy alone or Endoscopic transoral excision with negative margins. Advanced stages of the disease will need radical surgery followed by radiotherapy. OBJECTIVES : 1. To compare the olfactory acuity of patients prior to and after total laryngectomy. 2. Assess effectiveness of nasal airflow inducing maneuver technique for olfaction and the quality of life in laryngectomised patients. METHODS : A prospective study was done recruiting patients who were planned for total laryngectomy from September 2014 to July 2015. They were subjected to olfaction testing prior to surgery. Olfaction testing was done using Butanol threshold test and Odour identification test. Composite score was calculated which gave the olfaction score. Patient was followed up 2 weeks after surgery when a quality of life assessment was done using Appetite, Hunger and Sensory Perception (AHSP) questionnaire and repeat olfaction testing was done. Following this polite yawn technique was taught to the patient and the olfaction testing was repeated with the maneuver. RESULTS : Twenty eight patients were recruited in this study. There was significant loss in sense of smell in all the 28 patients following total laryngectomy. After a therapy session for polite yawn technique the olfaction score showed a significant improvement in the olfaction score of all the 28 patients. Quality of life assessment was done using AHSP questionnaire. The internal coefficient of this questionnaire was high in all the five domains and hence can be used as an effective questionnaire for quality of life assessment in total laryngectomy patients. CONCLUSION : In this study of 28 patients after total laryngectomy, there was a loss in the sense of smell in all the 28 patients, which was tested using Butanol threshold test and Odour identification score. The olfaction score after a 15 minute session of Nasal Airway Inducing Maneuver, the polite yawn technique showed significant improvement. Quality of life assessment was done using Appetite, Hunger and Sensory Perception questionnaire. The internal coefficient of this questionnaire was high and hence can be used as an effective questionnaire for quality of life assessment in total laryngectomy patients with respect to smell, taste, hunger feelings and appetite.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | rehabilitation of Olfaction, Total Laryngectomy. |
| Subjects: | MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Jan 2018 03:14 |
| Last Modified: | 11 Jan 2018 03:14 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5453 |
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