A new olfactory rehabilitation protocol based on physiological induction of nasal airflow after total laryngectomy: the Physiological Olfactory Recovery Technique (PORT)

Purpose: To evaluate whether a new nasal airflow induction manoeuvre based on the Physiological Olfactory Recovery Technique (PORT) could be an effective alternative to current techniques for restoring olfactory function in laryngectomised patients. Methods: This is a prospective observational cohort study, including patients who underwent total laryngectomy (TL) and primary tracheoesophageal puncture (TEP) placement for advanced laryngeal cancer (LC). To restore olfactory function, all patients underwent 10 sessions of PORT rehabilitation training at least 2 months after surgery. Outcomes in terms of olfactory acuity, subjective symptoms, and HRQoL were assessed using olfactometry and two structured questionnaires (the Chemosensory Complaints Score and University of Washington Quality of Life version 4), before and after treatment, and after a 6-month follow-up. Results: Twenty laryngectomised patients (15 men and 5 women, with a mean age of 65 ± 8 years) were enrolled in the study. These patients underwent proprioceptive training with a speech and language therapist and learnt the PORT method. Seventeen patients who were unable to smell before treatment became able to smell, while the remaining three patients, who were hyposmic at the beginning of treatment, became normosmic by the end. Following 10 sessions of the rehabilitation programme, all 20 patients demonstrated significant improvements across all outcome measures. These results were maintained in the long term. Conclusion: For laryngectomised patients, PORT is an effective alternative to the Nasal Air Flow Induction Maneuver (NAIM) for olfactory rehabilitation. This technique enabled all rehabilitated patients to regain their daily 'olfactory gesture' physiologically.