Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 19

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
SLP Division of Logopedics and Phoniatrics, Sahlgrenska University
Hospital, Göteborg, Ylitalo Riitta, MD, PhD Karolinska Institute,
Department of Logopedics and Phoniatrics B 69, Karolinska University
Hospital Huddinge Stockholm, Sweden
Objective: To examine the olfactory function in Swedish laryn-
gectomized patients and to assess the results of the NAIM odor-
rehabilitation technique using the validated Scandinavian Odor-
Identification Test (SOIT).
Methods: Twenty-four laryngectomized patients, 21 males and 3
females (mean age 68 years)
answered olfaction and gustation and quality of life question-
naires and were tested with SOIT before and after four NAIM
rehabilitation sessions.
Results: 72% of the patients with anosmia or hyposmia at base-
line improved during intervention with the NAIM technique
according to SOIT results. Before treatment 10 patients were
categorized as smellers while 14 patients were non-smellers i.e.
having anosmia according to SOIT. Postinventory, the patients’
with anosmia improved their olfaction significantly according to
SOIT and their selfestimation of olfaction, gustation and quality
of life improved.
Conclusion: The SOIT odor-differentiation test is an effective and
simple test for the assessment of olfaction acuity after laryngec-
tomy in Scandinavian patients. The NAIM rehabilitation method
is easy to learn and gives rapid and excellent results in improved
smell, taste and quality of life. We recommend that olfactory and
gustatory rehabilitation according to the NAIM technique should
be incorporated into routine rehabilitation program for laryngec-
tomees in Scandinavia.
Abstract no.: 028
Autonomic nerves of the vomeronasal organ
R. Eccles, Cardiff School of Biosciences, L. Malm, Dept. of ORL, Malmö
University Hospital, R. Uddman, Dept. of ORL, Malmö University Hospital
Electrical stimulation of the Vidian nerve causes a watery secre-
tion from the vomeronasal organ (VO) in cats. Stimulation of
sympathetic nerves causes rapid suction of secretion into the VO.
The mechanism behind the latter reaction is a constriction of sinu-
soids situated between an outer wall of cartilage and an inner wall;
a sac. Between the walls is erectile tissue. Similar to other erectile
tissues there is an intense vasoactive intestinal peptide(VIP)-like
immunoreactivity, demonstrated in cat and rat. The importance of
VIP in reproduction will be discussed.
Abstract no.: 029
Severe nasal polyposis treated with sustained release sys-
temic steroid. How safe is it?
Larsen K, Sct Joseph ENT-Clinic, Gram J, Endocrinological department,
Central Hospital, Esbjerg, DK
In patients with severe nasal polyposis systemic steroid can be an
adjunct to topical steroid and surgery in the treatment. Sustained
release steroids given as injection has been one of the treatment
modalities used in DK. When calculating equivalent daily doses
of steroid given the injection dose seems fairly low and should not
be supposed to involve serious problems when administered once
or twice yearly. To verify this attitude we investigated 11 patients
with severe recurrent nasal polyposis by the means of DXA-scan-
ning to evaluate any degree of osteopenia or osteoporosis. It is a
small group with especially severe symptomatic nasal polyposis.
More than half of the patients had endoscopic sinus surgery , the
remainder refused surgery. Despite surgery intensive medical
treatment was needed. They had one or two injections of sus-
tained release dexamethasone per year for at least three years.
The results showed that 9 patients had low Z-score and
the T-score was low in 10 patients. There were 5 patients with
osteoporosis and 3 with osteopenia using WHO- definitions.
Although treatment with sustained release systemic steroid is
very effective in the treatment of severe nasal polyposis it seems
to have its costs when used for years even in relatively small
amounts. Concomitant other risk factors should be borne in mind
and inclusion of an endocrinologist in the treatment regime in
such severe cases is advisable.
S-VII TREATMENT OF EARLY HEAD AND NECK CANCER
(T1NO-T2NO)
Abstract no.: 030
Endoscopic surgical treatment of early laryngeal cancer
- treatment of choice?
Remacle M, Department of ORL - Head & Neck Surgery, University hos-
pital of Louvain at Mont-Godinne, Belgium
Endoscopic excision of laryngeal cancers existed long before laser
came into use. An increasing number of reports in the literature
suggest that the endoscopic laser management of TIS, T1 and
some early T2 lesions is now a viable option. The comparison
of laser management with established conventional methods is
inevitable and necessary. The most important single requirement
is wide exposure of the lesion and the surrounding ‘normal tis-
sue’. If adequate laryngeal exposure could not be obtained for
whatever reason then the endoscopic excision, laser or non-laser,
cannot be accomplished. Subglottic lesions are most difficult for
endoscopic laser surgery. Surgery for malignant lesion involves
complete removal of the tumour, confirmed by intraoperative
frozen section assessment. Endoscopic surgery is indicated for
Tla glottic cancers; selected Tlb glottic cancers; selected T2 glot-
tic cancers; and T1 or T2 supraglottic cancers without infrahyoid
invasion of the epiglottis.
Based on the exhaustive literature review, our conviction is
that it is appropriate to consider C02 laser-assisted endoscopy
within a management strategy, where open reconstructive surgery
is also a possible option.
Endoscopic laser surgery for laryngeal malignancy usually
does not require routine tracheotomy. Hospitalisation following
endoscopic laser surgery usually lasts 1 to 3 days. Voice quality
following cordectomy depends on the extent of cordectomy. No
consensus has yet been reached for comparison of voice quality
following endoscopic treatment and after radiotherapy.
Læknablaðið/Fylgirit 51 2005/91 19
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