Development of a clinical instrument improving rehabilitation of olfaction with the Nasal Airflow-Inducing Maneuver in Swedish laryngectomized patients.

Conclusion: The protocol is a useful and reliable tool for evaluating the use of the Nasal Airflow-Inducing Maneuver (NAIM) in patients who have undergone total laryngectomy. It facilitates the optimization and improvement of olfactory treatment with NAIM and is sensitive to changes over time. However, further modification of the protocol is needed before a broad implementation into routine clinical practice can be recommended.
Objectives: To develop and assess whether a protocol evaluating NAIM variables is sensitive and reliable to study olfactory function after total laryngectomy.
Subjects and Methods: Video documentation from 21 laryngectomized patients receiving olfactory rehabilitation during the study period 2002-2005 was used. The patients' execution of NAIM was evaluated using a protocol with identified NAIM variables. Olfactory acuity was tested with the Scandinavian Olfactory Identification Test (SOIT). Data from the first (baseline) and third (after treatment) intervention sessions and from follow-up at 6 and 12 months are reported.
Results: According to the NAIM evaluation protocol patients significantly improved their execution of the NAIM technique over time and these improvements were associated with improvements in olfactory acuity (SOIT). Using the protocol important key variables for improvement of the NAIM technique were identified. The inter- and intra-rater reliability for the NAIM evaluation protocol was moderate to good.