Reduced olfactory bulb volume in total laryngectomy patients: a magnetic resonance imaging study

The olfactory bulb (OB) is a remarkably plastic structure with highly active afferent neurons, which is partly reflected by its volume. Although deterioration of olfaction after total laryngectomy is reported by many patients, this problem has not received widespread attention. There has been no study that had addresses this loss olfactory ability as a function of OB volume. The aim of this study was to determine OB volume changes after laryngectomy.

Twenty one patients post-total laryngectomy and 17 subjects with normal olfactory function underwent magnetic resonance imaging (MRI) for volumetric measurement of the OB. The history of all participants was taken in detail to exclude other possible causes of smell dysfunction. Volumetric measurement of the OB was performed by manual segmentation of the OB into coronal slices. Olfactory function was assessed with the orthonasal olfaction test.

There was no statistically significant difference in volume between the right and left sides of the OB in the study and control groups. However, the study group had smaller OB volumes than the control group. In our assessment of orthonasal olfaction, patients who were post-total laryngectomy had worse orthonasal olfactory function than the control group. There were significant correlations between OB volumes and orthonasal test scores.

Our MRI study showed that post-total laryngectomy patients had higher rates of olfactory bulb atrophy than the control subjects. Laryngectomy is associated with measurable decreases in olfactory function and this study hopes to further clarify this association by demonstrating that patients with total laryngectomy have reduced OB volumes when compared to the normal population.