[Estimation of smell sense rehabilitation in patients after total laryngectomy].

The loss of sense of smell significantly decreases a quality of life after total laryngectomy. That is why this problem should be considered within a complex rehabilitation of laryngectomized patients. The smell exercises ought to start parallely to the speech rehabilitation.

[Carbon granuloma--an unwanted effect of laryngeal laser microsurgery].

Over recent twenty years, laser microsurgery has gained great recognition in the treatment of early carcinoma. From 1990 to 2004, more than 800 operations on the larynx were performed using laser microsurgery, including 167 chordectomies for squamous cell carcinoma. In 14 patients who were on the follow-up for 1 to 6 months, we observed a spherical, smooth structure (3-5 mm in diameter) in the middle part of the scar, which imitated local relapse of the neoplastic process.

[Proposal of rehabilitation standard after total laryngectomy].

The aim of the paper is to propose a standard program of rehabilitation in patients after total laryngectomy in preoperative, early postoperative period and after the end of laryngological and oncological procedures. During the process of complex rehabilitation the teaching of oesophageal voice mechanism, the improving of respiratory system function, the psychological procedure and the supply of technical equipment must be taken into account. The role of laryngectomee clubs and associations in psychological support is discussed.

[Transcranial Doppler sonography in radical and function neck dissection].

To evaluate the influence of radical or functional neck dissection on cerebral hemodynamics, pre- and postoperatively TCD sonographic examinations were performed in a group of patients following unilateral radical or bilateral radical/functional neck dissection. Cerebral blood flow velocities (cm/s) and pulsatility index (PI) were studied preoperatively and postoperatively 4, 24 and 48 hours after the operation, using a 2 MHz-pulsed transcranial ultrasonographical system (TCD) with a transtemporal approach to the middle cerebral artery. To exclude the influence of general anaesthesia on cerebral circulation TDC was also performed in a group of patients, following operations under general anaesthesia but not radical nor functional neck dissection.