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Hildebrandt ME, Møller PR, Fjældstad AW, Ovesen T. Postinfectious conditions challenge disease-specificity of SNOT-22. Eur Arch Otorhinolaryngol 2024; 281:2395-2402. [PMID: 38177896 DOI: 10.1007/s00405-023-08385-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE The Sino-Nasal-Outcome-Test 22 (SNOT-22) questionnaire assesses treatment outcome and health-related quality of life (HRQOL) in patients with chronic rhinosinusitis (CRS). However, given the overlap between CRS and olfaction in terms of nasal function and the definition of CRS, a fundamental question arises: can patients with olfactory dysfunction (OD) stemming from other causes attain SNOT-22 scores similar to those seen in CRS, even in the absence of CRS? Our study aimed to explore whether OD arising from various postinfectious mechanisms challenges the disease-specificity of SNOT-22 for CRS. If so, could focus on scores within specific symptom domains of SNOT-22 prove valuable in distinguishing between different etiologies. METHODS The study adopted an observational, retrospective cohort design based on prospectively registered patients and related variables using the REDCap platform. 460 patients experiencing OD due to either (1) simple or (2) complex post-COVID-19, (3) postinfectious non-COVID-19, and (4) CRS, were included in the analysis. RESULTS The study revealed that the total SNOT-22 score lacks disease-specificity for CRS. This is evident, because complex postinfectious mechanisms resulting from COVID-19 can produce similar symptoms in patients. Notably, elevated total scores were primarily driven by high subdomain scores within the "sleep and cognition" domain. CONCLUSIONS The application of SNOT-22 as a screening tool needs to be approached with caution, as the total score alone does not provide disease-specific insights. A more thorough exploration of the four symptom domains and the identification of distinctive scoring patterns within the clinical context may prove pivotal in effectively differentiating between various underlying causes.
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Affiliation(s)
- Mascha E Hildebrandt
- Department of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, University Clinic for Balance, Flavour and Sleep, Hospitalsparken 15, 7400, Herning, Denmark.
| | - Patrick R Møller
- Department of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, University Clinic for Balance, Flavour and Sleep, Hospitalsparken 15, 7400, Herning, Denmark
| | - Alexander W Fjældstad
- Department of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, University Clinic for Balance, Flavour and Sleep, Hospitalsparken 15, 7400, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen's Boulevard 82, 8200, Aarhus N, Denmark
| | - Therese Ovesen
- Department of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, University Clinic for Balance, Flavour and Sleep, Hospitalsparken 15, 7400, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen's Boulevard 82, 8200, Aarhus N, Denmark
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Hernandez AK, Walke A, Haehner A, Cuevas M, Hummel T. Correlations between gustatory, trigeminal, and olfactory functions and nasal airflow. Eur Arch Otorhinolaryngol 2023; 280:4101-4109. [PMID: 37129608 PMCID: PMC10153028 DOI: 10.1007/s00405-023-07962-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE To determine the relationship of chemosensory screening and nasal airflow tests among the same set of participants, and to determine other factors that are related to the outcomes of these tests. METHODS Participants had no chemosensory complaints. Structured medical history was taken. Participants underwent 5 screening tests: q-sticks (orthonasal olfaction), q-powders (retronasal olfaction), trigeminal lateralization test, taste sprays, and peak nasal inspiratory flow (PNIF). Ratings of smell/taste ability and nasal airflow were obtained using visual analogue scales (VAS). Composite sinusitis symptoms and significance of olfaction questionnaire scores were also determined. RESULTS Four hundred participants were included in the study, 156 men, 244 women; aged 18-82 years (mean: 46). The q-powders and taste spray scores were weakly positively correlated with all the other chemosensory tests and PNIF. However, chemosensory test scores were not correlated with VAS, composite sinusitis symptoms, and significance of olfaction questionnaire scores. Various tests showed significant decrease starting at specific ages (in years, PNIF and trigeminal lateralization: 40, q-powders: 60, and q-sticks: 70). CONCLUSION Chemosensory screening tests and self-rated chemosensory function showed no correlation in participants without chemosensory complaints. In addition, gustatory function appeared to be correlated with olfactory and trigeminal function but also with nasal airflow, and nasal airflow was related not only to olfactory but also to trigeminal and taste function. Over all, the results suggest that chemosensory functions (orthonasal olfactory, trigeminal, retronasal olfactory, gustatory) and nasal airflow are correlated with each other, which we propose may be possibly mediated, at least in part, through central nervous system interactions.
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Affiliation(s)
- Anna Kristina Hernandez
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany.
- Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines.
- Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines.
| | - Antje Walke
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Mandy Cuevas
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
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Riccardi G, Niccolini GF, Bellizzi MG, Fiore M, Minni A, Barbato C. Post-COVID-19 Anosmia and Therapies: Stay Tuned for New Drugs to Sniff Out. Diseases 2023; 11:79. [PMID: 37366867 DOI: 10.3390/diseases11020079] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Background: Anosmia is defined as the complete absence of olfactory function, which can be caused by a variety of causes, with upper respiratory tract infections being among the most frequent causes. Anosmia due to SARS-CoV-2 infection has attracted attention given its main role in symptomatology and the social impact of the pandemic. Methods: We conducted systematic research in a clinicaltrials.gov database to evaluate all active clinical trials worldwide regarding drug therapies in adult patients for anosmia following SARS-CoV-2 infection with the intention of identifying the nearby prospects to treat Anosmia. We use the following search terms: "Anosmia" AND "COVID-19" OR "SARS-CoV-2" OR "2019 novel coronavirus". Results: We found 18 active clinical trials that met our criteria: one phase 1, one phase 1-2, five phases 2, two phases 2-3, three phases 3, and six phases 4 studies were identified. The drug therapies that appear more effective and promising are PEA-LUT and Cerebrolysin. The other interesting drugs are 13-cis-retinoic acid plus aerosolized Vitamin D, dexamethasone, and corticosteroid nasal irrigation. Conclusions: COVID-19 has allowed us to highlight how much anosmia is an important and debilitating symptom for patients and, above all, to direct research to find a therapy aimed at curing the symptom, whether it derives from SARS-CoV-2 infection or other infections of the upper airways. Some of these therapies are very promising and are almost at the end of experimentation. They also provide hope in this field, which not addressed until recently.
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Affiliation(s)
- Gabriele Riccardi
- Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | | | - Mario Giuseppe Bellizzi
- Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Unit of Translational Biomolecular Medicine, Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Antonio Minni
- Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Unit of Translational Biomolecular Medicine, Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
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Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S. Olfactory Function and Olfactory Disorders. Laryngorhinootologie 2023; 102:S67-S92. [PMID: 37130532 PMCID: PMC10184680 DOI: 10.1055/a-1957-3267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The sense of smell is important. This became especially clear to patients with infection-related olfactory loss during the SARS-CoV-2 pandemic. We react, for example, to the body odors of other humans. The sense of smell warns us of danger, and it allows us to perceive flavors when eating and drinking. In essence, this means quality of life. Therefore, anosmia must be taken seriously. Although olfactory receptor neurons are characterized by regenerative capacity, anosmia is relatively common with about 5 % of anosmic people in the general population. Olfactory disorders are classified according to their causes (e. g., infections of the upper respiratory tract, traumatic brain injury, chronic rhinosinusitis, age) with the resulting different therapeutic options and prognoses. Thorough history taking is therefore important. A wide variety of tools are available for diagnosis, ranging from short screening tests and detailed multidimensional test procedures to electrophysiological and imaging methods. Thus, quantitative olfactory disorders are easily assessable and traceable. For qualitative olfactory disorders such as parosmia, however, no objectifying diagnostic procedures are currently available. Therapeutic options for olfactory disorders are limited. Nevertheless, there are effective options consisting of olfactory training as well as various additive drug therapies. The consultation and the competent discussion with the patients are of major importance.
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Affiliation(s)
- T Hummel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - N Power Guerra
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Medizinische Universität Rostock, Rostock
| | - N Gunder
- Universitäts-HNO Klinik Dresden, Dresden
| | - A Hähner
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - S Menzel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
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5
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Anosmia: Brighton Collaboration case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2023; 41:1902-1910. [PMID: 36775774 DOI: 10.1016/j.vaccine.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/14/2022] [Indexed: 02/12/2023]
Abstract
This is a Brighton Collaboration case definition of anosmia to be used in the evaluation of adverse events following immunization, and for epidemiologic studies for the assessment of background incidence or hypothesis testing. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of SARS-CoV-2 vaccines. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and defined levels of certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network and by two expert reviewers prior to submission.
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6
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Increased risk of olfactory and taste dysfunction in the United States psoriasis population. Eur Arch Otorhinolaryngol 2023; 280:695-702. [PMID: 35790554 DOI: 10.1007/s00405-022-07530-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/24/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND It is plausible that immunopathological processes associated with psoriasis might contribute to the occurrence of olfactory or taste dysfunction. However, the actual association was still unknown. PURPOSE To determine the relationship between olfactory or taste dysfunction and psoriasis. METHODS Two cross-sectional studies were performed by using National Health and Nutrition Examination Survey (NHANES) data. Participants with psoriasis were defined as cases and those without psoriasis were identified as controls. Taste and smell self-reported questionnaires were used to define smell/taste alterations and identification tests were used to assure the smell/taste dysfunctions. Logistic regression models with inverse probability treatment weighting (IPTW) strategies were conducted to investigated the relationship between psoriasis and olfactory or taste dysfunction. RESULTS Self-reported questionnaires indicated that psoriasis patients were more likely to have perceived taste alteration (IPTW-aOR = 1.43) and smell alteration (IPTW-aOR = 1.22). Identification tests revealed that psoriasis was associated with taste dysfunction (IPTW-aOR = 1.28) and olfactory dysfunction (IPTW-aOR = 1.22). Relevant findings showed that psoriasis may be significantly associated with taste or olfactory dysfunction regardless of the questionnaire data or identification examination data used. CONCLUSION Olfactory and taste dysfunction could be considered comorbidities in patients with psoriasis based on our observational study. Therefore, physicians should be cautious of olfaction and taste alterations among patients with psoriasis.
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Hashemian F, Rezazadeh M, Irani AD, Moradi L. Olfactory disorders in COVID-19 patients as a prognostic factor: a systematic review. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2023. [PMCID: PMC9869306 DOI: 10.1186/s43163-022-00360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
Background
The reduction, loss, or impaired sense of smell and taste is common in patients with COVID-19. We aimed to investigate olfactory disorders (ODs) in patients with COVID-19 as a prognostic factor.
Methods
In this systematic review and meta-analysis, studies that assessed ODs in patients with COVID-19 were included. International databases, including PubMed, Embase, MEDLINE, Web of Science, and Scopus, were searched up to 20 March 2021. The random-effects model was used to combine the results of studies. Results were reported with a 95% confidence interval.
Results
In this study, out of 724 references, ten studies had the inclusion criteria. The odds of death in patients with the OD were 69% lower than in those without the ODs (OR = 0.31, 95% CI: 0.14, 0.69), and OD increased the odds of positive polymerase chain reaction (PCR) test (OR = 13.34, 95% CI: 4.2, 42.37).
Conclusions
The findings of our study showed that OD had an inverse and significant relationship with death in COVID-19 patients, and the patients with OD seemed to have a lower risk of mortality.
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8
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Partovi O, Tolebeyan AS. Various presentations of the olfactory hallucination in two patients with migraine disease: Case report. Front Neurol 2022; 13:992763. [PMID: 36452165 PMCID: PMC9702807 DOI: 10.3389/fneur.2022.992763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/31/2022] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVES To report two different presentations of migraine with the olfactory hallucinations. A case with the typical hallucinatory olfactory symptoms preceding migraine headaches and another case with longstanding olfactory hallucinations. BACKGROUND Migraine prevails in about 12% of the general population, with the migraine aura accountable for at least one-third of these cases. The most common aura is the visual aura, followed by the sensory aura, speech, and motor auras. Olfactory hallucinations preceding the headache phase of migraine are rare. To date, the International Classification of Headache Disorders (ICHD) has not recognized them as a subset of migraine aura. RESULTS This report presents a patient with a typical Phantosmia (PO) aura before her migraine headache and a patient who experiences a longstanding PO aura. CONCLUSION The olfactory hallucination may present differently in patients with migraine disease. Based on the clinical significance of migraine with olfactory hallucinations, we propose that the ICHD classify this phenomenon as a subtype of aura in the future. However, larger studies are still required to better assess the pathophysiology of this phenomenon.
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Affiliation(s)
- Omeed Partovi
- Medical College of Wisconsin, Wauwatosa, WI, United States
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9
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Konstantinidis I. Managing Post-traumatic Olfactory Disorders. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00431-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Purpose of Review
This study aims to summarize and critically review recent literature on management of post-traumatic olfactory dysfunction (PTOD) with emphasis on the diagnostic procedure and treatment options.
Recent Findings
Magnetic resonance imaging and olfactory testing are the basis of the diagnostic procedure. Time of diagnosis is critical as the most improvement occurs within the first year after trauma. Olfactory training and oral steroids seem to be a relatively evidence-based therapeutic option but with non-optimal results. Surgery has a limited place in the management of PTOD. Promising future options could be the development of olfactory implants and transplantation of olfactory epithelium or stem cells.
Summary
PTOD management is challenging as it has several pathogenetic mechanisms and relatively poor prognosis. Patients with olfactory impairment and head trauma have diminished quality of life, and increased risk for harmful events and development of depression. Thus, clinicians should not only focus to therapeutic options but equally to appropriate counseling to their patients in order to decrease risks of personal injury and improve their daily life.
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10
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Hura N, Yi JS, Lin SY, Roxbury CR. Magnetic Resonance Imaging as a Diagnostic and Research Tool in Patients with Olfactory Dysfunction: A Systematic Review. Am J Rhinol Allergy 2022; 36:668-683. [PMID: 35585698 DOI: 10.1177/19458924221096913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with acquired, idiopathic olfactory dysfunction (OD) commonly undergo magnetic resonance imaging (MRI) evaluation to rule out intracranial pathologies. This practice is highly debated given the expense of MRI relative to the probability of detecting a treatable lesion. This, combined with the increasing use of MRI in research to investigate the mechanisms underlying OD, provided the impetus for this comprehensive review. OBJECTIVE The purpose of this systematic review was to both assess the utility of MRI in diagnosis of idiopathic OD and to describe MRI findings among mixed OD etiologies to better understand its role as a research tool in this patient population. METHODS A literature search of PubMed, Embase, Cochrane, Web of Science, and Scopus for studies with original MRI data for patients with OD was completed. Studies exclusively investigating patients with neurocognitive deficits or those studying traumatic or congenital etiologies of OD were excluded. RESULTS From 1758 candidate articles, 33 studies were included. Four studies reviewed patients with idiopathic OD for structural pathologies on MRI, of which 17 of 372 (4.6%) patients had a potential central cause identified, and 3 (0.8%) had an olfactory meningioma or olfactory neuroblastoma. Fourteen studies (42.4%) reported significant correlation between olfactory bulb volume and olfactory outcomes, and 6 studies (18.8%) reported gray matter volume reduction, specifically in the orbitofrontal cortex, anterior cingulate cortex, insular cortex, parahippocampal, and piriform cortex areas, in patients with mixed OD etiologies. Functional MRI studies reported reduced brain activation and functional connectivity in olfactory network areas. CONCLUSION MRI uncommonly detects intracranial pathology in patients with idiopathic OD. Among patients with mixed OD etiologies, reduced olfactory bulb and gray matter volume are the most common abnormal findings on MRI. Further research is required to better understand the role of MRI and its cost-effectiveness in patients with acquired, idiopathic OD.
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Affiliation(s)
- Nanki Hura
- Department of Otolaryngology - Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Otolaryngology - Head and Neck Surgery, 6595University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Julie S Yi
- Department of Otolaryngology - Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sandra Y Lin
- Department of Otolaryngology - Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher R Roxbury
- Section of Otolaryngology - Head and Neck Surgery, 21727The University of Chicago Medical Center, Chicago, Illinois, USA
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11
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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12
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Heian IT, Helvik AS, Hummel T, Øie MR, Nordgård S, Bratt M, Thorstensen WM. Measured and self-reported olfactory function in voluntary Norwegian adults. Eur Arch Otorhinolaryngol 2022; 279:4925-4933. [PMID: 35195760 PMCID: PMC9474335 DOI: 10.1007/s00405-022-07298-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
Abstract
Purpose The lack of epidemiological data on the proportion of olfactory dysfunction (OD) using comprehensive olfactory assessment in healthy adults in Scandinavia motivated to the present study which aimed to explore the proportion of OD in voluntary healthy Norwegian adults, assessed by Sniffin’ Sticks, and its correlation to self-reported olfactory function. Furthermore, sociodemographic and clinical factors associated with olfactory function were analysed. Methods The sample included 405 Norwegian participants, aged 18–78 years, 273 women and 132 men, who underwent olfactory testing with extensive Sniffin’ Sticks test, allergy testing, clinical examination with nasal endoscopy and completed a self-administered questionnaire, including self-evaluation of olfactory function on a 100 mm Visual Analogue Scale. Results We found that 37% had OD, of which 1.2% had anosmia assessed with extensive Sniffin’ Sticks test. The proportion of hyposmia and anosmia increased with age. Men and participants with low education had poorer olfactory function scores. Allergy, smoking status, general health and endoscopic findings were not associated with measured olfactory function. We found no correlation between self-reported and measured olfactory function. Conclusions This study has identified that a large proportion of our sample of voluntary healthy Norwegian adults have OD, considerably more common in older adults and somewhat more common in men and individuals with low education. The lack of correlation between self-reported and measured olfactory function highlights the importance of using validated tests for a reliable olfactory evaluation.
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Affiliation(s)
- Ingrid Torvik Heian
- Institute of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway. .,Department of Otolaryngology, Head and Neck Surgery, Molde Sjukehus, Helse Møre og Romsdal, 6412, Molde, Norway.
| | - Anne-Sofie Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Thomas Hummel
- Department of Otolaryngology Smell and Taste Clinic, TU Dresden, Dresden, Germany
| | - Marte Rystad Øie
- Institute of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Otolaryngology, Head and Neck Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Ståle Nordgård
- Institute of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Otolaryngology, Head and Neck Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Mette Bratt
- Institute of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Otolaryngology, Head and Neck Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Wenche Moe Thorstensen
- Institute of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Otolaryngology, Head and Neck Surgery, St. Olavs University Hospital, Trondheim, Norway
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13
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Manan HA, Yahya N, Han P, Hummel T. A systematic review of olfactory-related brain structural changes in patients with congenital or acquired anosmia. Brain Struct Funct 2022; 227:177-202. [PMID: 34635958 PMCID: PMC8505224 DOI: 10.1007/s00429-021-02397-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/26/2021] [Indexed: 02/08/2023]
Abstract
Brain structural features of healthy individuals are associated with olfactory functions. However, due to the pathophysiological differences, congenital and acquired anosmia may exhibit different structural characteristics. A systematic review was undertaken to compare brain structural features between patients with congenital and acquired anosmia. A systematic search was conducted using PubMed/MEDLINE and Scopus electronic databases to identify eligible reports on anosmia and structural changes and reported according to PRISMA guidelines. Reports were extracted for information on demographics, psychophysical evaluation, and structural changes. Then, the report was systematically reviewed based on various aetiologies of anosmia in relation to (1) olfactory bulb, (2) olfactory sulcus, (3) grey matter (GM), and white matter (WM) changes. Twenty-eight published studies were identified. All studies reported consistent findings with strong associations between olfactory bulb volume and olfactory function across etiologies. However, the association of olfactory function with olfactory sulcus depth was inconsistent. The present study observed morphological variations in GM and WM volume in congenital and acquired anosmia. In acquired anosmia, reduced olfactory function is associated with reduced volumes and thickness involving the gyrus rectus, medial orbitofrontal cortex, anterior cingulate cortex, and cerebellum. These findings contrast to those observed in congenital anosmia, where a reduced olfactory function is associated with a larger volume and higher thickness in parts of the olfactory network, including the piriform cortex, orbitofrontal cortex, and insula. The present review proposes that the structural characteristics in congenital and acquired anosmia are altered differently. The mechanisms behind these changes are likely to be multifactorial and involve the interaction with the environment.
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Affiliation(s)
- Hanani Abdul Manan
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56 000, Kuala Lumpur, Malaysia.
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, School of Diagnostic and Applied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Pengfei Han
- The Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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14
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Bakhshaee M, Barzegar-Amini M, Motedayen Z, Khojasteh-Taheri R, Rafiee M, Amini M, Layegh P, Hashemzadeh K, Omidvar D, Hwang PH, Hosseinpoor M. Olfactory Dysfunction in Patients Infected with 2019 Novel Coronavirus. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2021; 33:163-171. [PMID: 34222108 PMCID: PMC8231298 DOI: 10.22038/ijorl.2021.51614.2750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/14/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The current study aimed at investigating the occurrence and features of olfactory dysfunction in patients with confirmed coronavirus disease 2019 (COVID-19) infection. MATERIALS AND METHODS Patients with laboratory and clinically confirmed COVID-19 infection were enrolled in this longitudinal study. They were managed in either the inpatient or outpatient setting. The demographic, clinical, and outcome data were retrieved from patients' medical records. Olfactory dysfunction features, including the onset pattern, duration, and recovery time were investigated. The visual analog scale (VAS) was utilized as a self-rating subjective measurement of olfactory function. RESULTS According to the results, the mean age of the patients (n=502) was obtained at 46.8±18.5 years; moreover, 52.4% and 47.6% of cases were female and male, respectively. It was also revealed that 35.4% and 64.5% of the subjects were outpatients and hospitalized, respectively. Based on the findings, 178 (38.4%) subjects had olfactory dysfunction. The mean values of VAS in hyposmic patients were estimated at 2.5±2.5, 8.3 ±2.1, and 9.4±1.6 at the first evaluation, in 2 weeks, and after 1 month of follow-up (P<0.001). The onset of olfactory dysfunction was more suddenly (58.7%). The majority of cases experienced olfactory dysfunction at the same time as other symptoms 72(51.1%). Based on the results, 0.4% of subjects infected with COVID-19 had olfactory dysfunction as an isolated symptom. The olfactory dysfunction was recovered after 2 weeks in 18 (25.3%) anosmic and 37(46.8%) hyposmic patients. CONCLUSION Olfactory dysfunction seemed to be an important symptom of COVID-19 infection. The occurrence of this disturbance as a transient self-limited condition was significantly higher among female subjects.
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Affiliation(s)
- Mehdi Bakhshaee
- Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Zohreh Motedayen
- Department of Otolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Roshanak Khojasteh-Taheri
- Department of Microbiology, Faculty of Science, Neyshaboor Branch, Islamic Azad University, Neyshaboor, Iran.
- Department of Research, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahdi Rafiee
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahnaz Amini
- Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Parvaneh Layegh
- Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Kamila Hashemzadeh
- Rheumatic Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Delaram Omidvar
- Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Peter H. Hwang
- Department of Rhinology & Endoscopic Skull Base Surgery, Stanford University School of Medicine, Palo Alto, California.
| | - Masoomeh Hosseinpoor
- Department of Otolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.
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15
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Su B, Bleier B, Wei Y, Wu D. Clinical Implications of Psychophysical Olfactory Testing: Assessment, Diagnosis, and Treatment Outcome. Front Neurosci 2021; 15:646956. [PMID: 33815048 PMCID: PMC8012732 DOI: 10.3389/fnins.2021.646956] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose of Review Olfactory dysfunction dramatically impairs quality of life with a prevalence of 20% in the general adult population. Psychophysical olfactory testing has been widely used to evaluate the ability to smell due to its validated utility and feasibility in clinic. This review summarizes the current literature regarding psychophysical olfactory testing and the clinical relevance of the olfactory testing with different components. Furthermore, the review highlights the diagnosis and treatment value of olfactory subtests in patients with olfactory dysfunction. Recent Findings With the accumulation of studies of psychophysical olfactory testing in olfactory disorders, the clinical relevance of olfactory testing with different components is expanding. Different olfactory domains present with distinct olfactory processing and cortical activity. Psychophysical assessment of olfaction with three domains reveals different levels of olfactory processing and might assist with analyzing the pathophysiologic mechanism of the various olfactory disorders. Furthermore, olfactory thresholds provided the largest amount of non-redundant information to the olfactory diagnosis. Sinonasal olfactory dysfunction and non-sinonasal-related olfactory dysfunction are emerging classifications of smell disorders with certain characteristics of olfactory impairment and different responses to the therapy including steroids, sinus surgery, and olfactory training. Summary These recent advancements should promote the understanding of psychophysical olfactory testing, the association between individual subcomponents and neurophysiological processes, and pave the way for precision assessment and treatment of the olfactory dysfunction.
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Affiliation(s)
- Baihan Su
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Benjamin Bleier
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States
| | - Yongxiang Wei
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Department of Otorhinolaryngology Head and Neck Surgery, Capital Institute of Pediatrics, Beijing, China
| | - Dawei Wu
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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16
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Addison AB, Wong B, Ahmed T, Macchi A, Konstantinidis I, Huart C, Frasnelli J, Fjaeldstad AW, Ramakrishnan VR, Rombaux P, Whitcroft KL, Holbrook EH, Poletti SC, Hsieh JW, Landis BN, Boardman J, Welge-Lüssen A, Maru D, Hummel T, Philpott CM. Clinical Olfactory Working Group consensus statement on the treatment of postinfectious olfactory dysfunction. J Allergy Clin Immunol 2021; 147:1704-1719. [PMID: 33453291 DOI: 10.1016/j.jaci.2020.12.641] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/28/2020] [Accepted: 12/08/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD). OBJECTIVE Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists. METHODS A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD. RESULTS The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction. CONCLUSIONS The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options.
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Affiliation(s)
- Alfred B Addison
- East Sussex North Essex Foundation Trust, Ipswich, United Kingdom
| | - Billy Wong
- East Sussex North Essex Foundation Trust, Ipswich, United Kingdom
| | - Tanzime Ahmed
- East Sussex North Essex Foundation Trust, Ipswich, United Kingdom
| | - Alberto Macchi
- ENT University of Insubria, Italian Academy of Rhinology, Varese, Italy
| | - Iordanis Konstantinidis
- Smell and Taste Clinic, 2nd ORL University Department, Aristotle University, Thessaloniki, Greece
| | - Caroline Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; Research Center, Sacré-Coeur Hospital Montréal, Montréal, Québec, Canada
| | - Alexander W Fjaeldstad
- Flavour Clinic, ENT Department, Regional Hospital West Jutland, Holstebro, Denmark; Flavour Institute, Aarhus University, Aarhus, Denmark
| | - Vijay R Ramakrishnan
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, Colo; Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colo
| | - Philippe Rombaux
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Katherine L Whitcroft
- Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Study, London, United Kingdom; South Yorkshire Deanery, Yorkshire and Humber School of Surgery, Yorkshire, United Kingdom
| | - Eric H Holbrook
- Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Mass
| | - Sophia C Poletti
- Department of Otorhinolaryngology - Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Julien W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University Hospitals of Geneva, Geneva, Switzerland
| | - Basile N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Antje Welge-Lüssen
- Department of Otorhinolaryngology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Devina Maru
- Royal College of General Practitioners, London, United Kingdom
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Carl M Philpott
- Fifth Sense, Barrow-in-Furness, United Kingdom; Norfolk Smell and Taste Clinic, James Paget University Hospital NHS Foundation Trust, Gorleston, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
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17
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Levinson R, Elbaz M, Ben-Ami R, Shasha D, Levinson T, Choshen G, Petrov K, Gadoth A, Paran Y. Time course of anosmia and dysgeusia in patients with mild SARS-CoV-2 infection. Infect Dis (Lond) 2020; 52:600-602. [PMID: 32552475 DOI: 10.1080/23744235.2020.1772992] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Ruth Levinson
- Internal Medicine Clinic, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Elbaz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - David Shasha
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tal Levinson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Guy Choshen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Internal Medicine H, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ksenia Petrov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Clinical Research Unit, Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avi Gadoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Paran
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Internal Medicine H, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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18
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19
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Qiao XF, Bai YH, Wang GP, Li X, Zheng W. Clinical effects of two combinations of olfactory agents on olfactory dysfunction after upper respiratory tract infection during olfactory training. ACTA ACUST UNITED AC 2020; 66:18-24. [PMID: 32130376 DOI: 10.1590/1806-9282.66.1.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To compare two combinations of olfactory agents for olfactory training therapy of olfactory dysfunction after upper respiratory tract infection (URTI) and investigate the influencing factors on clinical effects. METHODS 125 patients with olfactory dysfunction were randomly divided into two groups: test and control. During the olfactory training, four odors were used in both groups. The olfactory training lasted for 24 weeks. Then, participants were tested using Sniffin' Sticks and threshold-discrimination-identification (TDI) composite scoring before treatment and at 1, 3, and 6 months after treatment. The TDI scores were compared at different time points between the groups and within them, and influence factors were analyzed. RESULTS There was no significant difference in TDI scores between both groups. Furthermore, TDI scores did not significantly change after one month of treatment in either of the groups. After 3 and 6 months of treatment, TDI scores both significantly increased, and the odor discrimination and identification abilities significantly strengthened in both groups; however, the odor thresholds did not improve. The course of the disease was a significant influencing factor on the therapeutic effect of olfactory training for both groups. CONCLUSION The combination of essential balm, vinegar, alcohol, and rose perfume for olfactory training, which are scents commonly found in daily life, can effectively cure URTI-induced olfactory dysfunction, and significantly improve the odor discrimination and identification abilities. Furthermore, prolonging the treatment time can help with the recovery of olfactory functions, and earlier olfactory training can improve the therapeutic effect.
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Affiliation(s)
- Xiao-Feng Qiao
- . Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
| | - Yin-Huan Bai
- . Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
| | - Guo-Ping Wang
- . Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
| | - Xin Li
- . Department of Surgery, Children's Hospital of Shanxi Province, Taiyuan 030001, China
| | - Wei Zheng
- . Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
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20
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Birkenbeuel JL, Cheung DC, Sahyouni R, Goshtasbi K, Chua JT, Choy JAI, Bitner B, Kuan EC. The Use of Imaging to Detect Intracranial Tumors in Idiopathic Olfactory Dysfunction: A Systematic Review. Am J Rhinol Allergy 2019; 34:297-305. [PMID: 31747774 DOI: 10.1177/1945892419889325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To review the literature regarding the use of intracranial imaging as a screening tool for idiopathic olfactory loss (IOL) and to review the incidence of identifying a sinonasal or intracranial neoplasm as a result of intracranial imaging. Methods A systematic review of published English-language literature was performed using PubMed, Ovid MEDLINE, Scopus, and Cochrane databases. Results Of the 694 available abstracts, 5 met inclusion criteria for this review. Out of 470 eligible patients, intracranial imaging identified tumors causing IOL in 8 patients (1.7%). Tumor detection rates ranged from 0% to 4.9%. Of the 470 eligible patients, intracranial imaging detected intracranial or sinonasal pathology, excluding tumors, causing IOL in 53 patients (11%). The findings ranged from 0.77% to 23%. Of the 604 eligible IOL patients, 470 (81%) underwent intracranial imaging, ranging from 53% to 100%. Conclusions In most cases, diagnostic imaging in IOL patients is frequently ordered. This study finds computed tomography or magnetic resonance imaging to be an important recommendation given to all patients with IOL. Although the overall rate of detecting tumor from diagnostic imaging is low, it is important to offer diagnostic imaging to this subset of patients to avoid missing tumors at an early stage.
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Affiliation(s)
- Jack L Birkenbeuel
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Dillon C Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Ronald Sahyouni
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Janice T Chua
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Joseph A I Choy
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Benjamin Bitner
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California
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21
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Qiao XF, Wang GP, Li X, Bai YH, Zheng W. Analysis of the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection. Acta Otolaryngol 2019; 139:643-646. [PMID: 31124736 DOI: 10.1080/00016489.2019.1614224] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Olfactory dysfunction is a common symptom during otolaryngology outpatient service. Objective: To explore the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection (URTI), and its influence factors. Material and methods: A total of 60 confirmed cases of URTI-induced olfactory dysfunction were enrolled into the present study. The olfactory training lasted for 24 weeks. These patients were tested using Sniffin' Sticks and threshold-discrimination-identification (TDI) composite scoring before treatment, and at 1, 3 and 6 months after treatment. Results: It was found that URTI-induced olfactory dysfunction patients had more evident deterioration in odor identification ability. The effective rates of olfactory training on olfactory dysfunction at 1, 3 and 6 months after treatment were 1.67%, 26.67% and 41.67%, respectively. The TDI scores at the 3rd and 6th months, but not at the 1st month, were significantly higher, when compared to those before treatment. The course of diseases was a significant influence factor on the therapeutic effect of olfactory training (OR = 0.805, 95% CI: 0.696-0.931). Conclusions: Olfactory training can efficiently cure URTI-induced olfactory dysfunction, and in particular, significantly improve the odor discrimination ability and odor identification ability. Significance: Providing useful data for further research regarding olfactory dysfunction.
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Affiliation(s)
- Xiao-Feng Qiao
- Department of Otorhinolaryngology, Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Guo-Ping Wang
- Department of Otorhinolaryngology, Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Xin Li
- Department of Surgery, Children’s Hospital of Shanxi Province, Taiyuan, China
| | - Yin-Huan Bai
- Department of Otorhinolaryngology, Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Wei Zheng
- Department of Otorhinolaryngology, Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University, Taiyuan, China
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22
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Schofield PW, Doty RL. The influence of head injury on olfactory and gustatory function. HANDBOOK OF CLINICAL NEUROLOGY 2019; 164:409-429. [PMID: 31604560 DOI: 10.1016/b978-0-444-63855-7.00023-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Head injury, particularly that resulting in brain injury, is a significant public health concern. For example, annual incidence rates of traumatic brain injury, a common consequence of head injury, range from 54 to 60 million people worldwide, including 2.2-3.6 million people whose trauma is moderate to severe. Trauma to the face and brain, including blast injuries common in modern warfare, can result in alterations in the ability to both smell and taste. In the case of smell, these include total loss of function (anosmia), decreased sensitivity (hyposmia), alterations in odor quality (dysosmia), and hallucination (phantosmia). Although taste dysfunction, i.e., altered perception of such basic taste-bud-mediated sensations as sweet, sour, bitter, salty, and savory (umami), can be similarly influenced by head trauma, the effects are typically more subtle and less studied. The present review provides an up-to-date assessment of what is known about the impact of head injury on quantitative measures of taste and smell function, including the influences of severity, type of injury, location of insults, prognosis, and approaches to therapy.
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Affiliation(s)
- Peter W Schofield
- Neuropsychiatry Service, Hunter New England Local Health District and Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia.
| | - Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Wolf A, Liesinger L, Spoerk S, Schittmayer M, Lang-Loidolt D, Birner-Gruenberger R, Tomazic PV. Olfactory cleft proteome does not reflect olfactory performance in patients with idiopathic and postinfectious olfactory disorder: A pilot study. Sci Rep 2018; 8:17554. [PMID: 30510230 PMCID: PMC6277379 DOI: 10.1038/s41598-018-35776-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/09/2018] [Indexed: 01/15/2023] Open
Abstract
Technical advances including liquid chromatography-tandem mass spectrometry and its data analysis enable detailed proteomic analysis of the nasal mucus. Alterations of the nasal mucus proteome may provoke substantial changes of the nasal physiology and have already been associated with rhinologic diseases such as allergic rhinitis. This study was conducted as a pilot study to map the olfactory cleft proteome using current techniques for proteomic analysis. Furthermore, we aimed to investigate proteomic changes as potential biomarkers in patients suffering from idiopathic and postinfectious olfactory disorders compared to healthy controls. Seven patients with idiopathic hyposmia and anosmia, seven patients with postinfectious hyposmia and anosmia and seven healthy controls were included in this study. In total, 1117 different proteins were detected in at least five patients in at least one group. Results of this study did not reveal significant differences regarding the proteomic composition of the olfactory cleft mucus between patients versus healthy controls. Among proteins involved in olfactory perception the G protein family was detected but also found unchanged between groups. Investigation of protein composition by liquid chromatography-tandem mass spectrometry enabled us to perform an in-depth analysis of the olfactory cleft mucus proteome regarding the diversity of different proteins in individual patients. However untargeted proteomics of the olfactory cleft mucus may not be an applicable approach to develop biomarkers for olfactory disorders. Targeted analyses of distinct proteins known to be involved in olfactory perception but not detected by our approach, e.g. odorant binding proteins, may provide more information regarding pathophysiology of olfactory diseases.
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Affiliation(s)
- Axel Wolf
- Department of Otorhinolaryngology, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Laura Liesinger
- Gottfried Schatz Research Center, Medical University of Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
- Omics Center Graz, BioTechMed-Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
| | - Stefan Spoerk
- Gottfried Schatz Research Center, Medical University of Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
- Omics Center Graz, BioTechMed-Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
| | - Matthias Schittmayer
- Gottfried Schatz Research Center, Medical University of Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
- Omics Center Graz, BioTechMed-Graz, Stiftingtalstrasse 24, 8010, Graz, Austria
| | - Doris Lang-Loidolt
- Department of Otorhinolaryngology, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Ruth Birner-Gruenberger
- Gottfried Schatz Research Center, Medical University of Graz, Stiftingtalstrasse 24, 8010, Graz, Austria.
- Omics Center Graz, BioTechMed-Graz, Stiftingtalstrasse 24, 8010, Graz, Austria.
| | - Peter V Tomazic
- Department of Otorhinolaryngology, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria.
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Werner S, Nies E. Olfactory dysfunction revisited: a reappraisal of work-related olfactory dysfunction caused by chemicals. J Occup Med Toxicol 2018. [PMID: 30202422 DOI: 10.1186/s12995‐018‐0209‐6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Occupational exposure to numerous individual chemicals has been associated with olfactory dysfunction, mainly in individual case descriptions. Comprehensive epidemiological investigations into the olfactotoxic effect of working substances show that the human sense of smell may be impaired by exposure to metal compounds involving cadmium, chromium and nickel, and to formaldehyde. This conclusion is supported by the results of animal experiments. The level of evidence for a relationship between olfactory dysfunction and workplace exposure to other substances is relatively weak.
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Affiliation(s)
- Sabine Werner
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Unit Toxicology of Industrial Chemicals, Alte Heerstrasse 111, 53757 Sankt Augustin, Germany
| | - Eberhard Nies
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Unit Toxicology of Industrial Chemicals, Alte Heerstrasse 111, 53757 Sankt Augustin, Germany
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25
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Werner S, Nies E. Olfactory dysfunction revisited: a reappraisal of work-related olfactory dysfunction caused by chemicals. J Occup Med Toxicol 2018; 13:28. [PMID: 30202422 PMCID: PMC6124006 DOI: 10.1186/s12995-018-0209-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 07/30/2018] [Indexed: 11/10/2022] Open
Abstract
Occupational exposure to numerous individual chemicals has been associated with olfactory dysfunction, mainly in individual case descriptions. Comprehensive epidemiological investigations into the olfactotoxic effect of working substances show that the human sense of smell may be impaired by exposure to metal compounds involving cadmium, chromium and nickel, and to formaldehyde. This conclusion is supported by the results of animal experiments. The level of evidence for a relationship between olfactory dysfunction and workplace exposure to other substances is relatively weak.
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Affiliation(s)
- Sabine Werner
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Unit Toxicology of Industrial Chemicals, Alte Heerstrasse 111, 53757 Sankt Augustin, Germany
| | - Eberhard Nies
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Unit Toxicology of Industrial Chemicals, Alte Heerstrasse 111, 53757 Sankt Augustin, Germany
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26
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Magliulo G, De Vincentiis M, Iannella G, Ciofalo A, Pasquariello B, Manno A, Angeletti D, Polimeni A. Olfactory evaluation in obstructive sleep apnoea patients. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2018; 38:338-345. [PMID: 30197425 PMCID: PMC6146584 DOI: 10.14639/0392-100x-1981] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/24/2018] [Indexed: 12/31/2022]
Abstract
The sense of smell has a high impact on the quality of life. The aim of the present study was to investigate olfactory dysfunction in patients with obstructive sleep apnoea syndrome (OSAS) and correlate the severity of disease with olfactory dysfunction. The relationships between nasal obstruction, nasal mucociliary cleareance and olfactory tests were also evaluated. Sixty patients with a diagnosis of OSAS were enrolled and underwent olfactory function evaluation. In all patients olfactory performance was tested with the Sniffin' Sticks method. Mucociliary transport times and anterior rhinomanometry were performed to identify eventual nasal obstruction and deficits in nasal mucociliary clearance. Olfactory dysfunction was present in 22 (36.6%) patients of the study group: of these, hyposmia was present in 19 (86.4%) and anosmia in 3 (13.6%). The mean TDI score in the study group was 30. A strong correlation between the olfactory dysfunction and severity of sleep apnoea measured using the AHI was found. Patients with OSA would seem to have a high incidence of olfactory dysfunction. The degree of olfactory dysfunction appears to be related to the severity of disease. However, other co-factors such as nasal obstruction and reduced mucociliary clearance might also play a role in of the aetiology of this condition.
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Affiliation(s)
- G. Magliulo
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | | | - G. Iannella
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - A. Ciofalo
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - B. Pasquariello
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - A. Manno
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - D. Angeletti
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - A. Polimeni
- Department of Oral and Maxillo Facial Sciences, University Sapienza, Rome, Italy
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27
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Substantia nigra fractional anisotropy changes confirm the PD at-risk status of patients with idiopathic smell loss. Parkinsonism Relat Disord 2018; 50:113-116. [PMID: 29477459 DOI: 10.1016/j.parkreldis.2018.02.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/28/2017] [Accepted: 02/14/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Individuals with unexplained smell loss constitute an at-risk population for the development of Parkinson's disease (PD). Currently, no specific MRI patterns are known for early PD diagnosis. In this study, we measured the fractional anisotropy (FA) in the substantia nigra (SN) in PD patients, in patients with idiopathic smell loss, and in healthy controls. METHODS All subjects underwent extensive olfactory testing and MR imaging data were obtained to explore SN diffusion characteristics. The SN regions were manually identified by two independent raters on the individual imaging data. RESULTS FA measurements in the SN revealed significant group differences, with reduced values clearly distinguishing PD patients and patients with idiopathic smell loss from healthy controls. CONCLUSION These findings indicate a reduced intrinsic integrity of the SN in PD at-risk subjects and support the risk status of patients with idiopathic smell loss.
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28
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Yasak AG, Yigit O, Araz Server E, Durna Dastan S, Gul M. The effectiveness of platelet-rich plasma in an anosmia-induced mice model. Laryngoscope 2017; 128:E157-E162. [PMID: 29243256 DOI: 10.1002/lary.27029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/27/2017] [Accepted: 11/01/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE In this study, we aimed to functionally and morphologically demonstrate the effectiveness of platelet-rich plasma (PRP) on anosmia in a mouse model of anosmia. STUDY DESIGN Animal study. METHODS A total of 16 male mice were included. When selecting the mice, the food-finding test (FFT) was used to make sure that the animals could smell, and anosmia was induced by administration of intraperitoneal 3-methylindole. The mice were randomly divided into two groups of eight (groups A and B). After 1 week, topical PRP was administered to the mice in group A and topical saline was administered to the mice in group B. The FFT was again administered at 7, 14, and 21 days. The mice were sacrificed on day 21, the olfactory neuroepithelium was histopathologically examined, and the epithelial damage scores and epithelial thickness were measured. RESULTS After topical administration of PRP and saline, the difference in the average FFT values of the groups was statistically significant at 7, 14, and 21 days (P < 0,005). During the histopathological examination, the epithelial damage score was statistically significantly lower in the PRP group (P = 0.001) than in the saline group, and epithelial thickness was statistically significantly greater in the PRP group compared to the saline group (P = 0.003). CONCLUSION We showed that PRP administration has a curative effect on olfactory functions in an anosmia-induced mice model. However, there is a need for further research before PRP can be considered for use in patients with anosmia in clinical practice. LEVEL OF EVIDENCE NA. Laryngoscope, 128:E157-E162, 2018.
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Affiliation(s)
- Ahmet Gorkem Yasak
- Department of Otorhinolaryngology/Head and Neck Surgery, Kilis State Hospital, Kilis, Turkey
| | - Ozgur Yigit
- Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ela Araz Server
- Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Sevgi Durna Dastan
- Zootechnical and Animal Nutrition Faculty of Veterinary, Cumhuriyet University, Sivas, Turkey
| | - Mehmet Gul
- Histology and Embryology Department, Inonu University Faculty of Medicine, Malatya, Turkey
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Prognostic value of olfactory nerve damage measured with thallium-based olfactory imaging in patients with idiopathic olfactory dysfunction. Sci Rep 2017; 7:3581. [PMID: 28620194 PMCID: PMC5472561 DOI: 10.1038/s41598-017-03894-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/05/2017] [Indexed: 11/08/2022] Open
Abstract
Idiopathic olfactory disorder is resistant to treatment, and the recovery time is long. This study investigated the prognostic value of the migration of nasally administered thallium-201 to the olfactory bulb (thallium migration to the OB), a measure of olfactory nerve damage, in patients with idiopathic olfactory disorders. Twenty-four patients with idiopathic olfactory disorders were enrolled in the study (7 women and 17 men; aged 23-73 years). We retrospectively analyzed potential prognostic markers in subjects who underwent thallium-based olfactory imaging with the nasal administration of thallium-201 before conventional treatment with the Japanese herbal medicine tokishakuyakusan and compared those data with the prognosis. Log-rank tests were performed to assess the relationship between thallium migration to the OB (<4.6% [low] vs. ≥4.6% [high]; data dichotomized at the optimal cutoff value) and the duration until recovery of the odor recognition threshold determined by a standard olfactory function test (T&T olfactometry) after the treatment. Upon statistical analysis, we found that high thallium migration to the OB was significantly correlated with better prognosis in patients. Our results suggest that patients with intact olfactory nerve fibers could be selected using thallium-based imaging for the long-term follow-up of olfactory dysfunction.
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30
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Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, Muluk NB, Scadding G, Manole F, Hupin C, Fokkens WJ, Akdis C, Bachert C, Demoly P, Mullol J, Muraro A, Papadopoulos N, Pawankar R, Rombaux P, Toskala E, Kalogjera L, Prokopakis E, Hellings PW, Bousquet J. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy 2017; 7:17. [PMID: 28572918 PMCID: PMC5452333 DOI: 10.1186/s13601-017-0153-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.
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Affiliation(s)
- C. Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - P. Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - R. Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany
| | - C. Rondon
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - V. Hox
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - M. Rudenko
- London Allergy and Immunology Centre, London, UK
| | - N. B. Muluk
- ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - G. Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK
| | - F. Manole
- Faculty of Medicine, ENT Department, University of Oradea, Oradea, Romania
| | - C. Hupin
- Institut de Recherche Expérimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - W. J. Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - C. Akdis
- Christine Kuhne-Center for Allergy Research and Education, Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - C. Bachert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - P. Demoly
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - J. Mullol
- Unitat de Rinologia i Clinica de l’Olfacte, Servei d’Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia Spain
| | - A. Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - N. Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | | | - P. Rombaux
- Service d’ORL, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - E. Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA USA
| | - L. Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sestre milosrdnice, Zagreb, Croatia
| | - E. Prokopakis
- Department of Otorhinolaryngology, University Hospital of Crete, Crete, Greece
| | - P. W. Hellings
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - J. Bousquet
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
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Affiliation(s)
- Finja Thiermann
- Faculty of Life Sciences Clinical Pharmacy & Diagnostics Vienna Austria
| | - Gerhard Buchbauer
- Faculty of Life Sciences Clinical Pharmacy & Diagnostics Vienna Austria
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Abstract
Olfactory loss is frequent. However, in public not many people complain of that, or they are even not (fully) aware of it. This indicates that it is possible to live a life without a sense of smell, albeit it is more dangerous, less pleasant, and food tastes much less interesting. Most common causes for smell loss are sinunasal disease (chronic rhinosinusitis with and without nasal polyps), acute infections of the upper airways, head trauma, and neurodegenerative disorders. In many people smell loss seems to be due to the aging process. Before treatment olfactory disorders are diagnosed according to cause with the medical history being a big portion of the diagnostic process. Olfactory disorders are in principle reversible, with a relatively high degree of spontaneous improvement in olfactory loss following infections of the upper respiratory tract. Medical treatment is according to cause. It also involves surgical approaches as well as conservative treatments including the use of corticosteroids, antibiotics, or smell training. Because today olfactory dysfunction seems to receive more attention than in previous years it can be expected that tomorrow we will have more specific and effective treatment options available.
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Rombaux P, Huart C, Levie P, Cingi C, Hummel T. Olfaction in Chronic Rhinosinusitis. Curr Allergy Asthma Rep 2016; 16:41. [PMID: 27131498 DOI: 10.1007/s11882-016-0617-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Olfactory dysfunction is a frequent complaint in chronic rhinosinusitis patients and has a significant impact on quality of life. Therefore, it is essential that clinicians are aware of the importance of olfactory dysfunction in chronic rhinosinusitis (CRS) patients and know how to deal with it. Notably, the evaluation of olfactory function (i.e., using psychophysical testing) and imagery of olfactory bulb play an important role in the evaluation of patients and give essential information about the "baseline" olfactory function. Because the high impact of olfactory function on quality of life and medical and/or surgical treatment should be proposed to patients. However, it remains difficult to predict the outcome of treatment as well as long-term efficacy. The first section of this review is dedicated to the assessment of olfactory function. Secondly, we will discuss the etiopathology of olfactory dysfunction in CRS with and without nasal polyps. Finally, we will review literature findings about the efficacy of different treatments on olfactory function.
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Affiliation(s)
- Philippe Rombaux
- Department of Otorhinolaryngology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Av Hippocrate, 10, 1200, Brussels, Belgium. .,Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium.
| | - C Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Av Hippocrate, 10, 1200, Brussels, Belgium.,Institute of Neurosciences, Université Catholique de Louvain, Brussels, Belgium
| | - P Levie
- Department of Otorhinolaryngology, Clinique Sainte-Anne, Brussels, Belgium
| | - C Cingi
- ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - T Hummel
- Interdisciplinary Center "Smell & Taste", Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Jenkins EK, Lee-Fowler TM, Angle TC, Behrend EN, Moore GE. Effects of oral administration of metronidazole and doxycycline on olfactory capabilities of explosives detection dogs. Am J Vet Res 2016; 77:906-12. [DOI: 10.2460/ajvr.77.8.906] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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35
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Servello A, Fioretti A, Gualdi G, Di Biasi C, Pittalis A, Sollaku S, Pavaci S, Tortorella F, Fusetti M, Valenti M, Masedu F, Cacciafesta M, Marigliano V, Ettorre E, Pagliarella M. Olfactory Dysfunction, Olfactory Bulb Volume and Alzheimer's Disease: Is There a Correlation? A Pilot Study1. J Alzheimers Dis 2016; 48:395-402. [PMID: 26402003 DOI: 10.3233/jad-150232] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Olfactory dysfunction is present since the earliest stage of Alzheimer's disease (AD). In AD patients, the olfactory impairment has been correlated with atrophy of some structures of the olfactory system, but the role of the olfactory bulb remains unclear. OBJECTIVE The aim of our work is to test if patients suffering from AD exhibit a statistically significant reduction of the average volume of the olfactory bulb (OBV) compared to healthy subjects. METHODS 78 subjects were enrolled in the study and divided into three groups: 28 healthy elderly (22 females, 6 males, mean age 69.4 ± 9.2), 25 patients with mild cognitive impairment (MCI) amnestic type (14 females, 11 males, mean age 74.5 ± 7.5), and 25 mild AD patients (14 females, 11 males, mean age 73.7 ± 6.8). Every subject underwent an MRI study of the olfactory bulb and an olfactory assessment with the Sniffin' Stick Extended Test. RESULTS The statistical analysis showed no correlation between the OBV and MCI or AD. Moreover, olfactory function and OBV were not correlated in any of the three groups. CONCLUSION The reduction of OBV does not seem to represent an index of neuronal damage in the earliest stages of AD.
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Affiliation(s)
- Adriana Servello
- Department of Public Health and Infectious Disease, La Sapienza, University of Rome, Rome, Italy
| | - Alessandra Fioretti
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
| | - Gianfranco Gualdi
- Radiology, Umberto I Hospital, Department of Emergency, La Sapienza, University of Rome, Rome, Italy
| | - Claudio Di Biasi
- Radiology, Umberto I Hospital, Department of Emergency, La Sapienza, University of Rome, Rome, Italy
| | - Angelo Pittalis
- Radiology, Umberto I Hospital, Department of Emergency, La Sapienza, University of Rome, Rome, Italy
| | - Saadi Sollaku
- Radiology, Umberto I Hospital, Department of Emergency, La Sapienza, University of Rome, Rome, Italy
| | - Silva Pavaci
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
| | - Federica Tortorella
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
| | - Marco Fusetti
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
| | - Marco Valenti
- Section of Clinical Epidemiology, Department of Applied Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesco Masedu
- Section of Clinical Epidemiology, Department of Applied Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mauro Cacciafesta
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza, University of Rome, Rome, Italy
| | - Vincenzo Marigliano
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza, University of Rome, Rome, Italy
| | - Evaristo Ettorre
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza, University of Rome, Rome, Italy
| | - Martina Pagliarella
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
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Muller MLTM, Albin RL, Bohnen NI, Jennings D, Siderowf A, Stern M, Seibyl J, Eberly S, Oakes D, Marek K. Imaging prodromal Parkinson disease: The Parkinson Associated Risk Syndrome Study. Neurology 2015; 84:2292. [DOI: 10.1212/wnl.0000000000001654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cantone E, Maione N, Di Rubbo V, Esposito F, Iengo M. Olfactory performance after crenotherapy in chronic rhinosinusitis in the elderly. Laryngoscope 2015; 125:1529-34. [PMID: 25639589 DOI: 10.1002/lary.25173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/17/2014] [Accepted: 12/31/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of crenotherapy on the olfactory performance of elderly patients with chronic rhinosinusitis (CRS). STUDY DESIGN A longitudinal case-control study of a cohort of elderly patients affected by CRS and olfactory dysfunction assessed with the Sniffin' Sticks (Burghart Medical Technology, Wedel, Germany) (SS) olfactory test. METHODS One hundred and thirty-seven elderly subjects with CRS were divided into two groups. The investigational arm (n = 69) underwent crenotherapy with hyperthermal water, rich in mineral salts, and the control group (n = 68) underwent NaCl 0.9% both for 12 days. At baseline and at 1 and 6 months after treatment, both groups underwent ear nose and throat assessment and SS. Self-report questionnaires were administered at baseline to evaluate the patients' own olfactory response, and after treatment to evaluate their degree tolerability. Olfactory performance was then evaluated in elderly subjects with hyposmia without CRS (n = 40) and in younger subjects with both hyposmia and CRS (n = 40). RESULTS No adverse reactions were reported after crenotherapy. The SS total score showed that crenotherapy induced a statistically significant improvement in the olfactory function of both the elderly and the younger subjects with hyposmia and CRS. By contrast, no improvement was observed in the control arm and in the elderly with hyposmia without CRS. All subjects showed a good degree of tolerability. CONCLUSIONS We demonstrated that crenotherapy effectively improves olfactory function in elderly patients with CRS. Finally, our study suggests that crenotherapy represents a safe therapeutic strategy for the treatment of CRS and olfactory dysfunction in the elderly.
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Affiliation(s)
- Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT.,Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples
| | - Nunzia Maione
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT
| | - Vittoria Di Rubbo
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT
| | - Fabrizio Esposito
- Department of Medicine and Surgery, University of Salerno, Baronissi (SA), Italy
| | - Maurizio Iengo
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT
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