1
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Pieniak M, Tutar C, Jedryczka W, Benkhatar H, Debroise Blanchard-Dignac V, Haehner A, Hummel T. A practical test for retronasal odor identification based on aromatized tablets. J Neurosci Methods 2024; 406:110135. [PMID: 38583589 DOI: 10.1016/j.jneumeth.2024.110135] [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: 01/27/2024] [Revised: 03/17/2024] [Accepted: 04/03/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Olfactory perceptions elicited by odors originating from within the body (retronasal olfaction) play a crucial role in well-being and are often disrupted in various medical conditions. However, the assessment of retronasal olfaction in research and the clinical practice is impeded by the lack of commercially available tests and limited standardization of existing testing materials. NEW METHOD The novel ThreeT retronasal odor identification test employs 20 flavored tablets that deliver a standardized amount of odorous stimuli. The items represent common food- and non-food-related odors. RESULTS The ThreeT test effectively distinguishes patients with olfactory dysfunction from healthy controls, achieving a specificity of 86% and sensitivity of 73%. Its scores remain stable for up to 3 months (r=.79). COMPARISON WITH EXISTING METHOD ThreeT test exhibits a strong correlation with "Tasteless powders" measure of retronasal olfaction (r=.78) and classifies people into healthy and patient groups with similar accuracy. Test-retest stability of ThreeT is slightly higher than the stability of "Tasteless powders" (r=.79 vs r=.74). CONCLUSIONS ThreeT is suitable for integration into scientific research and clinical practice to monitor retronasal odor identification abilities.
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Affiliation(s)
- Michal Pieniak
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany; Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | - Can Tutar
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany
| | - Wiktoria Jedryczka
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany; Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | - Hakim Benkhatar
- Centre Hospitalier de Versailles, Service ORL et Chirurgie Cervico-Faciale, Le Chesnay-Rocquencourt, France
| | | | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstrasse 74, Dresden 01307, Germany.
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2
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Stafford LD, Nunkoosing K, Haydon-Laurelut M, Fisher M. Experiences of living without a sense of smell: Like "Being Behind Glass". PLoS One 2023; 18:e0293110. [PMID: 37856489 PMCID: PMC10586628 DOI: 10.1371/journal.pone.0293110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
This study addresses the paucity of research concerning the subjective experiences of those affected by anosmia. In the study, we interviewed individuals(n = 11) recruited via the charity (Fifth Sense) and used Interpretative Phenomenological Analysis (IPA) to analyse the data. Findings revealed three main themes and seven sub themes. The main themes are Living with Anosmia; Remembrance of things old and new and Resilience. The study reveals the process of becoming aware of being anosmic and the relationships with others in this process including potentially unhelpful minimisations of the impact by professionals. In addition to a sense of isolation and insecurity, living with anosmia for some participants brought with it an identification of being 'anosmic' and feeling part of a community. This was in contrast to a general lack of public knowledge and understanding of anosmia. The findings of the study demonstrated the importance of smell to time, place and relationship and the recalling of smells as bringing a sense of connectivity to loved ones, of times past and also a sense of loss of ability. Participants also described the ways in which they coped and adapted to a life with anosmia and focused on positive aspects of life. These findings provide a rich qualitative account of the experience of anosmia. The findings point towards future research which could inform us about the lives of those who are anosmic and currently unaware and of those recently diagnosed, which will create a richer understanding of the experiences of anosmia.
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Affiliation(s)
- Lorenzo D. Stafford
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Karl Nunkoosing
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | | | - Michael Fisher
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
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3
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Hummel T, T. Liu D, A. Müller C, A. Stuck B, Welge-Lüssen A, Hähner A. Olfactory Dysfunction: Etiology, Diagnosis, and Treatment. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:146-154. [PMID: 36647581 PMCID: PMC10198165 DOI: 10.3238/arztebl.m2022.0411] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/03/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Disorders of the sense of smell have received greater attention because of the frequency with which they occur as a symptom of SARS-CoV-2 infection. Olfactory dysfunction can lead to profound reduction in quality of life and may arise from many different causes. METHODS A selective literature review was conducted with consideration of the current version of the guideline issued by the Association of the Scientific Medical Societies in Germany. RESULTS The cornerstones of diagnosis are the relevant medical history and psychophysical testing of olfactory function using standardized validated tests. Modern treatment strategies are oriented on the cause of the dysfunction. While treatment of the underlying inflammation takes precedence in patients with sinunasal dysosmia, olfactory training is the primary treatment option for other forms of the disorder. The prognosis is determined not only by the cause of the olfactory dysfunction and the patient's age, but also by the olfactory performance as measured at the time of diagnosis. CONCLUSION Options for the treatment of olfactory dysfunction are available but limited, depending on the cause. It is therefore important to carry out a detailed diagnostic work-up and keep the patient informed of the expected course and prognosis.
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Affiliation(s)
- Thomas Hummel
- Interdisciplinary Center for Smell and Taste, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden
| | - David T. Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria
| | - Christian A. Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria
| | - Boris A. Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, Giessen and Marburg University Hospital Ltd., Marburg
| | - Antje Welge-Lüssen
- Interdisciplinary Center for Smell and Taste, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden
| | - Antje Hähner
- Department of Otorhinolaryngology, Basel University Hospital, Switzerland
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4
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Schlosser RJ, Dubno JR, Eckert MA, Benitez AM, Gregoski M, Ramakrishnan V, Matthews L, Soler ZM. Unsupervised Clustering of Olfactory Phenotypes. Am J Rhinol Allergy 2022; 36:796-803. [PMID: 35837713 PMCID: PMC10031609 DOI: 10.1177/19458924221114255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Current clinical classifications of olfactory function are based primarily upon a percentage of correct answers in olfactory identification testing. This simple classification provides little insight into etiologies of olfactory loss, associated comorbidities, or impact on the quality of life (QOL). METHODS Community-based subjects underwent olfactory psychophysical testing using Sniffin Sticks to measure threshold (T), discrimination (D), and identification (I). The cognitive screening was performed using Mini-Mental Status Examination (MMSE). Unsupervised clustering was performed based upon T, D, I, and MMSE. Post hoc differences in demographics, comorbidities, and QOL measures were assessed. RESULTS Clustering of 219 subjects, mean age 51 years (range 20-93 years) resulted in 4 unique clusters. Cluster 1 was the largest and predominantly younger normosmics. Cluster 2 had the worst olfaction with impairment in nearly all aspects of olfaction and decreased MMSE scores. This cluster had higher rates of smoking, heart disease, and cancer and had the worst olfactory-specific QOL. Cluster 3 had normal MMSE with relative preservation of D and I, but severely impaired T. This cluster had higher rates of smoking and heart disease with moderately impaired QOL. Cluster 4 was notable for the worst MMSE scores, but general preservation of D and I with moderate loss of T. This cluster had higher rates of Black subjects, diabetes, and viral/traumatic olfactory loss. CONCLUSION Unsupervised clustering based upon detailed olfactory testing and cognitive testing results in clinical phenotypes with unique risk factors and QOL impacts. These clusters may provide additional information regarding etiologies and subsequent therapies to treat olfactory loss.
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Affiliation(s)
- Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Mark A Eckert
- Department of Otolaryngology-Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Andreana M Benitez
- Department of Neurology, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Matthew Gregoski
- Department of Public Health Sciences, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Viswanathan Ramakrishnan
- Department of Public Health Sciences, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Lois Matthews
- Department of Otolaryngology-Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, South Carolina
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, 2345Medical University of South Carolina, Charleston, South Carolina
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5
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Retronasal olfaction is relatively less affected in older individuals with subjectively normal olfactory function. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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6
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James J, Palte IC, Vilarello BJ, Axiotakis LG, Jacobson PT, Gudis DA, Overdevest JB. Beyond aroma: A scoping review on the impact of chronic rhinosinusitis on retronasal olfaction. FRONTIERS IN ALLERGY 2022; 3:969368. [PMID: 36118172 PMCID: PMC9470759 DOI: 10.3389/falgy.2022.969368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background Retronasal olfaction (RNO) refers to the perception of odorants inhaled through the mouth and carried through the nasopharynx to olfactory receptors within the olfactory cleft, enabling the perception of flavor. Although orthonasal olfactory dysfunction in chronic rhinosinusitis (CRS) has been widely described, the impact of CRS on RNO is less clear. In this study, we systematically review available literature to provide an update on RNO in the setting of CRS. Methods We systematically searched PubMed, Ovid Embase, Web of Science, and the Cochrane Library for studies examining RNO in patients with documented CRS. The primary outcome of interest was objective psychophysical measurement of olfaction, including characterization of RNO. Results We identified 404 unique references that underwent title and abstract review by two independent reviewers, with 52 articles undergoing full-text review, where 10 relevant studies underwent data extraction. Although outcome measures varied, all included studies demonstrated diminished RNO in patients with CRS. Of six studies evaluating the relationship between retronasal and orthonasal olfactory test scores in CRS patients two out of six (33%) demonstrated a correlation between both forms of olfaction and CRS, and two out of six studies (33%) found significantly lower orthonasal olfactory test scores compared to retronasal olfactory test scores. Two of three found significant improvement in RNO with treatment of underlying CRS. Of three studies examining patient reported outcome measures (PROMs) in CRS, two found significant associations between retronasal olfactory test scores and PROMs. Conclusions Based on the current literature, CRS patients appear to have diminished RNO, which may be associated with orthonasal olfactory dysfunction and decreased quality of life in this population. Higher level of evidence studies are required to further elucidate these relationships and the impact of medical and surgical CRS management on RNO.
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Affiliation(s)
- Joel James
- Department of Medical Education, CUNY School of Medicine, New York, NY, United States
| | - Ilan C. Palte
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, United States
| | - Brandon J. Vilarello
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Lucas G. Axiotakis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
| | - Patricia T. Jacobson
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
| | - David A. Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
| | - Jonathan B. Overdevest
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
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7
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Niklassen AS, Sakthivel S, Fjaeldstad AW, Ovesen T. Danish Validation of a Retronasal Olfactory Powder Test and Development of a Novel Quick Retronasal Olfactory Test. Int Arch Otorhinolaryngol 2022; 26:e615-e623. [PMID: 36405477 PMCID: PMC9668440 DOI: 10.1055/s-0041-1740597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/08/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction
Quality of life is closely linked to retronasal olfactory function. Familiarity with odors vary, so tests need validation. Testing can be time-consuming, so a quick test and a thorough test are needed for clinical and research settings.
Objectives
The objectives of this study were to validate the original retronasal powder olfactory test in a Danish population and to develop a novel quick retronasal test for easy application.
Methods
Ninety-seven participants were included in the study, 59 healthy controls and 38 patients with olfactory impairment. The retronasal test was modified by substituting unfamiliar odors and descriptors and validated with a criterion of correct identification rate of 50% in the original test and 90% in the quick test. Items with over 90% correct identification rate in the modified original test were included in the quick test, resulting in a 10-item test.
Results
The modified retronasal olfactory test achieved good test characteristics, with a 10th percentile cut-off value of 13: sensitivity was 88.9%, specificity 83.0%, positive predictive value 78%, negative predictive value 91.7%, and the receiver operating characteristics area under the curve (ROC-AUC) was 0.86. The quick test achieved acceptable test characteristics, with a 10th percentile cut-off value of 8.2: sensitivity was 72.2%, specificity 90.6%, positive predictive value 83.9%, negative predictive value was 82.8%, and ROC-AUC 0.81.
Conclusion
Validation of both tests demonstrated satisfactory accuracy. We recommend the quick test for screening purposes, and the modified original version for a thorough evaluation. The tests are easily implemented as they are easy to understand and very affordable.
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Affiliation(s)
- Andreas Steenholt Niklassen
- University Clinic for Flavour, Balance and Sleep, Ear, Nose and Throat Department, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Alexander Wieck Fjaeldstad
- University Clinic for Flavour, Balance and Sleep, Ear, Nose and Throat Department, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Therese Ovesen
- University Clinic for Flavour, Balance and Sleep, Ear, Nose and Throat Department, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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8
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Recent evidence for the impacts of olfactory disorders on food enjoyment and ingestive behavior. Curr Opin Food Sci 2021. [DOI: 10.1016/j.cofs.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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9
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Odours count: human olfactory ecology appears to be helpful in the improvement of the sense of smell. Sci Rep 2021; 11:16888. [PMID: 34413403 PMCID: PMC8376892 DOI: 10.1038/s41598-021-96334-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
Odours modify human behaviour. Research in this field develops rapidly, providing more and more exciting discoveries. In this context, our daily odorous environment has been surprisingly poorly explored. The aim of our study was to quantify olfactory perception and preliminarily identify factors affecting the frequency of odorous experiences. We were also interested in knowing whether human olfactory ecology relates with olfactory performance. In this study, patients with olfactory deficits (n = 62) and healthy controls (n = 97) had their olfactory threshold and odour identification abilities measured before and after a two-week intervention comprising counting of conscious perception of odours naturally occurring in the environment. In both groups, we observed enhanced olfactory performance after the intervention suggesting that (1) the conscious focus on odours may change its perception, and that (2) social and physical environment can effectively stimulate the human olfactory system, presumably supporting the improvement of olfactory sensitivity.
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10
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Blomkvist A, Hofer M. Olfactory impairment and close social relationships. A narrative review. Chem Senses 2021; 46:6342176. [PMID: 34351415 PMCID: PMC8385889 DOI: 10.1093/chemse/bjab037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Olfactory impairment is one of the more unique symptoms of COVID-19 infection and has therefore enjoyed increased public attention in recent months. Olfactory impairment has various implications and consequences ranging from difficulty detecting dangerous pathogens to hindering social functioning and social behaviors. We provide an overview of how olfactory impairment can impact 3 types of close social relationships: family relationships, friendships, and romantic relationships. Evidence is divided into several categories representing potential mechanisms by which olfactory impairment can impact close social relationships: bonding disruptions, decreased social support, missed group-eating experiences, hygiene concerns, and altered sexual behaviors. We conclude with a discussion of emerging future research questions.
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Affiliation(s)
| | - Marlise Hofer
- University of Victoria, Department of Psychology.,University of British Columbia, Department of Psychology
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11
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Völter* C, Peter Thomas* J, Maetzler W, Guthoff R, Grunwald M, Hummel T. Sensory Dysfunction in Old Age. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:512-520. [PMID: 34158149 PMCID: PMC8476826 DOI: 10.3238/arztebl.m2021.0212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/14/2020] [Accepted: 04/14/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The senses serve as the crucial interface between the individual and the environment. They are subject to aging and disease processes. METHODS This review is based on pertinent publications retrieved by a selective search in the Medline and Cochrane Library databases. RESULTS Approximately 40% of persons aged 70 to 79 manifest dysfunction in at least one, and more than 25% in multiple senses. Sensory changes are accompanied by diverse comorbidities which depend on the particular sense(s) affected. The presence of sensory deficits is associated with an increased risk of developing dementia (OR: 1.49 [95% confidence interval: 1.12; 1.98] for dysfunction in a single sensory modality, 2.85 [1.88; 4.30] for dysfunction in three or more sensory modalities). The risk of developing depressive symptoms is elevated as well (OR 3.36 [2.28; 4.96]). The individual's ability to cope with the demands of everyday life is largely determined by the ability to carry out multisensory integration, in which the perceptions of the different senses are bound together. This function itself is subject to age-related changes that can be either adaptive or maladaptive; it can, therefore, serve as an indicator for pathological aging processes. CONCLUSION Sensory dysfunction in old age should be detected as early as possible. This implies the need for close collaboration of all of the involved disciplines. It would be desirable to develop sensory screening tests as well as a procedure for testing multisensory integration in routine clinical practice.
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Affiliation(s)
- Christiane Völter*
- * Joint first authors
- Hearing Competence Center, St. Elisabeth- Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University of Bochum
| | - Jan Peter Thomas*
- * Joint first authors
- Department of Otorhinolaryngology, Head and Neck Surgery, St.-Johannes-Hospital, Dortmund
| | - Walter Maetzler
- Department of Neurology, Faculty of Medicine, University of Kiel
| | - Rainer Guthoff
- Department of Ophthalmology, Düsseldorf University Hospital
| | - Martin Grunwald
- Haptic Research Lab, Paul Flechsig Institute of Brain Research, Medical Faculty of the Universität Leipzig
| | - Thomas Hummel
- Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Carl Gustav Carus, Dresden
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12
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Flavor Enhancement in Daily Life of Patients with Olfactory Dysfunction. CHEMOSENS PERCEPT 2021. [DOI: 10.1007/s12078-021-09289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract
Introduction
Patients with olfactory dysfunction report deterioration of taste due to loss of flavor, leading to less food enjoyment, alterations in dietary behaviors and stress. The aim of this study was to introduce flavor enhancement to investigate its acceptance and possible effects on quality of life.
Methods
In this prospective, controlled, randomized, single-blinded, cross-over pilot study, we recruited 30 olfactory dysfunction patients, of which 16 were hyposmic and 14 anosmic. After single-blinded triangle flavor discrimination test, flavor drops were randomized either in high or low concentration for 14 days and vice versa for another 14 days. Records included a daily diary and the questionnaire of olfactory disorders.
Results
Usage rates were excellent with 82.2% of all days, while drops were mainly used for breakfast (44.6%, p < 0.05). Hyposmics used flavor enhancement on significantly more days (median = 14) compared to anosmics (median = 11, p = 0.0094). QOD improved in 12 patients to a meaningful extent.
Conclusions
In this pilot study, we show that flavor enhancement is feasible accompanied by high compliance and acceptance in olfactory dysfunction patients. Flavor drops were used regardless of low or high concentrations with no adverse events noted.
Implications
Our findings give rise to further studies illuminating the possible advantages of flavor enhancement in patients with olfactory disorders.
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13
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Pieniak M, Oleszkiewicz A, Klockow M, Yoshino A, Haehner A, Hummel T. q-Powders: a quick test for screening retronasal olfactory disorders with tasteless powders. Eur Arch Otorhinolaryngol 2021; 279:779-784. [PMID: 33948681 PMCID: PMC8096134 DOI: 10.1007/s00405-021-06849-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/23/2021] [Indexed: 01/06/2023]
Abstract
Purpose To investigate the clinical utility of q-Powders—a retronasal identification screening test. Methods A total of 156 subjects (92 females, mean age: 54.5 years ± 17.3 years) completed a 3-item q-Powders retronasal identification test and a 16-items Sniffin’ Sticks orthonasal identification test. We analyzed whether the q-Powders test could differentiate between subjects with normosmia and subjects with an olfactory disorder. Results Our data indicated that subjects with an olfactory disorder scored lower in the q-Powders test than subjects with normosmia. The analyses revealed q-Powders test sensitivity of 84% and a test specificity of 64.9% with a score of 2 points taken as a cutoff for olfactory disorders. Conclusion The 3-item q-Powders retronasal test may be used for screening purposes in clinical research. Level of evidence 4
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Affiliation(s)
- Michal Pieniak
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527, Wroclaw, Poland.
| | - Anna Oleszkiewicz
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527, Wroclaw, Poland
| | - Marie Klockow
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Ayaho Yoshino
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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14
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Han P, Seo H, Klockow M, Yan X, Hähner A, Hummel T. Oral irritation in patients with chemosensory dysfunction. FLAVOUR FRAG J 2021. [DOI: 10.1002/ffj.3660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Pengfei Han
- Smell and Taste Clinic, Department of Otorhinolaryngology Technische Universität Dresden Dresden Germany
- Faculty of Psychology Southwest University Chongqing China
| | - Han‐Seok Seo
- Department of Food Science University of Arkansas Fayetteville AR USA
| | - Marie Klockow
- Smell and Taste Clinic, Department of Otorhinolaryngology Technische Universität Dresden Dresden Germany
| | - Xiaoguang Yan
- Smell and Taste Clinic, Department of Otorhinolaryngology Technische Universität Dresden Dresden Germany
| | - Antje Hähner
- Smell and Taste Clinic, Department of Otorhinolaryngology Technische Universität Dresden Dresden Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology Technische Universität Dresden Dresden Germany
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15
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Yoshino A, Pellegrino R, Luckett CR, Hummel T. Validation study of a novel approach for assessment of retronasal olfactory function with combination of odor thresholds and identification. Eur Arch Otorhinolaryngol 2021; 278:3847-3856. [PMID: 33606083 PMCID: PMC7893845 DOI: 10.1007/s00405-021-06687-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/08/2021] [Indexed: 02/06/2023]
Abstract
Purpose The present study aimed to establish a test battery for the clinical assessment of retronasal odor thresholds and retronasal odor identification. Study design Prospective case–control series. Methods Sixty participants (36 women, 24 men, mean age 37.6 ± 19.4 years) were enrolled in this study; 36 were healthy controls and 24 were patients with olfactory dysfunction. Orthonasal olfactory function was assessed with the “Sniffin’ Sticks” test battery. Retronasal olfaction was assessed with oral odorant delivery using special containers for threshold function, and with oral tasteless powders for odor identification. Results Retronasal and orthonasal olfaction were significantly correlated for threshold scores, identification score, and the sum of threshold and identification score (TI score). Validity analyses showed that the retronasal TI score was able to discriminate between healthy controls and patients with olfactory dysfunction. Conclusions Normosmic participants can be distinctly differentiated from patients with olfactory dysfunction using a valid test battery comprised of retronasal threshold and identification tests. Based on the current findings, we advocate a TI score of 16 as a cut-off between patients and controls. Therefore, TI scores of 17 and above would indicate retronasal normosmia.
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Affiliation(s)
- Ayaho Yoshino
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan.
| | - Robert Pellegrino
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- Department of Food Science, University of Tennessee, Knoxville, TN, USA
| | - Curtis R Luckett
- Department of Food Science, University of Tennessee, Knoxville, TN, USA
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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16
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Schäfer L, Schriever VA, Croy I. Human olfactory dysfunction: causes and consequences. Cell Tissue Res 2021; 383:569-579. [PMID: 33496882 PMCID: PMC7835667 DOI: 10.1007/s00441-020-03381-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/06/2020] [Indexed: 01/08/2023]
Abstract
The sense of smell essentially contributes to social communication, guides nutrition behaviour and elicits avoidance towards environmental hazards. Olfactory smell impairment may hence entail severe consequences for affected individuals. Compared with sensory loss in other modalities, reduced olfactory function is often unnoticed by those affected and diagnosed late. Those patients seeking help frequently suffer from long-term impairments resulting in reduced well-being and quality of life. The current review provides an overview of aetiology, prevalence and specifics of diagnostics in acquired and congenital olfactory loss and focusses on short- and long-term consequences. Compensation strategies are elaborated, and treatment options are mentioned. Individual characteristics associated with the development of serious mental health impairment are discussed in order to help practitioners identifying populations at risk.
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Affiliation(s)
- Laura Schäfer
- Klinik Und Poliklinik Für Psychotherapie Und Psychosomatik, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Valentin A Schriever
- Abteilung Neuropädiatrie, Klinik Und Poliklinik Für Kinder- Und Jugendmedizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Ilona Croy
- Klinik Und Poliklinik Für Psychotherapie Und Psychosomatik, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany.
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17
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Abstract
Approximately 5% of the general population is affected by functional anosmia with approximately additional 15% exhibiting decreased olfactory function. Many of these individuals ask for help. Because the subjective rating of olfactory function is biased, assessment of olfactory function is important. Olfactory measurements are needed for patient counseling and the tracking of changes in the sense of smell over time. The present review provides an overview of frequently used psychophysical tests for olfactory function, discusses differences between threshold and suprathreshold aspects of olfactory function, and gives examples on how to apply psychophysical tests.
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Affiliation(s)
- Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, "Technische Universität Dresden", Dresden, Germany
| | - Dino Podlesek
- Department of Neurosurgery, "Technische Universität Dresden", Dresden, Germany
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18
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Yan X, Whitcroft KL, Hummel T. Olfaction: Sensitive indicator of inflammatory burden in chronic rhinosinusitis. Laryngoscope Investig Otolaryngol 2020; 5:992-1002. [PMID: 33364387 PMCID: PMC7752087 DOI: 10.1002/lio2.485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/14/2020] [Accepted: 10/16/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Olfactory dysfunction has a high prevalence in chronic rhinosinusitis (CRS) patients and significantly affects quality of life. CRS is recognized as a complex disorder encompassing heterogeneous inflammatory processes in the nose and paranasal sinuses. Olfactory dysfunction in CRS patients is associated with the level of inflammatory mediators and the efficiency of inflammatory control. Learning about the association between CRS-related inflammation and olfactory function will provide clues to the pathogenesis of CRS. STRUCTURE The first section of this review describes the assessment of olfactory function using various measures, from ratings to MR based imaging. Then, we discuss the conductive and inflammatory mechanisms related to olfactory dysfunction in CRS: olfaction is associated with certain inflammatory patterns and is potentially a marker of CRS subtype. Finally, we review anti-inflammatory therapies including conservative and surgical approaches, and their effectiveness in olfactory dysfunction in CRS. CONCLUSION Assessment of olfactory function should be considered in the clinical evaluation of CRS patients, not only for detecting and quantifying patients' symptom, but also because it appears to be useful to objectively assess the efficacy of CRS treatment over time. In addition, olfaction can be expected to expand the library of CRS phenotypes and endotypes and, hence, pave the way for more precise, tailored treatment options.
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Affiliation(s)
- Xiaoguang Yan
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
| | - Katherine Lisa Whitcroft
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
- UCL Ear Institute, University College LondonLondonUK
| | - Thomas Hummel
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
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19
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Radiological Markers of the Olfactory Cleft: Relations to Unilateral Orthonasal and Retronasal Olfactory Function. Diagnostics (Basel) 2020; 10:diagnostics10110989. [PMID: 33238552 PMCID: PMC7700302 DOI: 10.3390/diagnostics10110989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 11/22/2020] [Indexed: 11/24/2022] Open
Abstract
The opacification of the olfactory cleft (OC) has been associated with birhinal orthonasal olfaction in patients with chronic rhinosinusitis (CRS). The aim of this study was to determine the associations between monorhinal and birhinal orthonasal, and retronasal olfaction with radiological markers of the OC in a cohort of patients with CRS. Results were analyzed in a CRS-cohort including 13 patients with nasal polyposis (CRSwNP) and 12 patients with non-eosinophilic CRS (non-eCRS). Monorhinal and birhinal orthonasal olfactory function, and OC-air volume were higher in non-eCRS compared CRSwNP. OC-opacification was also higher in CRSwNP compared to non-eCRS. In the entire CRS-cohort, those with higher OC-opacification showed significantly lower orthonasal and retronasal olfactory test results compared to those with lower OC-opacification across all three coronal planes. Similarly, higher unilateral OC-opacification was also associated with lower ipsilateral orthonasal olfactory function. Correlation analysis further revealed a positive correlation between monorhinal and birhinal orthonasal olfaction with ipsilateral and overall OC-air volume. Likewise, birhinal and monorhinal orthonasal, and retronasal olfactory test results correlated negatively with the overall and ipsilateral Lund-Mackay scores. Monorhinal and birhinal orthonasal, and retronasal olfactory function were lower in CRS patients with higher ipsilateral and overall OC-opacification compared to those with lower OC-opacification.
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20
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Liu DT, Besser G, Prem B, Sharma G, Speth MM, Sedaghat AR, Mueller CA. Self-perceived Taste and Flavor Perception: Associations With Quality of Life in Patients With Olfactory Loss. Otolaryngol Head Neck Surg 2020; 164:1330-1336. [PMID: 33048605 DOI: 10.1177/0194599820965242] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate associations between self-perceived chemosensory functions of smell, taste, and flavor perception with olfactory-specific quality of life (QoL) in patients with olfactory dysfunction (OD) and whether these associations would be influenced by other factors, such as duration or etiology of smell loss. STUDY DESIGN Retrospective cohort study. SETTING Tertiary care, academic center. METHODS Olfactory-specific QoL was measured with the Questionnaire of Olfactory Disorders (QOD). The QOD measures the impact of OD on QoL (QOD-negative statements) and the ability of patients to cope with smell loss (QOD-positive statements). Orthonasal olfactory function, patients' demographics, self-perceived chemosensory perception, and duration and etiology of OD were retrospectively collected in a cohort of patients with quantitative OD. Correlations and multivariable linear regression models were computed to determine possible associations with the outcome measure of QOD-negative and QOD-positive statement scores. RESULTS A total of 133 patients with OD were included. Analysis revealed a positive correlation between self-perceived taste and flavor perception with QOD-negative statement scores, while self-perceived smell showed no significant correlation. Similarly, longer duration of smell loss and higher age were also correlated with higher QOD-positive statement scores. Multivariable regression models confirmed that self-perceived taste was independently associated with the QOD-negative statement score, while age and duration of OD were independently associated with the QOD-positive statement score. CONCLUSIONS These findings suggest that the impact of diminished flavor perception during eating and drinking has a stronger impact on the QoL of patients with OD as compared with decreased orthonasal olfaction.
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Affiliation(s)
- David T Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Gerold Besser
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Bernhard Prem
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Gunjan Sharma
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Marlene M Speth
- Department of Otorhinolaryngology, Kantonsspital Aarau, Aarau, Switzerland
| | - Ahmad R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Christian A Mueller
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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21
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Negoias S, Meves B, Zang Y, Haehner A, Hummel T. Characteristics of Olfactory Disorder With and Without Reported Flavor Loss. Laryngoscope 2020; 130:2869-2873. [PMID: 32965693 DOI: 10.1002/lary.29070] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/07/2020] [Accepted: 07/07/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES/HYPOTHESIS Quality of life related to olfactory disorder (OD) depends on the perceived impairment. It is not known why some patients with OD report smell and flavor loss while others report smell loss only. In order to understand this, we compared the two clinical presentation forms in terms of demographics, clinical features, and orthonasal olfaction test results. STUDY DESIGN Observational, analytic, cross-sectional study. METHODS A total of 401 patients with measured orthonasal OD presenting at a tertiary referral center were divided in 2 groups according to their subjective reports (smell loss only = 129 patients vs. smell and flavor loss = 272 patients). Groups were compared in terms of demographic (age, sex), clinical features (duration of disease, type of onset, etiology, degree of impairment due to the disorder) and test results (taste and orthonasal olfaction). RESULTS Groups did not differ in terms of age, sex distribution, orthonasal olfactory, or taste function. Patients reporting smell and flavor loss were characterized by a mainly sudden onset of the disorder and a predominance of postinfectious olfactory loss. They also have a shorter disease duration and a higher disease impairment. For patients reporting smell loss only, disease duration is longer, they feel less impaired, the onset of the disorder is to a higher degree protracted and the main cause is idiopathic. CONCLUSIONS Patients with orthonasal OD reporting smell and flavor loss feel more impaired and present significant different clinical features compared to patients reporting smell loss only. Future studies measuring retronasal olfaction are necessary to fully understand flavor perception in OD. LEVEL OF EVIDENCE 4 Laryngoscope, 130:2869-2873, 2020.
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Affiliation(s)
- Simona Negoias
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Basel University Hospital, Basel, Switzerland
| | - Benjamin Meves
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
| | - Yunpeng Zang
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Dresden, Dresden, Germany
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22
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Besser G, Liu DT, Sharma G, Bartosik TJ, Kaphle S, Enßlin M, Renner B, Mueller CA. Ortho- and retronasal olfactory performance in rhinosurgical procedures: a longitudinal comparative study. Eur Arch Otorhinolaryngol 2020; 278:397-403. [PMID: 32813170 PMCID: PMC7826311 DOI: 10.1007/s00405-020-06300-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023]
Abstract
Purpose Testing olfaction should be an integral part of a clinical work-up in rhinosurgical procedures. Importantly, intact olfactory experience also includes retronasally perceived odors (retronasal olfaction). This study aimed at comprehensively assessing olfaction in patients undergoing rhinosurgical procedures in a comparative manner and evaluating relations to patient-reported outcome measurements (PROMs). Methods Each nostril odor threshold and discrimination, and birhinal identification were tested using Sniffin’ Sticks in 14 subjects assigned for septoplasty (SP), 21 for septorhinoplasty (SRP), and 30 for endoscopic sinus surgery (ESS). The 27-Candy-Smell-Test was used to quantify retronasal abilities. Tests were repeated 3 months after surgery. Results Olfactory dysfunction was preoperatively present in 21% of SP, in 47.6% of SRP, and in 80% of ESS patients. Odor threshold side differences were most frequently found in SRP. Frequently, SRP and ESS patients showed severely impaired retronasal olfaction. Half of included subjects re-visited after 3 months, but olfactory function did not improve overall and rarely on an individual basis to a meaningful extent. Subjective ratings on nasal patency and PROMs were not associated with olfaction nor with changes in olfactory scores. Conclusion Olfactory function can decisively be impaired a priori not only in patients awaiting sinus surgery, but also in those assigned for functional septorhinoplasty. This impairment may not improve in the short term, which has to be taken into account in patient counseling. This study adds to the current literature on olfaction in rhinosurgery with the extension of retronasal testing.
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Affiliation(s)
- Gerold Besser
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Gunjan Sharma
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Tina J Bartosik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Sebastian Kaphle
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Max Enßlin
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian A Mueller
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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23
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Xie DX, Leland EM, Seal SM, Lin SY, Rowan NR. A Systematic Review and Meta-Analysis of Taste Dysfunction in Chronic Rhinosinusitis. Laryngoscope 2020; 131:482-489. [PMID: 32609889 DOI: 10.1002/lary.28827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/29/2020] [Accepted: 05/19/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Patients with chronic rhinosinusitis (CRS) often describe alterations in sense of taste. These complaints have historically been attributed to olfactory dysfunction; however, there is evidence of direct, objective, gustatory disturbances in the setting of CRS that are not thoroughly characterized. This study sought to investigate and summarize gustatory dysfunction experienced by patients with CRS. METHODS PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases were reviewed following PRISMA guidelines. English language, original studies investigating objective taste in adult patients with CRS were included. A meta-analysis with inverse variance, random-effects model was performed. RESULTS Of 2750 studies screened, 11 articles with 471 unique patients were included. Patients with CRS exhibit worse gustatory function compared to healthy controls (standardized mean difference 0.94 [95% CI, 0.44-1.45]). Hypogeusia was identified in 32/95 (33.7%) patients from three studies that used methods with a validated definition of hypogeusia. Older age, male gender, and smoking history were associated with taste dysfunction, while objective gustatory and olfactory dysfunction were not correlated. Subjective taste and quality of life measures were also not associated with objective taste. The impact of sinus surgery on objective taste is unclear. CONCLUSION Approximately 34% of patients with CRS experience hypogeusia. Neither olfactory function nor subjective taste were associated with objective gustatory function. Given the substantial prevalence of taste dysfunction patients with CRS, there is significant potential for growth in understanding of pathogenesis, impact on quality of life, and potential treatment strategies of taste impairment in the CRS patient population. LEVEL OF EVIDENCE 1 Laryngoscope, 131:482-489, 2021.
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Affiliation(s)
- Deborah X Xie
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Evelyn M Leland
- Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Stella M Seal
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Sandra Y Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
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24
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Chen B, Akshita J, Han P, Thaploo D, Kitzler HH, Hummel T. Aberrancies of Brain Network Structures in Patients with Anosmia. Brain Topogr 2020; 33:403-411. [DOI: 10.1007/s10548-020-00769-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/07/2020] [Indexed: 02/04/2023]
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25
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Besser G, Oswald MM, Liu DT, Renner B, Mueller CA. Flavor education and training in olfactory dysfunction: a pilot study. Eur Arch Otorhinolaryngol 2020; 277:1987-1994. [PMID: 32248300 PMCID: PMC7286942 DOI: 10.1007/s00405-020-05950-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/29/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Olfactory training is recommended in olfactory dysfunction (OD) showing promising results. OD patients frequently ask for training modifications in the hope of a better outcome. Also, a lack of knowledge of the flavor system is evident. This investigation sought to implement flavor education (FE) and encourage patients to experience flavors in terms of a flavor training (FT). METHODS In included patients (n = 30), OD was either of postinfectious (86.7%) or posttraumatic (13.3%) cause. Chemosensory abilities were tested orthonasally (using Sniffin Sticks = TDI) and retronasally (using the Candy Smell Test = CST). Key points of flavor perception were demonstrated in an educative session. Subjects were instructed to consciously experience flavors out of a list of 50. Effects of FT were explored in two groups (group A and B), with group B starting FT 17 weeks later. RESULTS FE was appreciated and drop-out rate stayed very low (one participant). Compliance was high and 30.4 ± 12.9 flavors were tried. Overall TDI scores improved in 10 patients (6 group A, 4 group B) in a clinically significant way (> 5.5). For group A (starting FT earlier) rm-ANOVA showed a significant effect of session (timepoint) on CST (p < 0.01). CONCLUSION Flavor education is demonstrated as feasible and appreciated in a clinical setting. FT seems to be a welcomed second-line therapy in patients with olfactory dysfunction. This study shows beneficial trends of FT; however, further studies with larger sample sizes and standardized training protocols are needed.
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Affiliation(s)
- Gerold Besser
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Michaela M Oswald
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.,Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian A Mueller
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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26
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Abstract
Olfactory dysfunction (OD) is one of the cardinal symptoms of chronic rhinosinusitis (CRS), and its prevalence ranges from 60% to 80% in patients with CRS. It is much more common in CRS with nasal polyposis patients compared to CRS without nasal polyposis. Decreased olfactory function is associated with significant decreases in patient-reported quality of life (QOL), and notably, depression and the enjoyment of food. Objective measures can help detail the degree of OD, whereas subjective measures can help to determine in the impact on patient. There is variable treatment response to OD with both medical and surgical therapies.
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