Long-term Recovery Patterns of Olfactory Function after Trans-sphenoidal Approach with Nasoseptal Flap Elevation

Abstract Introduction Nasoseptal flap is widely used in reconstruction of the skull base to prevent cerebrospinal fluid leakage after surgery for skull base lesions. There has been a debate on whether more severe olfactory dysfunction occurs after nasoseptal flap elevation than the conventional trans-sphenoidal approach. Objective To compare the long-term recovery patterns associated with nasoseptal flap and the conventional trans-sphenoidal approach. Methods The subjects were divided into the conventional trans-sphenoidal approach group and the nasoseptal flap elevation group. We followed up self-reported olfactory score using the visual analogue scale and threshold discrimination identification (TDI) score of the Korean Version of the Sniffin Stick test II for 12 months, with olfactory training. Results The study included 31 patients who underwent the trans-sphenoidal approach. Compared with preoperative status, the mean visual analogue scale and TDI scores in the conventional trans-sphenoidal approach group recovered 2 months postoperatively, while in the nasoseptal flap elevation group the visual analogue scale and TDI scores recovered 6 months and 3 months after surgery, respectively. Twelve months after surgery, the visual analogue scale and TDI scores in the conventional trans-sphenoidal approach group were 9.3 ± 0.5 and 28.5 ± 4.3, while those from the nasoseptal flap elevation group were 8.9 ± 1.5 and 27.2 ± 4.7 (p = 0.326; 0.473). Only one of the patients in the nasoseptal flap elevation group had permanent olfactory dysfunction. Conclusion The olfactory function recovered more gradually in the nasoseptal flap elevation group than in the conventional trans-sphenoidal approach group, but there was no difference between the two groups after 6 months.

Possible effects of low testosterone levels on olfactory function in males / Possíveis efeitos dos baixos níveis de testosterona na função olfativa em homens

Abstract Introduction: Functions attributed to androgens have increased, ranging from the role in hypothalamic-pituitary-gonadal axis and reproductive behaviors to modulation of cognition, mood and some other functions. Sex differences and changes in circulating sex hormones affect human sensory function. In the literature, authors reported this kind of influence for olfaction predominantly in females. Objective: To investigate the effects of low testosterone levels on olfactory functions in males, in this prospective clinical study. Methods: Male patients diagnosed with prostate cancer were included. Thirty-nine patients with prostate cancer whose testosterone levels were lower than 50 ng/dL due to castration, were the study group. Thirty-one patients with prostate cancer who were not castrated with testosterone levels higher than 50 ng/dL were selected as the control group. Acoustic rhinometry and peak nasal inspiratory flow tests were performed for all participants; and for evaluation of olfactory function, both groups completed the Connecticut chemosensory clinical research center olfactory test. Results: The mean ages of the patients and controls were 69.6 ± 7.2 (57-89) and 66.3 ± 5.8 (50-78) years, respectively (= 0.039). There was a significant difference between groups in terms of testosterone levels (p < 0.0001). The multivariate logistic regression revealed testosterone level as the only predictive factor determining the difference between the groups. In terms of olfactory parameters, all scores were lower in the emasculated group (butanol threshold test p = 0.019, identification p = 0.059, and Connecticut center score p = 0.029) There was a significant correlation between testosterone levels and olfactory parameters (p = 0.023; p = 0.025 for identification and Connecticut center scores, respectively). Conclusion: Low testosterone levels in males have negative effects on olfactory functions. Further molecular research is required to understand the connection between testosterone and olfaction.

Resumo Introdução: As funções atribuídas aos andrógenos aumentaram, variam desde o papel no eixo hipotálamo-hipófise-gonadal e comportamentos reprodutivos até a modulação da cognição, humor e outras funções. As diferenças entre os sexos e as mudanças nos hormônios sexuais circulantes afetam a função sensorial humana. Na literatura, os autores relataram esse tipo de influência para o olfato, principalmente no sexo feminino. Objetivo: Investigar os efeitos dos baixos níveis de testosterona nas funções olfativas em homens, neste estudo clínico prospectivo. Método: Pacientes do sexo masculino com diagnóstico de câncer de próstata foram incluídos no estudo. Compreenderam o grupo de estudo 39 pacientes com câncer de próstata cujos níveis de testosterona eram inferiores a 50 ng/dL devido à castração. Foram determinados como grupo controle 31 pacientes com câncer de próstata que não foram emasculados, com níveis de testosterona superiores a 50 ng/dL. Testes de rinometria acústica e pico de fluxo inspiratório nasal foram feitos para todos os participantes; e para avaliação da função olfativa, ambos os grupos concluíram o teste olfativo do Connecticut chemosensory clinical research center. Resultados: A média da idade dos pacientes e controles foi de 69,6 ± 7,2 (57 ± 89) e 66,3 ± 5,8 (50 ± 78) anos, respectivamente (= 0,039). Houve uma diferença significante entre os grupos em relação a níveis de testosterona (p < 0,0001). A regressão logística multivariada revelou o nível de testosterona como o único fator preditivo que determinou a diferença entre os grupos. Em termos de parâmetros olfativos, todos os escores foram menores no grupo castrado (teste do limiar de butanol p = 0,019, identificação p = 0,059 e escore do Connecticut center p = 0,029). Houve uma correlação significante entre o nível de testosterona e os parâmetros olfativos (p = 0,023; p = 0,025 para identificação e escore do Connecticut center, respectivamente). Conclusão: Baixos níveis de testosterona em homens têm efeito negativo na função olfativa. Mais pesquisas moleculares são necessárias para entender a conexão entre testosterona e olfação.

Effect of different concentrations of moxa smoke exposure on nasal mucosal injury and expression of serum IL-1, IL-6 and TNF-α in rats / 中国针灸

OBJECTIVE@#To observe the effect of long-term moxa smoke exposure of different concentrations on olfactory function in rats, and provide experimental basis of safety study of moxa smoke produced by moxibustion.@*METHODS@#Forty SD rats were randomly divided into a normal control group, a low-concentration moxa smoke group, a moderate-concentration moxa smoke group and a high-concentration moxa smoke group, 10 rats in each one. The rats in the moxa smoke groups were put into three plexiglass moxibustion boxes with different moxa smoke concentrations, 4 hours per times, twice a day for 90 days. The general state of rats was evaluated before and during the experiment. After the intervention, the olfactory function was evaluated by two-bottle experiment (TBE); the morphology of nasal mucosa was observed by HE staining; the apoptosis of olfactory epithelial cells in nasal mucosa was detected by TUNEL method; the serum levels of interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by ELISA method.@*RESULTS@#In the late stage of moxa smoke exposure (45-90 days into intervention), the behavioral activity of rats in the moderate-concentration moxa smoke group and the high-concentration moxa smoke group was weaker than that in the normal control group, and their response to stimulation was strong, and their mental state was worse. After intervention, the drinking rate of vinegar-water mixture in the moderate-concentration moxa smoke group and the high-concentration moxa smoke group was higher than that in the normal control group and the low-concentration moxa smoke group (@*CONCLUSION@#The long-term exposure to low, moderate and high concentrations of moxa smoke could cause pathological changes in nasal mucosa and increase the serum levels of IL-1, IL-6 and TNF-α; the moderate and high concentrations of moxa smoke exposure could cause a series of damage to olfactory function and reduce olfactory sensitivity in rats.

The comparison of urine AD7c-NTP levels and olfactory function among three types of dementia patients / 中华老年医学杂志

Objective To explore the diagnostic value of Alzheimer-associated neuronal thread protein(AD7C-NTP)and olfactory function in the differentiation of three types of dementia,and to evaluate their clinical application value.Methods Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment(MoCA)were applied to evaluate cognitive function of all subjects with Alzheimer disease(AD),frontotemporal dementia (FTLD),or mixed dementia (MD).Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of AD7c-NTP in urine.T&T test method was applied to detect the olfactory function.Spearman rank correlation was used to evaluate the correlation of urine AD7c NTP with MMSE and MoCA scores.Results There was no significant difference in the demographic profile (except age)among three types of dementia of AD,FTLD and MD(F =4.05,P =0.02).Among the three dementia groups,the mean age of the MD group was highest.The statistically significant difference in MMSE scores was found among the three groups(F 3.79,P=0.03),while there was no significant difference inMoCAand NPI scores among the three dementia groups.The levels of the urine AD7c-NTP were different among the three dementia groups,but without statistical significance(H 1.25,P =0.53).Additionally,the FTLD group had the highest urine AD7c NTP level.Spearman rank correlation analysis showed no correlation of AD7c-NTP with MMSE and MoCA(r =0.18,P =0.25;r =0.14,P =0.39,respectively).No differences in olfactory function of the recognition domain(H =3.40,P=0.18)and in the detection domain(H =2.07,P=0.36)were found among three dementia groups of AD,FTLD and MD.Conclusions The level of urine AD7c-NTP is not of clinical significance in differentiating three types of dementia,and it is not correlated with the MMSE and MoCA scores.This study fails to find the clinical value of olfactory function test for distinguishing three types of dementia.

Clinical Feasibility of Scent Survey for Screening Test for Olfactory Function

BACKGROUND AND OBJECTIVES: The scent survey for screening (SSS) test is a subjective olfactory questionnaire devised for this study. We demonstrated the correlation of the SSS test with other olfactory tests and the efficacy of the SSS test as an olfactory screening test compared to KVSSII. SUBJECTS AND METHOD: A total of 363 patients who visited our ORL outpatient department underwent the SSS test, VAS, and KVSS I and II. The patients were divided into two groups, a group with normal olfactory function and a group with olfactory dysfunction according to the KVSS II test. In each group, the correlations between the olfactory tests were studied, and the cut-off value of the SSS test as a screening test was investigated. RESULTS: There was positive correlation between CCSIT and KVSS I, II, T, D, and I tests and the SSS test in the total group and in the olfactory dysfunction group (p<0.05). The identification test in the KVSS II showed the highest positive correlation. While the cut-off value of normal olfactory function in the KVSS II is 28, the SSS test showed the highest specificity and sensitivity of 74 under an ROC curve. CONCLUSION: The SSS test showed very high correlation with other olfactory tests, especially in an olfactory dysfunction group. This result indicates that the SSS is appropriate as a screening test to select people with olfactory disorder.

Cirugía hipofisiaria endoscópica transesfenoidal, con realización de colgajo nasoseptal: evaluación del impacto de la técnica en la olfación:. serie de casos / Endoscopic pitituary surgery transsphenoidal, with nasoseptal flap: assessment of the impact of the technique in the olfaction: cases series

Introducción: La cirugía endoscópica transesfenoidal en la exéresis de patología hipofisaria ha sido ratificada dentro de la mejores opciones para conseguir abordajes exitosos. Para cerrar la brecha ósea, se puede utilizar el colgajo nasoseptal, el cual lograría un cierre adecuado y seguro, evitando complicaciones como persistencia de fístulas de líquido cefalorraquídeo. Dentro de los probables efectos secundarios de este colgajo se señala la presencia de anosmia o hiposmia. Objetivo: Nuestro objetivo es mostrar los resultados obtenidos empleando la técnica del colgajo nasoseptal y la evaluación del olfato posoperatorio. Material y método: Incluimos 14 pacientes con diagnóstico de adenoma hipofisiario intervenidos en nuestro servicio entre diciembre 2014 a diciembre 2015. Se evaluaron diversos parámetros entre otros, olfatometría pre y posoperatorias. A todos se les realizó la técnica endoscópica transesfenoidal. Efectuando la disección del colgajo con la técnica tipo Hadad. La exéresis tumoral fue realizada por neurocirujano, se cubrió la osteotomía con este colgajo. Resultados: De los 14 pacientes, 13 llegaron al estado olfativo preoperatorio. 1 paciente se mantuvo hipósmico mantenidamente. En nuestro estudio, no hemos encontrado deterioro significativo en la calidad del sentido del olfato. Así como tampoco observamos otras complicaciones. Conclusiones: Esta experiencia aún inicial, estimamos que podría ya esbozar una tendencia de mantención de la función olfativa en este tipo de cirugía.

Introduction: Transsphenoidal endoscopic surgery resection of pituitary pathology has been ratified within the best options for successful approaches. To close the gap bone, you can use the nasoseptal flap, which achieved an adequate and secure closure, preventing complications such as persistent cerebrospinal fluid leaks. Among possible side effects of this flap anosmia-hyposmia noted. Aim: Our goal is to show the results obtained using the technique of nasoseptal flap and postoperative evaluation of smell. Material and method: We included 14 patients with a diagnosis of pituitary adenoma surgery in our department between December 2014 to December 2015. Various parameters were evaluated pre and post operative, specially olfactory function. All underwent transsphenoidal endoscopic technique. Performing dissection flap with the technical type Hadad. The tumor resection was performed by neurosurgeon, osteotomy covered with this flap. Results: Of the 14 patients, 13 reached the olfactory preoperative state. 1 patient remained with hyposmia. In our study, we found no significant deterioration in the quality of the sense of smell. Not other complications were found. Conclusions: This is an initial experience, and we estimate that could outline a trend of maintaining olfactory function in this surgery approach.

Effect of Endoscopic Sinus Surgery in the Treatment of Sinusitis and Nasal Polyps and Its Effect on Nasal Ventilation and Olfactory Function / 现代生物医学进展

Objective:To investigate the clinical effect of endoscopic sinus surgery in the treatment of sinusitis and nasal polyps and its effect on nasal ventilation and olfactory function.Methods:80 patients with sinusitis and nasal polyps were selected in our hospital from January 2014 to June 2016,who were randomly divided into observation group and control group,each group of 40 cases.The control group was treated with traditional enucleation,while the observation group was treated with endoscopic sinus surgery.The clinical efficacy,the symptom scores,nasal airway resistance and olfactory function score before treatment and 3 months after treatment were compared between the two groups.Results:The total effective rate of the observation group was 95.00％,which was significantly higher than that of the control group 77.50％ (P＜0.05).There was no significant difference in nasal congestion,purulent nasal discharge,olfactory dysfunction,pain and total symptom score between the two groups before treatment (P＞0.05),nasal congestion,purulent nasal discharge,olfactory dysfunction,pain and total symptom score between the two groups at 3 months after treatment were lower than before treatment,and nasal pus,smell disorder,pain and total symptom scores of the patients in the observation group were lower than the control group (P＜0.05).There was no significant difference in nasal airway resistance and olfactory function score between the two groups before treatment and 3 months after treatment (P＞0.05),nasal airway resistance,olfactory function score of patients in two groups at 3 months after treatment were lower than before treatment,and the observation group was lower than that ofthe control group (P＜0.05).Conclusion:Endoscopic sinus surgery for sinusitis and nasal polyps is helpful to improve the clinical symptoms,promote the olfactory function and recovery of nasal ventilation,which is an effective method for treatment of sinusitis and nasal polyps.

Modulation of cerebral haemodynamic response to olfactory stimuli by emotional valence detected by functional magnetic resonance imaging / Modulação da resposta hemodinâmica cerebral pela valência emocional de estímulos olfativos detectada pela por ressonância magnética funcional

ABSTRACT. Olfactory perception, although restricted to just a few contexts in everyday life, is key in medicine. Several dementia conditions have been associated with early loss of olfactory discrimination. Despite the fact that several brain areas have been associated with olfaction in functional magnetic resonance imaging (fMRI), the mechanisms by which emotional valence is conveyed to the brain are not fully understood. Methods. In this study, we compared cerebral activations by olfactory stimuli using different emotional valence stimuli on event-related fMRI. We used three standard olfactory odorants with different valence (positive, neutral and negative). Forty-three healthy subjects (22 males) were scanned on a 3.0T MR system. Olfactory stimulation was attained through a delivery system synchronized with image acquisition and subjects´ breathing instructions. fMRI data analysis was performed by the FSL package (Oxford University) including head movement correction, GLM modeling of the neurovascular (BOLD) response and group activation maps produced at p<0.05 and corrected for multiple comparison. Results. Increased cerebral responses within the anterior cingulate, amygdaloid nuclei, as well as the dorsolateral prefrontal, occipital and orbitofrontal cortices were observed in positive and negative valence conditions, while response to neutral valence arousal was less intense and not observed in the amygdaloid complex. The most significant statistical response aroused from the stimuli clusters was observed in the negative condition. Conclusion. The results of the present study support the hypothesis that neutral stimuli may be more sensitive to early losses in pathological conditions, particularly dementia.

RESUMO. Apesar de praticamente restrita a alguns contextos na rotina diária, a percepção de estímulos olfativos é bastante relevante em medicina. Várias condições patológicas, e em particular as demências, estão associadas à perda precoce da capacidade de discriminação e percepção olfativa. Apesar de estudos de ressonância magnética funcional (RMf), terem identificado várias áreas cerebrais relacionadas à percepção olfativa, ainda não sabemos quais destas são moduladas pela valência emocional do estímulo olfativo. Neste estudo investigamos o padrão de resposta cerebral à odorantes com diferentes valências emocionais em indivíduos saudáveis estudados por RMf relacionada à eventos. Métodos. Comparamos a resposta cerebral em um desenho de RMf relacionado à eventos e com uso de três estímulos olfatórios padronizados e com diferentes valências emocionais (positiva, neutra e negativa). Quarenta e três indivíduos normais (22 homens) foram estudados por RMf relacionada à eventos em aparelho de 3T. A estimulação olfativa foi realizada por meio de sistema sincronizado à aquisição das imagens e às instruções dadas aos sujeitos. A análise dos dados foi feita por meio do software FSL (Universidade de Oxford) e incluiu correções de movimento, modelagem de sinal com técnica GLM e mapas de grupo com nível de significância < 0,5. Resultados. As respostas cerebrais no cíngulo anterior, bem como no córtex dorsolateral pré-frontal, occipital e órbitofrontal foram observadas nas condições de valência positiva e negativa, porém a resposta ao estímulo neutro foi menos intensa e não foi observada em complexos amigdaloides. A resposta estatística mais significante foi observada no cluster de estímulos com valência negativa. Conclusão. Estes dados representam evidências para a hipótese de que possivelmente a perda da percepção discriminativa de estímulos com valência emocional neutra pode ser mais sensível em relação às manifestações iniciais de condições patológicas, inclusive demências.

The Possibility of Morning Sickness from Olfactory Hypersensitivity during Pregnancy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nausea and vomiting in early pregnancy are well-known phenomena. It has been suggested that the mechanism that triggers nausea and vomiting in pregnancy may be related to olfactory changes. We planned to investigate olfactory function changes and the relationship between olfaction changes and nausea and vomiting in early pregnancy. SUBJECTS AND METHODS: Two groups of participants with the total of 75 women (35 pregnant women; 40 non-pregnant women) were analyzed prospectively. Objective olfactory function was tested using Korean Version of Sniffin' Sticks-II test (KVSS-II test). In addition, pregnant subjects were investigated using the questionnaire to evaluate the severity of nausea and vomiting, and whether the changes were due to olfactory sensitivity. RESULTS: Subjective olfactory sensitivity was increased in pregnant subjects. However, there was no significant difference in the objective olfactory function between the two groups. CONCLUSION: Based on this study, we concluded that pregnancy is accompanied by changes in subjective olfactory sensitivity and higher subjective olfactory discomfort. But these findings do not support the hypothesis that nausea and vomiting is dependent of the changes in the objective olfactory function during early pregnancy.

A Case of Post-Traumatic Olfactory Disorder Presenting Negative Results of Schneider Test due to Trigeminal Nerve Injury / 대한이비인후과학회지

There has been a considerable increase in the number of patients with olfactory disorder due to head and facial injuries. Conventional olfactory function evaluation methods, such as T&T olfactometer, the Schneider test and the Alinamin test have been widely used in clinical practice. Among these, the Schneider test can determine whether the patient is a malingerer. A woman who sustained head and facial injuries visited our department with the chief complaint of anosmia. The patient underwent conventional olfactory function tests, including T&T olfactometer and the Schneider test. T&T olfactometer revealed olfactory loss, but the Schneider test did not. Thus, she was diagnosed with malingering. However, her diagnosis of olfactory disorder and concurrent trigeminal nerve injury was made definite during the follow-up period. We herein report a 30-year-old female patient with olfactory disorder who was misdiagnosed with olfactory malingering based on the negative result of the Schneider test. A brief review of the literature has been included.

Olfactory function and Parkinson's disease in Southern Brazil / Função olfatória e doença de Parkinson no sul do Brasil

The idiopathic Parkinson disease (IPD) is traditionally diagnosed by motor signs, but non-motor symptoms and signs are frequent and may help in the clinical diagnosis. PURPOSE: To evaluate the olfactory function in Brazilian healthy subjects, patients with early-onset PD (EOPD) and late-onset PD (LOPD) using the Sniffin' Sticks odor-identification test (SST). METHOD: We studied 70 patients with IPD (19 EOPD and 51 LOPD) and 70 controls matched for gender, age and years of schooling. Subjects with dementia and loss of smell for other reasons were excluded. RESULTS: The SST showed a significant difference (p<0.001) between groups: control groups (12.0±0.3), EOPD (8.3±0.7), and LOPD (6.7±0.4) when the groups were adjusted for gender, age, disease duration, and years of schooling. CONCLUSION: Both groups of IPD patients presented olfactory impairments, but those whose symptoms started before 45 years-old (EOPD) had better sense of smell than the LOPD patients.

A doença de Parkinson idiopática (DPI) tradicionalmente é diagnosticada pelos sinais motores, porém os sinais e sintomas não-motores são freqüentes. OBJETIVO: Avaliar a função olfatória em sujeitos brasileiros saudáveis e em pacientes com doença de Parkinson precoce (DPP) e doença de Parkinson tardia (DPT) utilizando o teste Sniffin' Sticks (TSS) de identificação de odores. MÉTODO: Setenta pacientes com DPI (19 DPP e 51 DPT) e 70 controles pareados para as variáveis gênero, idade e anos de escolaridade foram estudados. Foram excluídos sujeitos com demência e/ou perda de olfato por outros motivos. RESULTADOS: O TSS mostrou uma diferença significativa (p<0,001) entre os grupos controle (12,0±0,3), DPP (8,3±0,7) e DPT (6,7±0,4) quando os grupos foram ajustados para sexo, idade, duração da doença e anos de escolaridade. CONCLUSÃO: Pacientes com DPI apresentam redução do olfato, sendo mais importante entre aqueles com DPT. A disfunção olfatória pode ser uma ferramenta muito útil no diagnóstico de DPI.

Correlation between Olfactory Threshold Test, Olfactory Identification Test and Subjective Symptoms / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Psychophysical tests such as 16-item Korean Version of Sniffin' Sticks test (KVSS) identification test and Butanol Threshold Test (BTT) are relatively objective tests, but such tests cannot completely explain olfactory complaints. Furthermore, the correlation between KVSS and BTT has not been validated in Korea. We evaluated subjective olfactory symptoms of patients by a questionnaire and the correlation between two tests and the symptom questionnaire. SUBJECTS AND METHOD: A total of 789 patients who visited olfactory clinic of Seoul National University Bundang Hospital from April 2004 through July 2007 were included in this study. BTT and KVSS identification tests were performed and all the patients filled out an olfactory questionnaire. The questionnaire was composed of 4 parts: general olfaction, general taste, odorspecific olfaction and quality of life. Patients were categorized into 4 groups according to KVSS identification score. KVSS identification scores 0 to 3 represent anosmia, 4 to 7 severe hyposmia, 8 to 12 mild to moderate hyposmia and 13 to 16 normosmia. We analyzed the differences in the subjective symptom questionnaire scores of 4 groups. RESULTS: KVSS and BTT showed a significant correlation (R=.646, p<.001). Each part of the questionnaire also showed significant correlation to KVSS or BTT. The mean scores of subjective symptoms were 2.69 for anosmia, 3.04 for severe hyposmia, 3.84 for mild to moderate hyposmia and 4.02 for normal and the difference was significant. CONCLUSION: BTT and KVSS identification test scores and subjective symptoms exhibited significant correlations between each other and the odor-specific olfaction part of the questionnaire showed the greatest correlation to olfactory function tests.

Olfactory Evoked Potential for Objective Olfactory Function Evaluation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The exact diagnosis for olfactory dysfunction plays an indispensable complementary role to the proper management of olfactory dysfunction. But there is no confirmative objective method for olfactory function evaluation. Recently, olfactory evoked potential by jet steam method was introduced as an objective method for the evaluation of olfactory function. The purpose of this study is to evaluate clinical efficacy of olfactory evoked potential. SUBJECTS AND METHOD: Thirty two normal individuals were evaluated with olfactory evoked potential and their olfactory thresholds were within normal range when tested with T&T olfactometry. Odorant, skatole was introduced 1cm apart from the nostril by jet steam pulse. The results were averaged by Neuropack Four Computer. RESULTS: Twenty-nine individuals had typical positive waves with latency near 0.1ms, but three individuals had no typical positive wave. The threshold of twenty individuals in electro-olfactometry was E1 with E1 recognition or detection threshold in T&T olfactometry. The threshold of other nine individuals in electro-olfactometry was E2 with E1 recognition and detection threshold in T&T olfactometry. CONCLUSION: Olfactory evoked potential has good correlation with classic T&T olfactometry and could be used as an objective method for the evaluation of olfactory function.

A cross-sectional study on olfactory function among young adult smokers

Objective: To determine the olfactory function and/or dysfunction of young adults who are cigarette smokers using a locally validated smell identification test. Design: Cross-sectional study Setting:Tertiary hospital in Metro Manila Patients: The volunteer study group was composed of 60 male and 21 female students and] employees of a tertiary hospital and its affiliated medical school (both in Quezon City). All subjects were young adults within the age range of 20-35 years with a mean age of 27.58 years (+/- 4.33). All the subjects were currently smoking cigarettes with no medical history of recent viral infection, nasal/sinus surgery, nasal/brain tumors, head trauma, radiotherapy, chronic rhinitides in exacerbation ortracheostomy. Olfactory function of each subject was evaluated using the Sto. Tomas Smell Identification Test (ST-SIT) which is a locally-validated test. Results: Majority of the subjects fell within the 24-27 age group with a mean age of 27.58 years (+/- 4.33). Males outnumbered females 74.1 percent as against 25.9 percent. An inverse relation between pack years and ST-SIT score was present indicating that there could be a dose-related effect off cigarette smoking on olfactory function. Among the 81 subjects, 15 (18.5 percent) turned out to be anosmic, 46 (56.7 percent) were hyposmic I and 20 (24.6 percent) had normal olfactory function. A mean ST-SIT score was computed at 81.183 (+/- 12.58), indicating that majority of the subjects had olfactory dysfunction, meaning they were hyposmic. Conclusion: Smoking cigarettes has become part of the lifestyle of a lot of people in spite of its hazards to health. In the present study, a majority of supposedly healthy young adults who currently smoked cigarettes were proven to suffer from olfactory impairment based on the scores of a locally-validated smell identification test. An inverse relation between ST-SIT scores and pack years was also noted which may indicate a dose-related effect of smoking on olfactory function. (Author)

Objective olfactory function test through analysis of human Q-EEG changes / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Increased industrialization and the changing environment have caused complex olfactory problems in the modern population, and the need for an objective evaluation of such problems has thus come to our attention. In this study, we used the human Q-EEG (Bio-Logic, Brain Atlas III) equipment to evaluate olfactory fuction, and tried to lay out a basis for an objective test of olfactory function in humans. MATERIALS AND METHODS: Twenty normosmic adults and ten anosmic patients were studied by the human Q-EEG equipment. EEG changes were analyzed by a nonparametric test (Mann-Whitney test, p<0.05). A mixture of S-D alcohol, benzophenol, BHT (benzyl hydroxy toluene), water, and fragrance were used as an odorant. The odorant was applied to the one third anterior of the inferior turbinate using a small piece of filter paper soaked in the odorant. RESULTS: During odorant stimulation, the Q-EEG analyzer showed that the delta band (0-3.5 Hz) decreased in the whole brain region, while the alpha band (8-11.5 Hz) increased in the bilateral temporal region in the normosmic patients. There was no Q-EEG changes in the anosmic patients. CONCLUSION: It is suggested that human Q-EEG analysis may provide the basis for the development of an objective test of olfactory function in humans.

Transition of the Olfactory Recovery in Patients with Olfactory Disturbance / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, there has been an increase in olfactory disorders due to many etiologies. Many therapeutic methods have been tried with some favorable results. Some of the therapeutic methods are functional endoscopic sinus surgery (FESS), oral and topical steroids, and other pharmacologic therapies (vitamin A, aminophylline, zinc sulfate, etc). In this study, we tried to find out the transition of olfactory recovery in patients with olfactory disturbance. MATERIALS AND METHODS: Sixty-one patients with olfactory disturbance were studied. There were 25 patients who had chronic sinusitis with nasal polyp, 10 patients who had chronic sinusitis without nasal polyp, 12 patients who had upper respiratory infection, 5 patients who had congenital disorder, 4 patients who had head trauma, and 5 patients who had nasal septal deviation. Chronic sinusitis was treated by functional endoscopic sinus surgery, nasal septal deviation was treated by septoplasty and others were treated by drug therapy and topical steroid. The degree of olfactory disturbance and recovery was scored with a KVSS test (Korean Version of Sniffin Sticks test) prior to treatment and also three and six months after the treatment. RESULTS: Twenty-one patients with chronic sinusitis with nasal polyp (84%) showed improvement of olfaction on the third postoperative month, and 6 months later (p<0.01). Seven patients with chronic sinusitis without nasal polyp (70%) also showed improvement of olfaction (p<0.01). But seven patients with upper respiratory tract infection (58%) did not show significant improvement of olfaction, and it would be necessary to follow up these patients longer. Patients with congenital disorder, nasal septal deviaton, and head trauma did not show significant improvement of olfaction. CONCLUSION: The mentioned test can aid in investigating the etiology of olfactory disturbance, and in accurately assessing the degree of the olfactory disturbance.

Olfactory Function in Chromium Exposed Workers Without Nasal Septum Perforation / 대한산업의학회지

OBJECTIVES: The chrome-induced olfactory alterations is caused by inhalation of chromic acid, a highly corrossive and toxic materials. And nasal septum perforation(NSP) has been suspected with possible causative factor of olfactory alterations. To our knowledge, there has been no report of the detailed findings of the olfactory alterations in chrome exposed subjects without nasal septum perforation(NSP). So we present the results of olfactory function test measured by T&T olfactometer and olfactometer perception test among chromium exposed workers without NSP. METHODS: We performed this study in 25 study subjects and 25 control subjects matched with age, alcohol and smoking. All of subjects are man. We performed olfactory function test measured by T&T olfactometer and olfactometer perception test. RESULTS: 1) The age distribution of the subjects involved in this study was from 20 to 54 years old (average 33.3 years old) and the mean duration exposed to chromium was from 64. 9 months. 2) The olfactory function was checked by detection and recognition thresholds in five odorants. The detection thresholds of exposed group dealing with chromium were significantly increased in A and B ordorants than nonexposed group. The recognition thresholds of exposed group were significantly increased in D ordorants than nonexposed group. 3) The mean threshold of olfactometer perception test of exposed group were more increased than nonexposed group. But thresholds difference did not show statistical significance, 4) The detection thresholds of A and D ordorants, recognition threshold of C ordorants and thresholds of olfactometer perception test were increased in the relation with duration of chrome exposure. CONCLUSIONS: There has been no remarkable alterations in olfactory sense (TkT olfactometer and Olfactometer Perception Test) in subjects without nasal septum perforation(NSP) exposed to chromic acid.

A Study on Recovery from Smell Dysfunction Induced by 3-Methylindole in Rats

BACKGROUND AND OBJECTIVES: Evaluating the olfactory function is as important in animal research as morphological study. However, it is difficult to gauge the smell function in rats because of the underdevelopment of current electrophysiologic measuring devices. The aim of this study is to assess changes in smell dysfunction induced by 3-methylindole (3-MI) in rats using an 8-odor olfactometer. MATERIALS AND METHOD: Eight female Sprague-Dawley rats were used. Ethyl acetate at 10(-4.0) (v/v) concentration was used as an S+ odorant, and six different concentrations (10 (-4.0), 10(-4.5), 10(-5.0), 10(-5.5), 10(-6.0), 10(-6.5)) of butanol mixed with ethyl acetate were used as an S- odorant. S+ and S- stimuli were delivered randomly using the 8-odor olfactometer. After injection of 3-MI at a dosage of 300 mg/kg, mixed odor discrimination test was performed for five weeks. RESULTS: Normal rats were able to discriminate ethyl acetate from ethyl acetate mixed with butanol to a concentration down to 10(-6.2) (v/v). Immediately after the 3-MI injection, the rats lost all capacity for smell. From 16 days later, the smell function began improving spontaneously. At the end of the fifth week, the discrimination threshold was 10(-5.7) (v/v), which was almost equal to the original level. CONCLUSIONS: Systematically administered 3-MI caused smell loss in rats. Though not completely, the smell function was recovered spontaneously. An olfactometer is a reliable and accurate device in evaluating the olfactory function in rats.

Olfactory Dysfunction in Chromium Exposed Workers / 예방의학회지

Chromium is one of the representative toxic substance by occupational exposure which damage the mucosa of respiratory tract including nasal septal perforation. The aim of this study is to evaluate the effect of chromium exposure on olfactory function and to obtain the fundamental information about chromium exposure. The authors performed olfactory function test, laboratory tests and questionnaire interview on the subject of three groups, that is, two exposed groups and one nonexposed group from May 1 to June 30, 1994. Exposed group 1 was 15 male workers without nasal septal perforation, exposed group 2 was 15 male workers with nasal septal perforation among 103 workers in 22 chromium plating factories, and nonexposed group was 15 male medical students. The gathered informations were histories of chromium exposure, habits of smoking and alcohol drinking, the concentrations of chromium in serum and urine, and asparate aminotransferase(AST), alanine aminotransferase(ALT), gamma-gluutamyl transferase,etc. Olfactory function was checked by T and T olfectometer using phenyl ethyl alcohol(material A), methyl cyclopentenolone(material B), iso-valeric acid(material C), gamma-undecalactone(material D), skatole(material E) and the results were expressed by detection threshold(DT) and recognition threshold(RT). There was a significant difference between exposed groups and nonexposed group in A, B, C, D, E substances by DT and in A, B, C, D substances by RT(p<0.01) The degree of olfactory dysfunction was highest in the exposed group 2 and lowest in the nonexposed group in all five substance by Dt and it was same in A B, D substance RT and the difference of RT and DT. As summary, olfactory dysfunction by chromium exposure was recognized and the degree of olfactory dysfunction was higher in the exposed group with nasal septal perforation. Therefore, it would be helpful to apply olfactory function test for the early detection of olfactory dysfunction, and this test would be considered as the basic tool within workers' compensation system.