Revisión narrativa de la literatura Rehabilitación olfatoria en pacientes sometidos a laringectomía total / Narrative Review olfactory evaluation and training for total laryngectomized patients

La laringectomía total es un procedimiento quirúrgico que implica la extracción de la laringe, ocasionando la separación de las vías aéreas superiores e inferiores, identificándose disminución en la percepción del olfato y gusto en pacientes laringectomizados totales. Sin embargo, las investigaciones actuales acerca de la rehabilitación del olfato son escasas, especialmente en América Latina. La presente revisión narrativa de la literatura tiene como objetivo presentar los métodos actuales utilizados para la rehabilitación y recuperación de la percepción el olfato en pacientes laringectomizados totales, mediante la búsqueda de literatura en la base de datos: PubMed, así como, literatura gris. Esta revisión se consolidó con base en el análisis de 35 artículos. Los resultados permitieron identificar diferentes protocolos para la evaluación del olfato, así mismo, la rehabilitación olfatoria, siendo identificados diferentes métodos como; el bypass laríngeo, enjuague sinusal, la maniobra de flujo de aire nasal espiratorio (ENAMM) y la maniobra de inducción del flujo de aire nasal (NAIM), la cual presenta mayor evidencia científica. Por lo anterior, se resalta la necesidad de analizar el impacto de los tratamientos oncológicos en la percepción del olfato y la necesidad de crear programas por parte de fonoaudiología para la rehabilitación olfatoria, generando efectos positivos en la calidad de vida de los pacientes.

Total laryngectomy is a surgical procedure that involves the removal of the larynx, resulting in the separation of the upper and lower airways, with a decrease in the perception of smell and taste in total laryngectomized patients. However, current research on olfactory rehabilitation is scarce, especially in Latin America. This narrative literature review aims to present the current methods used for the rehabilitation and recovery of olfactory perception in total laryngectomized patients by searching the PubMed database as well as gray literature. This review is based on the analysis of 35 articles. The results identified different protocols for olfactory assessment, as well as olfactory rehabilitation, with various methods such as laryngeal bypass, sinus rinse, Expiratory Nasal Airflow Maneuver (ENAMM), and Nasal Airflow Induction Maneuver (NAIM) being identified, with NAIM having the strongest scientific evidence. Therefore, the need to analyze the impact of oncological treatments on olfactory perception and the need to create speech therapy programs for olfactory rehabilitation, leading to positive effects on patients' quality of life, is highlighted.

Experimental study on the effect of olfactory training on olfactory function in mice with olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective@#To observe the effect of olfactory training on mice with olfactory dysfunction induced by 3-methylindole (3-MI).@*Methods@#Thirty-one male BALB/c mice were randomly divided into 3 groups by random digits table: control group (group A, n=10), olfactory dysfunction group (group B, n=10) and olfactory dysfunction+olfactory training group (group C, n=11). Mice in group B and group C were intraperitoneally injected with 150 mg/kg 3-MI to induce olfactory dysfunction model, while mice in group A were intraperitoneally injected with corn oil of the same volume. From the first day after injection, mice in group C were treated with 4 kinds of odors by inhalation, while mice in group B were treated with distilled water by inhalation, with 2 times/d, 30 min/time/kind of odor, and continuous training for 28 d. Group A was not treated. Buried food pellet tests were conducted before injection and at 7, 14, 21 and 28 days after injection, respectively. The olfactory epithelium was harvested for observation of the number of olfactory marker protein (OMP) and the thickness of olfactory epithelium on the 28th day after injection. SPSS 23.0 software was used for statistical analysis.@*Results@#Before injection, all mice in each group had no olfactory dysfunction. At the 7th, 14th, 21st and 28th days after injection, the food finding time of mice in group C was shorter than that in group B, and the difference was statistically significant ((175.88±100.50) s vs (266.73±46.83) s, (132.00±84.62) s vs (264.10±48.50) s, (103.57±77.43) s vs (197.43±69.78) s, (67.79±32.54) s vs (176.63±61.06) s, all P<0.05), but food finding time of mice in group B and C was longer than that in group A (the food finding time of group A at the 7th, 14th, 21st and 28th days after injection was (27.13±5.36) s, (25.83±7.28) s, (23.13±2.72) s, (26.63±7.60) s, respectively, all P<0.05). At the 28th day after olfactory training, the number of OMP positive cells in group B and C were fewer than that in group A, and the difference was statistically significant ((108.00±28.19)/HP vs (288.22±84.06)/HP, (199.33±58.55)/HP vs (288.22±84.06)/HP, all P<0.05). The number of OMP positive cells in group C were higher than that in group B (P<0.05). The number of OMP positive cells had negative correlation with food finding time (r=-0.886, P<0.01). As for the thickness of the olfactory epithelium, the thickness of group B was thinner than that in group A and C, and the difference was statistically significant ((59.57±31.27) μm vs (114.55±40.70)μm vs (90.54±37.72) μm, all P<0.05).@*Conclusion@#Olfactory training can accelerate the recovery of olfactory function in 3-MI-induced olfactory impaired mice.

Experimental study on the effect of olfactory training on olfactory function in mice with olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

To observe the effect of olfactory training on mice with olfactory dysfunction induced by 3-methylindole (3-MI). Thirty-one male BALB/c mice were randomly divided into 3 groups by random digits table: control group (group A, 10), olfactory dysfunction group (group B, 10) and olfactory dysfunction+olfactory training group (group C, 11). Mice in group B and group C were intraperitoneally injected with 150 mg/kg 3-MI to induce olfactory dysfunction model, while mice in group A were intraperitoneally injected with corn oil of the same volume. From the first day after injection, mice in group C were treated with 4 kinds of odors by inhalation, while mice in group B were treated with distilled water by inhalation, with 2 times/d, 30 min/time/kind of odor, and continuous training for 28 d. Group A was not treated. Buried food pellet tests were conducted before injection and at 7, 14, 21 and 28 days after injection, respectively. The olfactory epithelium was harvested for observation of the number of olfactory marker protein (OMP) and the thickness of olfactory epithelium on the 28th day after injection. SPSS 23.0 software was used for statistical analysis. Before injection, all mice in each group had no olfactory dysfunction. At the 7th, 14th, 21st and 28th days after injection, the food finding time of mice in group C was shorter than that in group B, and the difference was statistically significant ((175.88±100.50) s (266.73±46.83) s, (132.00±84.62) s (264.10±48.50) s, (103.57±77.43) s (197.43±69.78) s, (67.79±32.54) s (176.63±61.06) s, all 0.05), but food finding time of mice in group B and C was longer than that in group A (the food finding time of group A at the 7th, 14th, 21st and 28th days after injection was (27.13±5.36) s, (25.83±7.28) s, (23.13±2.72) s, (26.63±7.60) s, respectively, all 0.05). At the 28th day after olfactory training, the number of OMP positive cells in group B and C were fewer than that in group A, and the difference was statistically significant ((108.00±28.19)/HP (288.22±84.06)/HP, (199.33±58.55)/HP (288.22±84.06)/HP, all 0.05). The number of OMP positive cells in group C were higher than that in group B (0.05). The number of OMP positive cells had negative correlation with food finding time (=-0.886, 0.01). As for the thickness of the olfactory epithelium, the thickness of group B was thinner than that in group A and C, and the difference was statistically significant ((59.57±31.27) μm (114.55±40.70)μm (90.54±37.72) μm, all 0.05). Olfactory training can accelerate the recovery of olfactory function in 3-MI-induced olfactory impaired mice.

The Effects of Olfactory Training with Intranasal Corticosteroid Spray in Korean Patients with Olfactory Dysfunction

Comparing the Effectiveness of Olfactory Training, According as Type and Preference of Odorant

Entrenamiento olfatorio: revisión de literatura / Olfactory training: review of literature

RESUMEN La disfunción olfatoria es una patología frecuente que trae consigo una disminución importante en la calidad de vida de los pacientes y que incluso conlleva una mortalidad aumentada respecto a la población general. Sin embargo, es una condición subdiagnosticada, ya sea por desconocimiento de los profesionales o por falta de un método diagnóstico adecuado. A la fecha no existe un tratamiento efectivo para estos pacientes y generalmente se les deja sin tratar. Una alternativa para este gran problema es el entrenamiento olfatorio, tratamiento propuesto recientemente con resultados promisorios.

ABSTRACT Olfactory dysfunction is a frequent pathology associated with an important decrease in the quality of life of patients and an increased mortality respect to the general population. However, it is an underdiagnosed condition, either due to lack of knowledge of the professionals or due to the lack of an adequate diagnostic method. To date there is no effective treatment for these patients and they are usually left untreated. An alternative to this problem is olfactory training, a treatment recently proposed with promising results.

The Effect of Olfactory Training Using Korean Version Odorants: A Preliminary Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several studies have reported the benefits of olfactory training (OT) for patients with olfactory dysfunction. However, training odorants should be customized according to the characteristics of individual patients. The aim of this study was to evaluate the effects of OT using odorants familiar to Korean patients with post-upper respiratory infection (URI) olfactory dysfunction. SUBJECTS AND METHOD: We prospectively evaluated patients with post-URI olfactory loss. We carried out OT over a period of 6 months using four odorants: pine, cinnamon, lemon, and peppermint. Olfaction was tested before and at 1, 3, and 6 months after training initiation using the following olfactory tests; Butanol threshold test (BTT), Cross-Cultural Smell Identification Test (CCSIT) and Visual Analog Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE) scale, Sino-Nasal Outcome Test (SNOT-20), and Beck Depression Inventory (BDI). RESULTS: Of the 88 patients who initially enrolled, 82 completed the BTT, CCSIT, VAS, NOSE, SNOT-20, and BDI. In total, 10 Korean patients were included in our analysis, nine of whom showed an improvement in olfaction after OT. All patients reported changes in olfaction and the perception of smells over the duration of OT. Some patients reported an increased sense of smell after OT, although he could not distinguish different smells. CONCLUSION: OT using odorants specifically selected for Korean patients resulted in improved olfactory function, as indicated by the BTT and CCSIT scores. The findings of the present study suggest that customization of odorants to fit the characteristics of patients, including ethnicity, environment, and race, among others, increases the effectiveness of OT.

Efficacy and associated factors of olfactory training in the treatment of olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the clinical effects and the influence factors of olfactory training in the treatment of olfactory dysfunction.@*Methods@#A total of 86 patients with olfactory dysfunction (49 post-infectious and 37 post-traumatic) in Beijing Anzhen Hospital during Dec 2016 to May 2017 were recruited in this prospective study. The clinical data of patients were analyzed, including gender, age, body mass index (BMI), course of disease, smoking history, drinking history, diabetes history, hypertension history, hyperlipidemia history, and anxiety visual analogue score (VAS). All patients were treated with olfactory training for 16 weeks, and all of them underwent Sniffin′ Sticks olfactory test before and after treatment, which was evaluated by composite threshold-discrimination-identification score (TDI). SPSS 23.0 software, paired t test and univariate and multivariate Logistic regression analysis were used to analyze the data.@*Results@#Eighty patients received treatment, including 46 post-infectious olfactory dysfunction and 34 post-traumatic olfactory dysfunction. After olfactory training, the total scores of TDI increased with statistically significant (18.3±8.6 vs 13.6±7.4, t=-6.158, P<0.05). The overall efficacy was 40% (32/80). The effective rate were 45.7% (21/46) in post-infectious olfactory dysfunction and 32.4% (11/34) in post-traumatic olfactory dysfunction respectively, with no statistically significant difference (χ2=1.441, P=0.230). Logistic regression analysis showed that the course of disease was an influence factor in the clinical curative effect (OR=0.881, 95%CI: 0.799-0.973, P=0.012). In patients with less than a year of olfactory dysfunction, the olfactory function improved obviously with the efficiency of 50.9% (29/57).@*Conclusion@#Sixteen weeks of olfactory training provides a significant therapeutic effect on the post-infectious and post-traumatic olfactory dysfunction, and the olfactory training can achieve better therapeutic effects at the early stage.

Present status of the treatment for olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Olfactory dysfunction is defined as decrease or loss of smell perception.This review systematically summarizes classification, etiology and diagnosis progress of olfactory dysfunction, and focuses on advancement in management of olfactory dysfunction, including pharmaceutical remedy, surgical treatment as well as olfactory training.Glucocorticoids play an important role in the treatment of olfactory dysfunction. Sodium citrate, vitamin A, and nonspecific phosphodiesterase inhibitors (theophylline, pentoxifylline) are promising drugs.Endoscopic paranasal sinuses surgery can improve the olfactory dysfunction caused by chronic sinusitis to some extent.Olfactory training has been proven to be effective for a variety of causes of olfactory dysfunction.

Nebulized glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction / 中国耳鼻咽喉头颈外科

OBJECTIVETo investigate the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.METHODSPatients with postviral olfactory dysfunction were recruited in this study. All patients underwent T&T olfactory testing, sinonasal computer tomgraphy scanning, as well as magnetic resonance scanning of the olfactory pathway. Nebulizing glucocorticoid (pulmicort repulse) was inhaled once daily at the starting dose of 2 mg tapered to 1 mg after two weeks combined with olfactory training for 4 weeks. T&T olfactory testing were repeated after 4-week treatment.RESULTS Twenty four patients received teatment, with a mean age of 54 years old(range 37 to 81 years old), a mean olfactory dysfunction course of 2.20 months(range, 0.25-9 months). Of whom, 21 were anosmia, 3 were hyposmia. After teatment, complete recovery were achieved in 4 patients(16.7%), obvious improvement in 9 (37.5%), improvement in 5 (20.8%), no improvement in 6 (25.0%). No side effect and untoward effect were found.CONCLUSIONThe primmary outcomes suggest the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.