Can Sodium Citrate Effectively Improve Olfactory Function in Non-Conductive Olfactory Dysfunction? / 대한이비인후과학회지

The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I²=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I²=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I²=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I²=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

Assessing Olfactory Function in Healthy Korean Children Using the Cross-Cultural Smell Identification Test and Butanol Threshold Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are no reported studies of olfactory function of Korean children, and the existing tests of olfactory function for Korean adults may not be suitable for very young children. This study assessed the applicability of the Butanol Threshold Test (BTT) and Cross-Cultural Smell Identification Test (CC-SIT) to children. SUBJECTS AND METHOD: A total of 79 children were included in the study: they were between 6-12 years of age, and had visited University Hospital Health Care Center between January 2012 and December 2013. All children were administered the BTT and CC-SIT. RESULTS: Using BTT, 69.62% of the sample was classified as moderate hyposmia. On the other hand, when CC-SIT was used, 45.57% of the sample was classified as moderate and 43.04% as mild hyposmia. CC-SIT and BTT scores were not correlated. Although gender and age were not taken into account in the test results, the CC-SIT could measure age-specific olfactory development. CONCLUSION: Our study provides fundamental data on the clinical use of the CC-SIT and BTT in healthy Korean children.

Olfactory Dysfunction and Cognitive Impairment

BACKGROUND: The aim of the current study was to investigate the changes of the olfactory function in the Korean elderly population related to cognitive decline by using the CDR (Clinical Dementia Rating scale) and KVSS Test (Korean Version of Sniffin' Sticks Test). METHODS: 41 subjects between the ages of 65-85 years, were included in this study. All subjects were screened to exclude conditions affecting olfactory functions. These subjects were divided into three groups according to CDR. 23 subjects belonged to the CDR 0 group, 9 to the CDR 0.5 group and 9 to the CDR 1 group. The KVSS Test consisted of the olfactory threshold test and olfactory identification test. RESULTS: Significant differences were found among the CDR 0 group, CDR 0.5 group and CDR 1 group (p0.05). CONCLUSIONS: These results suggest that the cognitive deficits were associated with the decrease of scores in the olfactory identification test and that the olfactory identification test may have clinical utility in the diagnosis of the dementia.

Assessment of Olfactory Function after Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients and Clinical Validity of Cross-Cultrual Smell Identification Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) improves olfactory dysfunction due to chronic rhinosinusitis. Cross-Cultural Smell Identification test (CC-SIT) is known to be one of the useful methods to assess the olfactory dysfunction. We assessed the influence of ESS on olfactory function by using symptom scores and CC-SIT, and determined the clinical validity of CC-SIT. MATERIALS AND METHODS: 151 patients with chronic rhinosinusitis who had received ESS were evaluated. Prior to and three months following the surgery, each patient was requested to mark a 5-point scale ranging from normosmia to anosmia. Preoperative and postoperative CC-SITs were performed for 20 patients who complained of olfactory dysfunction. To evaluate the clinical validity of CC-SIT, we assessed the correlations between CC-SIT scores, symptom scores and CT scores using the Lund-Mackay CT scoring system. RESULTS: There were a significant decrease in the symptom scores and an increase in the CC-SIT scores after ESS. However, normosmia was achieved in only 38.5% (25/65) of the patients determined by symptom scores and 23.5% (4/17) by CC-SITs. There were significant correlations between CC-SIT scores, symptom scores and CT scores (r=-0.416, r=-0.357, r=0.510, p<0.05). CONCLUSION: Although the average postoperative olfactory ability after ESS was in the hyposmic range, ESS could improve the olfactory ability in patients with chronic rhinosinusitis. The 5-point scale and the CC-SIT scores reflected well the severity of olfactory dysfunction in patients with chronic rhinosinusitis, and therefore, we recommend them as convenient and practical tools to assess olfactory ability before and after ESS.

Evaluation of Clinical Validity of Cross-Cultural Smell Identification Test (CC-SIT) in Korean / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The development of a l2-item Cross-Cultural Smell Identification Test (CC-SIT) was based upon items from the University of Pennsylvania Smell Identification Test (UPSIT), The selected CC-SIT items were familiar to most persons from American, European, and Asian cultures. Since there were no reports about its clinical validity for Koreans, we evaluated its identifiability in this study. MATERIALS AND METHODS: The CC-SIT were administered to 30 normal subjects and 32 patients with decreased sense of smell, and compared with those of the Korean K-SIT and buthanol threshold test (BTT), items of which many Koreans are familiar with. RESULTS: In the normal group, the mean percent-correct scores of CC- SIT and K-SIT were 87.5+/-7.8% and 90.5+/-9.7%, respectively. In the patient group, the scores were 48.2+/-14.1 and 49.6+/-10.2%, respectively. The results of CC-SIT showed a high correlation with the K-SIT (gamma=0.822, p < 0.001). CONCLUSION: The CC- SIT can be used as an olfactory identification test for Koreans.

Selection of Olfactory Identification Items for Koreans / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The olfactory identification test has been used in clinical assessment of olfactory ability for the following reasons: it is fast, it yields results compatible to a threshold test, and it gives a picture of how well the patient can deal with odors of everyday life. However, items in UPSIT (University of Pennsylvania Smell Identification Test)and CCCRC (Connecticut Chemosensory Clinical Research Center)identification test which are widely used in the world are selected for western people. Accordingly, these items in the tests are not appropriate for Koreans of different cultural background. MATERIALS AND METHODS: For the selection of proper items for the olfactory identification test, 42 natural odors familiar to Koreans were applied to 40 normal subjects and 40 patients with decreased sense of smell without sinonasal diseases. Among 42 items, 16 items with high identifiability and familiarity were chosen according to the results of test-retest in normal subjects. RESULTS: The results of olfactory identification test using 16 selected items showed high correlation with olfactory threshold. CONCLUSION: These 16 items can be used for an olfactory identification test for Koreans.