Artificial intelligence-assisted prediction of olfactory disorders in patients with chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the influencing factors and perform the prediction of olfactory disorders in patients with chronic rhinosinusitis（CRS） based on artificial intelligence. Methods:The data of 75 patients with CRS who underwent nasal endoscopic surgery from October 2021 to February 2023 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. There were 53 males and 22 females enrolled in the study, with a median age of 42.0 years old. The CRS intelligent microscope interpretation system was used to calculate the proportion of area glands and blood vessels occupy in the pathological sections of each patient, and the absolute value and proportion of eosinophils, lymphocytes, plasma cells and neutrophils. The patients were grouped according to the results of the Sniffin' Sticks smell test, and the clinical baseline data, differences in nasal mucosal histopathological characteristics, laboratory test indicators and sinus CT were compared between the groups. Determine the independent influencing factors of olfactory disorders and receiver operating characteristic curves（ROC） were used to evaluate the performance of the prediction model. Statistical analysis was performed using SPSS 25.0 software. Results:Among the 75 CRS patients, 25 cases（33.3%） had normal olfaction and 50 cases（66.7%） had olfactory disorders. Multivariate Logistic regression analysis showed that tissue eosinophils percentage（OR=1.032, 95%CI 1.002-1.064, P=0.036）, Questionnaire of olfactory disorders-Negative statement（QOD-NS）（OR=1.079, 95%CI 1.004-1.160, P=0.040） and Anterior olfactory cleft score（AOCS）（OR=2.672, 95%CI 1.480-4.827, P=0.001） were independent risk factors for olfactory disorders in CRS patients. Further research found that the area under the ROC curve（AUC） of the combined prediction model established by the tissue eosinophil percentage, QOD-NS and AOCS was 0.836（95%CI 0.748-0.924, P<0.001）, which is better than the above single factor prediction model in predicting olfactory disorders in CRS. Conclusion:Based on pathological artificial intelligence, tissue eosinophil percentage, QOD-NS and AOCS are independent risk factors for olfactory disorders in CRS patients, and the combination of the three factors has a good predictive effect on CRS olfactory disorders.

Changes in olfaction and taste in patients hospitalized for COVID-19 and their relationship to patient evolution during hospitalization

Abstract Objectives: During the COVID-19 pandemic, several cases of changes in olfaction and taste associated with the infection have been reported. Therefore, otolaryngologists are frequently the first medical professionals sought by patients. The aim of this study was to evaluate the frequency of olfaction and taste disorders in patients hospitalized with COVID-19, and their association with other clinical manifestations and patient evolution during hospitalization. Methods: 248 patients, admitted to three public hospitals in Belo Horizonte, Minas Gerais, Brazil, were prospectively included: Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG), Hospital Júlia Kubitschek (HJK) and Hospital Eduardo de Menezes (HEM), who, upon admission to hospital, presented with Severe Acute Respiratory Syndrome due to COVID-19. Clinical and laboratory variables and outcomes during hospitalization were prospectively collected from the electronic medical records. The collection of sociodemographic and symptomatology data during the acute phase was carried out prospectively in electronic medical records and confirmed with the patients at a subsequent outpatient visit. Results: The most frequently reported symptoms were dyspnea (77.4%), cough (69.8%) and fever (55.2%). During the acute phase of the disease, 95 (38.3%) and 87 (35.1%) patients reported taste and olfaction disorders, respectively. There was a lower prevalence of dysosmia among patients with previous comorbidities (p < 0.05). Both symptoms were associated with less need for intensive care admission (p = 0.001 for dysgeusia and p = 0.021 for dysosmia) and a negative correlation with length of hospital stay (dysosmia: r= −0.175, p < 0.05; dysgeusia: r = −0.29, p < 0.001) and length of stay in the ICU (dysosmia: r = −0.136, p < 0.05; dysgeusia: r = −0.215, p < 0.05). The absence of taste disorders was also associated with a greater need for mechanical ventilation (p < 0.001). Conclusion: Changes in taste and olfaction were reported by a large number of patients in the acute phase of COVID-19. In this study, both were markers of better clinical patient evolution. Level of evidence: 1B.

Olfactory and taste disorders in COVID-19: a systematic review / Desordens olfativas e gustativas na COVID-19: uma revisão sistemática

Abstract Introduction: The SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases. Objective: To identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19. Methods: A systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine and Reasearch Gate. Inclusion criteria: (1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions. Exclusion criteria: (1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale. Results: Six articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders. Conclusion: Olfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.

Resumo Introdução: O vírus SARS-CoV-2 causa a COVID-19 e é responsável pela maior pandemia desde o surto de influenza H1N1 de 1918. Os sintomas clássicos da doença já foram bem definidos pela Organização Mundial da Saúde; entretanto, distúrbios olfativo-gustativos têm sido relatados em alguns estudos, mas ainda com várias lacunas no entendimento e no consenso sobre a condução clínica desses casos. Objetivo: Identificar evidências na literatura científica sobre os distúrbios olfativo-gustativos acerca da apresentação clínica, prevalência e possíveis tratamentos específicos associados à COVID-19. Método: Revisão sistemática de artigos publicados até 25 de abril de 2020 nas bases de dados: Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus e Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine e Research Gate. Foram critérios de inclusão: 1) Estudos com indivíduos com COVID-19; 2) Registro dos sinais/sintomas da COVID-19 e das funções olfativo-gustativa. Foram critérios de exclusão: 1) Estudos sobre coronavírus não humano; 2) Artigos de revisão; 3) Estudos experimentais (em animais ou in vitro); 4) Distúrbios olfativos-gustativos iniciados previamente à infecção pelo SARS-CoV-2. A avaliação de risco de viés dos estudos selecionados foi feita por meio da escala de Newcastle-Ottawa. Resultados: Seis artigos dos 1.788 registros foram selecionados. Um total de 1.457 pacientes de diversas etnias foi avaliado; desses, 885 (60,7%) apresentaram perda do olfato e 822 (56,4%) perda do paladar, sendo as mulheres as mais afetadas. Os distúrbios olfativo-gustativos estiveram presentes mesmo sem obstrução nasal/rinorreia e com início mesmo antes dos sinais/sintomas clínicos da COVID-19; a recuperação do olfato/paladar, quando ocorre, geralmente se dá nas duas primeiras semanas após a resolução da doença. Há evidências de que os distúrbios olfativo-gustativos sejam fortes preditores de infecção pelo SARS-CoV-2, podendo-se recomendar o isolamento do paciente, já a partir da consulta médica, para evitar a disseminação do vírus. Não foram identificadas evidências científicas para tratamentos eficazes para qualquer dos distúrbios. Conclusão: Podem ocorrer distúrbios olfativo-gustativos em intensidades variáveis e prévios aos sintomas gerais da COVID-19, devem ser considerados como parte dos sintomas da doença, mesmo em quadros leves. Não há ainda evidências científicas de tratamentos específicos para tais distúrbios na COVID-19.

Incomplete and late recovery of sudden olfactory dysfunction in COVID-19 / Recuperação incompleta e tardia da perda súbita do olfato na COVID-19

Abstract Introduction Sudden olfactory dysfunction is a new symptom related to COVID-19, with little data on its duration or recovery rate. Objective To characterize patients with sudden olfactory dysfunction during the COVID-19 pandemic, especially their recovery data. Methods An online survey was conducted by the Brazilian Society of Otorhinolaryngology and Cervico-Facial Surgery, and Brazilian Academy of Rhinology, including doctors who assessed sudden olfactory dysfunction patients starting after February 1st, 2020. Participants were posteriorly asked by e-mail to verify data on the recovery of sudden olfactory loss and test for COVID-19 at the end of the data collection period. Results 253 sudden olfactory dysfunction patients were included, of which 59.1% were females with median age of 36 years, with a median follow-up period of 31 days. 183 patients (72.3%) had been tested for COVID-19, and of those 145 (79.2%) tested positive. Patients that tested positive for COVID-19 more frequently showed non-specific inflammatory symptoms (89.7% vs. 73.7%; p = 0.02), a lower rate of total recovery of sudden olfactory dysfunction (52.6% vs. 70.3%; p = 0.05) and a longer duration to achieve total recovery (15 days vs. 10 days; p = 0.0006) than the ones who tested negative for COVID-19. Considering only positive-COVID-19 patients, individuals with sudden hyposmia completely recovered more often than the ones with sudden anosmia (68.4% vs. 50.0%; p = 0.04). Conclusion Positive-COVID-19 patients with sudden olfactory dysfunction showed lower total recovery rate and longer duration than negative-COVID-19 patients. Additionally, total recovery was seen more frequently in positive-COVID-19 patients with sudden hyposmia than the ones with sudden anosmia.

Resumo Introdução A perda súbita do olfato é um novo sintoma relacionado à COVID-19, porém com poucos dados sobre sua duração ou resolução. Objetivo Caracterizar pacientes que apresentaram perda súbita do olfato durante a pandemia da COVID-19 e em especial a sua recuperação. Método Pesquisa online desenvolvida pela Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial e Academia Brasileira de Rinologia direcionado aos médicos que atenderam pacientes com perda súbita do olfato com início após 1° de fevereiro de 2020. Os participantes foram questionados posteriormente por e-mail, para verificar os dados sobre a recuperação da perda súbita do olfato e teste para COVID-19, no final do período de coleta de dados. Resultados Foram incluídos 253 pacientes com perda súbita de olfato, 59,1% mulheres e idade mediana de 36 anos, acompanhados por 31 dias (mediana). Testagem para COVID-19 foi feita em 183 (72,3%) pacientes, 145 (79,2%) positivos e 38 (20,8%) negativos. COVID-19 positivos apresentaram sintomas inflamatórios inespecíficos mais frequentemente (89,7% vs. 73,7%; p = 0,02); menor taxa de recuperação total da perda súbita do olfato (52,6% vs. 70,3%; p = 0,05) e maior tempo para atingir a recuperação total (15 dias vs. 10 dias; p = 0,0006) comparados aos COVID-19 negativos. Considerando somente COVID-19 positivos, hiposmia súbita apresentou melhoria total mais frequentemente do que anosmia súbita (68,4% vs. 50,0%; p = 0,04). Conclusão A perda súbita do olfato em pacientes COVID-19 positivos apresentou menor taxa de recuperação total e duração mais prolongada do que em Covid-19 negativos. E a hiposmia súbita apresentou recuperação total mais frequentemente do que a anosmia súbita em COVID-19 positivos.

A study on the quality of life and mental health of sinusitis patients with olfactory disorders / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to investigate the incidence of dysosmia in patients with and without nasal polyps, and the impact of dysosmia on the quality of life and mental health in patients with Sinusitis. A total of 105 randomly selected patients with Sinusitis were divided into two groups based on the results of the Sniffin's Sticks olfactory examination: The dysosmia group and the non dysosmia group, the quality of life （Qol） of olfaction quality of life scale and SCL-90 symptom checklist-90（SCL-90） were scored respectively. The incidence of olfactory disorders in chronic sinusitis patients with nasal polyps was significantly higher than those without nasal polyps（χ²=37.133, 0.05）. The risk of dysosmia in patients with Sinusitis polyps was significantly higher than that in patients without nasal polyps, and the quality of life in patients with Sinusitis was significantly lower than that in patients without sinusitis, women also had a greater impact on their quality of life than men, and Sinusitis patients with dysosmia had no significant impact on their mental health.

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.

A study on the quality of life and mental health of sinusitis patients with olfactory disorders / 临床耳鼻咽喉头颈外科杂志

Objective@#The aim of this study is to investigate the incidence of dysosmia in patients with and without nasal polyps, and the impact of dysosmia on the quality of life and mental health in patients with Sinusitis. @*Method@#A total of 105 randomly selected patients with Sinusitis were divided into two groups based on the results of the Sniffin's Sticks olfactory examination: The dysosmia group and the non dysosmia group, the quality of life （Qol） of olfaction quality of life scale and SCL-90 symptom checklist-90（SCL-90） were scored respectively. @*Result@#The incidence of olfactory disorders in chronic sinusitis patients with nasal polyps was significantly higher than those without nasal polyps（χ²=37.133, P<0.001）. The quality of life score of the olfactory disturbance scale the quality of life score of the olfactory disturbance group（26.5±5.9） was significantly higher than that of the non olfactory disturbance group（11.76±3.58）（t=14.30, P<0.0001）. Life quality score（30.2±4.9） of female patients with olfactory dysfunction was significantly higher than that of male patients（22.3±4.0）（P<0.001）, The score of SCL-90 of chronic sinusitis patients with olfactory dysfunction（n=64） is 6.6（6.0-8.0）, while the score of SCL-90 of chronic sinusitis patients without olfactory dysfunction（n=41） is 7.0（6.2-7.6）, and there was no significant difference between the two groups（P>0.05）. @*Conclusion@#The risk of dysosmia in patients with Sinusitis polyps was significantly higher than that in patients without nasal polyps, and the quality of life in patients with Sinusitis was significantly lower than that in patients without sinusitis, women also had a greater impact on their quality of life than men, and Sinusitis patients with dysosmia had no significant impact on their mental health.

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.

Olfactory dysfunction in Alzheimer's disease: systematic review and meta-analysis / Alterações olfatórias em Doença de Alzheimer: revisão sistemática e meta-análise

Abstract Alzheimer's disease (AD), a neurodegenerative condition, is one of the most prevalent kinds of dementia, whose frequency doubles for every 5 years of age in elderly. Objective: To determine the correlation between AD and olfactory alterations, identifying the most affected domains and exploring the utility of olfactory tests for complementing early diagnosis. Methods: Databases were searched using the terms "olfactory OR smell OR olfaction AND alzheimer" for articles related to the proposed theme. The selected studies were categorized and evaluated separately depending on the method of analysis of the olfactory tests: identification of odors, discrimination and recognition, and a meta-analysis was carried out. Results: Fifty-one articles were selected for analysis. The effect size for most studies was large, as were the summary values for each category of individualized olfactory analysis. Conclusion: Among the olfactory domains, except memory, identification appears to be the most altered in AD. The possibility of including tests that specifically evaluate the identification of odors as an item in early diagnostic evaluation should be explored. PROSPERO registration: CRD42018089076.

Resumo Neurodegenerativa, a doença de Alzheimer (DA) é um dos tipos mais prevalentes de demência, com frequência dobrando a cada 5 anos em idosos. Objetivo: Verificar a correlação entre DA e alterações olfatórias, identificando os domínios mais afetados e a possibilidade de utilização de testes olfatórios como complemento de diagnóstico precoce. Métodos: Bases de dados foram acessadas utilizando os termos "olfactory OR smell OR olfaction AND alzheimer" buscando artigos relacionados ao tema proposto. Os estudos selecionados foram categorizados e avaliados em separado a depender do método de análise olfatória: identificação de odores, discriminação e reconhecimento e uma meta-análise foi realizada. Resultados: Cinquenta e um artigos foram selecionado para análise. O tamanho do efeito da maioria dos estudos foi grande, assim como os valores sumários de cada categoria de análise olfatória. Conclusão: Entre os domínios olfatórios, excetuando memória, a identificação parece ser a mais alterada em DA. É possível explorar a possibilidade de adição de testes específico para avaliação de identificação de odores como um item na avaliação diagnóstica precoce. Registro PROSPERO: CRD42018089076.

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.

Relationship between olfactory dysfunction and rhinoplasty / 中华整形外科杂志

The olfactory disorders are mainly studied in the field of otolaryngology, but less in plastic surgery. In this review, the author summarized the anatomy of olfactory system, the etiology of dysosmia, the test of olfactory function, the relationship between dysosmia and nasal plastic surgery, and the treatment and prevention of dysosmia, in order to explore the relationship between olfactory disorders and plastic surgeries, especially rhinoplasty.

Quantitative instruments used to assess children's sense of smell: a review article / Instrumentos quantitativos para avaliação do olfato na população infantil: artigo de revisão

Purpose: To systematically gather from the literature available the quantitative instruments used to assess the sense of smell in studies carried out with children. Research strategy: The present study included a survey in the Pubmed and Bireme platforms and in the databases of MedLine, Lilacs, regional SciELO and Web of Science, followed by selection and critical analysis of the articles found and chosen. Selection criteria: We selected original articles related to the topic in question, conducted only with children in Portuguese, English, and Spanish. We excluded studies addressing other phases of human development, exclusively or concurrently with the pediatric population; studies on animals; literature review articles; dissertations; book chapters; case study articles; and editorials. Data analysis: A book report protocol was created for this study, including the following information: author, department, year, location, population/sample, age, purpose of the study, methods, and main results. Results: We found 8,451 articles by typing keywords and identifiers. Out of this total, 5,928 were excluded by the title, 2,366 by the abstract, and 123 after we read the full text. Thus, 34 articles were selected, of which 28 were repeated in the databases, totalizing 6 articles analyzed in this review. Conclusion: We observed a lack of standardization of the quantitative instruments used to assess children's sense of smell, with great variability in the methodology of the tests, which reduces the effectiveness and reliability of the results. .

Objetivo: Levantar na literatura, de forma sistemática, os instrumentos quantitativos utilizados para a avaliação do olfato em estudos com crianças. Estratégia de pesquisa: O presente estudo incluiu pesquisa nas plataformas Pubmed e Bireme e nas bases de dados MedLine, Lilacs, SciELO regional e Web of Science, seguindo etapas de seleção e análise crítica dos periódicos encontrados e escolhidos. Critérios de seleção: Foram selecionados artigos originais relacionados ao tema, realizados somente com a população infantil nas línguas portuguesa, inglês e espanhol. Foram excluídos estudos abordando outras fases do desenvolvimento humano, exclusivamente, ou concomitantemente com a população pediátrica; estudos com animais; artigos de revisão de literatura; dissertações; capítulos de livros; artigos de estudo de caso e editoriais. Análise dos dados: Foi criado um fichamento protocolar para este estudo contemplando os seguintes pontos: autor, departamento, ano, local, população/amostra, idade, objetivo do estudo, métodos utilizados e resultados principais. Resultados: Foram encontrados 8.451 artigos a partir da busca de descritores e termos livres. Desse total, 5.928 foram excluídos pelo título, 2.366 pelo resumo e 123 pela leitura do texto completo, sendo selecionados 34, dos quais 28 estavam repetidos nas bases de dados. Ao final, seis artigos foram analisados nesta revisão. Conclusões: Foi observada ausência de padronização dos instrumentos quantitativos utilizados para a avaliação do olfato na população infantil, com grande variabilidade na metodologia dos testes, diminuindo, portanto, a efetividade e a confiabilidade dos resultados encontrados. .

Sniffin’ Sticks test in evaluating olfactory function in Parkinson’ s disease / 中华神经科杂志

Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease (PD) recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks(SS-16) tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr (H-Y) rating, and cognitive function level (Montreal Cognitive Assessment) was analyzed.Results (1)The prevalence of olfactory dysfunction in PD group (83.3%) was significantly higher than that in control group (21.2%).The Sniffin’ Sticks test showed that the odor threshold score (6.6 ±3.2, P=0.000), odor discrimination score (6.6 ±3.3, P=0.000), 16 kinds of odor identification score (6.8 ±2.4, P=0.000) in PD group were significantly lower than those in control group.( 2 ) When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.( 3 ) The olfactory score in PD group was positively correlated with cognitive function (r=0.243, P=0.046), and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age (r=-0.270, P=0.018), but positively correlated with cognitive function (r=0.281, P=0.014).Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .

Current status of chronic constipation, sleep disturbances and olfactory disorders in the elderly of Chinese residents / 中华老年医学杂志

Objective To investigate the current status and distribution characteristics of chronic constipation,sleep disturbances and olfactory disorders in Chinese elderly.Methods In 2010,the 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces and Xinjiang Production & Construction Corps.42 668 Chinese aged over 60 years in 98 548 households were randomly selected from 162 National Disease Surveillance Points (DSPs) by a stratified multistage cluster sampling.All subjects received a set of standardized questionnaire and interview.After a complex weighing,the differences in the prevalence of constipation,sleep disturbances and olfactory disorders were investigated among the residents with different genders,ages,urban or rural areas and regions.Results In all subjects aged over 60 years,the general prevalence of self-reported constipation was 5.06 ％,which increased with age.The general prevalence of self-reported constipation was higher in females than in males (5.80％ vs.4.27％,x2 =21.78,P＜0.05),higher in urban areas than in the rural areas (6.04％ vs.4.58％,x2 =5.66,P＜0.05),and there were no significant differences among residents in eastern,central,and western regions.The general prevalence of self-reported sleep disturbances was 14.19％,which increased with age.The general prevalence of self-reported sleep disturbances was higher in females than in males (17.27％ vs.10.94％,x2 =165.53,P＜0.05),and there were no significant differences among residents in urban and rural areas or in different regions.The general prevalence of self-reported olfactory disorders was 8.49％,which increased with age.The general prevalence of self-reported olfactory disorders was higher in females than in males (9.36％ vs.7.58％,x2 =22.32,P＜0.05).There were significant differences in the prevalence of self-reported olfactory disorders among residents in eastern,central and western regions (6.98％,8.28％ and 11.00％,x2 =6.66,all P＜0.05 respectively),and no significant difference was found between residents in urban and rural areas.Conclusions The prevalences of self-reported constipation,sleep disturbances and olfactory disorders are increased with age and significantly more common among women in Chinese elderly residents.

Clinical study on non-motor symptoms of essential tremor / 中华神经科杂志

Objective To survey the prevalence, distribution of non-motor symptoms (NMS) in essential tremor (ET) and the relationship with disease severity and duration.Methods Fahn-Tolosa-Matin Tremor Rating Scale (TRS) was used to assess motor symptoms in 62 patients with ET.The Parkinson's disease (PD) NMS Questionnaire and T&T olfacmeter and Mini-mental State Examination (MMSE) were used to explore non-motor symptoms in ET patients.Results In ET, a range of NMS occurred across all disease stages.More than half patients (51.6%, 32/62) had olfactory dysfunction,significantly higher than the healthy control group (30.0%, 18/60, x~2=12.371, P<0.05).A third had hyposmia.16.1% had partial olfactory loss.Each ET patient had 5 different NMS on average.Seven NMS were more common in ET patients than in control, including remembering, olfactory dysfunction, intense vivid dreams, anhedonia, depression, anxiety, sleep disorders.The incidences of remembering, olfactory dysfunction,intense vivid dreams were 58.1% (36/62),51.6% (32/62),48.4% (30/62), ranked top 3 in ET patients.Olfaction had inverse correlation with age, while there was a negative correlation between NMS score and TRS score, gender, disease duration and weather to be treated.Conclusion Besides posture tremor and kinetic tremor,NMS occur in ET,and should be well recognized and treated.

Alteraciones olfatorias en rinitis alérgicas / Olfactory alterations in allergic rhinitis

Los trastornos del olfato pueden causar serias consecuencias por la incapacidad de detectar señales olorosas de riesgo (humo, gases, alimentos en mal estado), y pueden afectar significativamente la nutrición y aun el comportamiento sexual. Estos trastornos tienen un impacto significativo en la calidad de vida de los pacientes. La hiposmia es una queja común entre los pacientes afectados por rinitis alérgica o no alérgica de larga data. En la consulta clínica por estas afecciones la pérdida del olfato es raramente explorada, centrándose la atención en los estornudos, rinorrea, congestión y prurito nasal. En la rinitis alérgica parece haber un continuo en la duración y severidad de la afección y la pérdida olfatoria, paralelo al grado de afectación rinosinusal. La pérdida olfatoria es mayor en los pacientes con rinitis no alérgica que en los afectados por rinitis alérgica estacional o perenne. En general los estudios no encuentran correlación entre la medición del grado de congestión nasal y la pérdida de olfato. En cambio existe mejor correlación con la inflamación eosinofílica. Los mecanismos subyacentes por los cuales la rinitis /rinosinusitis afectan el olfato probablemente sean multifactoriales, y podrían incluir la alteración del flujo aéreo y depósito de las sustancias olorosas, cambios en la composición del moco, y efectos de los mediadores inflamatorios en la diferenciación, maduración y función de las células receptoras. Las terapias actuales son efectivas en revertir la pérdida olfatoria solo parcial o transitoriamente. Los corticoides inhalados o sistémicos han probado ser parcialmente efectivos en mejorar el olfato en pacientes con rinitis alérgica.(AU)

Olfactory disorders can cause serious consequences from the inability to detect many olfactory warning signals (eg, smoke, spoiled food, and gas leaks) and can significantly impact nutritional status and even sexual behavior. Disorders of olfaction have significant quality of life impact. Hyposmia is a fairly common complaint in patients with long-continuing allergic or nonallergic rhinitis. Smell loss is often overlooked in the clinical setting of rhinitis, with attention instead focused on the respiratory complaints of nasal obstruction, hypersecretion, sneezing and nasal pruritus. There appears to be a continuum of duration and severity of olfactory loss in allergic rhinitis that parallels increasing severity of nasal-sinus disease. The nonallergic rhinitis patients' sense of smell was poorer than that of seasonal or perennial allergic rhinitis patients. Associations are generally lacking between measures of airway patency and olfactory function in this patients. The eosinophilic inflammation has a better correlation with the olfactory loss. The underlying mechanisms by which rhinitis/rhinosinusitis impact olfactory ability are likely to be multifactorial and might include altered air flow and odor deposition, changes in mucus composition, and effects of inflammatory mediators on receptor cell differentiation, maturation, or function. Current therapies are only partially or transiently effective in reversing olfactory loss. Inhaled and systemic steroids have been proved partially effective in improving olfactory function in patients with allergic rhinitis (AU)

Clinical Analysis of the Etiology of Korean Olfactory Disorders / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study examined the causes and epidemiologic factors of smell loss in Koreans using the Korean Version of the Sniffin' Sticks Test and compared the results with cases of foreign countries. SUBJECTS AND METHOD: The data of 386 patients who visited clinics complaining of smell loss were retrospectively analyzed with medical charts. RESULTS: Idiopathic, upper respiratory tract infection, trauma, nasal and paranasal sinus disease were the major causes of smell loss in this study. The distribution of gender and age, severity of smell loss, association of smell loss with allergies and nasal polyps were discussed in detail. CONCLUSION: The proportion of each cause observed in this study was different compared with the results of other domestic reports of nasal and paranasal sinus disease, but came out similar to the results of foreign studies.