Different treatment protocols for moderate idiopathic sudden sensorineural hearing loss.

Treatment of idiopathic sensorineural hearing loss (ISSNHL) is problematic due to the unclear etiology of the illness. Corticosteroid is recommended by some papers, and hyperbaric oxygen (HBO2) by others. Recently HBO2 has been shown to be an important therapy for ISSNHL, with an increasing number of studies demonstrating its beneficial results. Recovery from ISSNHL depends on the interval period between onset and treatment, hearing loss severity and audiogram type used to determine damage. Treatment of ISSNHL requires a detailed analysis. In this retrospective study we reviewed data from 56 patients with moderate ISSNHL. These patients were divided into three groups based on different treatments: corticosteroid group; corticosteroid + HBO2 (combination)group; and HBO2-only group. Additionally, all patients received intravenous vasodilator treatment. Hearing levels before and after treatment were compared. All three groups had a similar recovery rate, with an effective rate of more than 50%, and a hearing gain average of 17.38 decibels (dB). HBO2 treatment got a higher recovery rate. The combination therapy, which included corticosteroid and HBO2, did not elevate the recovery rate.

Evaluation of idiopathic olfactory loss with chemosensory event-related potentials and magnetic resonance imaging.

BACKGROUND: Idiopathic olfactory loss (IOL) accounts for a sizable fraction of olfactory dysfunction, but very little is known about its etiology and electrophysiological changes in the olfactory pathway. METHODS: We analyzed the physiology of IOL using chemosensory event-related potentials (ERPs) (olfactory and trigeminal: oERP and tERP) and olfactory pathway magnetic resonance imaging (MRI) measured in adult patients with IOL and healthy controls. Subjective olfactory function was measured by Toyota and Takagi (T&T) olfactometry and Sniffin' Sticks (SS). RESULTS: Olfactory function was worse in patients with IOL compared to controls (T&T, p < 0.001; SS, p < 0.001). oERPs could be evoked in 17 IOL patients. Signals in these patients showed lower amplitude in the N1 and P2 waves than controls (p < 0.05 for both), but there were no difference in latency between the 2 groups (p > 0.05). tERP were detected in all patients and controls; there were no differences in latency and nor amplitude between the 2 groups (p > 0.05). The olfactory bulb (OB) volume was significantly smaller in the IOL group than controls (p < 0.001), but there was no difference in the olfactory sulcus depth between groups (p > 0.05). Better olfactory function was associated with increasing magnitude of N1 amplitude in oERPs (p < 0.05) and increasing OB volume (p < 0.05). CONCLUSION: IOL patients show neurophysiologic deficits and some anatomic differences compared to healthy controls.

Gender difference in Chinese adults with post-viral olfactory disorder:a hospital-based study.

CONCLUSIONS: This hospital-based study found a gender differences in Chinese subjects with post-viral olfactory disorder (PVOD). Women appear to face higher susceptibility to PVOD, a finding that appears to be magnified with age and duration of olfactory loss. OBJECTIVES: PVOD is one of the most common reasons for acquired olfactory dysfunction, but there is little data in Chinese populations. We analyzed Chinese subjects with PVOD in order to determine demographic risk factors and clinical features in this major population group. METHODS: Data from 143 consecutive subjects with PVOD and 117 subjects with other olfactory disorders (controls) were analyzed. This study examined age, duration, and severity of olfactory loss, and compared the differences of subjective and objective olfactory function tests between two groups, using Sniffin' Sticks, Olfactory Event Related Potential (OERP), and olfactory pathway MRI. RESULTS: There were more women in the PVOD group compared to controls (p < 0.001). Older subjects with PVOD were more likely to be women (p = 0.027), and the proportion of women with PVOD increased with the duration of olfactory loss (p = 0.032). There were no differences in the prevalence of abnormal OERP between two groups, although the female-to-male ratio was higher in the PVOD group (p = 0.041). Women with PVOD were less likely to have olfactory pathway abnormalities by MRI compared to controls (p < 0.001).

[Observation of nasal obstruction symptom evaluation questionnaire and Epworth sleep score in nasal cavity ventilation expansion techniques for patients with obstructive sleep apnea hypopnea].

OBJECTIVE: To realize the application of nasal obstruction symptom evaluation (NOSE) and Epworth sleep score (ESS) before and after nasal cavity ventilation expansion techniques. METHOD: Forty-two OSAHS patients with nasal obstructive symptoms were diagnosed by clinical symptoms and polysomnography. Nasal cavity ventilation expansion technique was performed. Before and after the surgery, the NOSE and ESS were used to compare the difference. Postoperative data were obtained at least 3 months later. RESULT: Compared the data before and after operation, the NOSE and ESS were significantly decreased respectively (P<0. 05), there is no significant difference between 3 groups (P>0. 05). CONCLUSION: The result suggest that OSAHS patients taking nasal cavity ventilation expansion operations showed improvement in severity of nasal obstructive symptoms and daily sleepy.

Evaluation of post-traumatic anosmia with MRI and chemosensory ERPs.

Magnetic resonance imaging (MRI) and chemosensory event-related potentials (ERPs) are important methods to evaluate olfactory function, but there is lack of study to explore the application of MRI and chemosensory ERPs in the patients with traumatic anosmia. The data of 26 post-traumatic anosmic patients and 21 healthy controls were retrospectively surveyed; olfaction and olfactory pathway of all participants were measured clinically using the T&T olfactometer, the Sniffin' Sticks, chemosensory ERPs and MRI. All patients were anosmic based on complaints and clinical examinations. In five patients, the olfactory bulb volume was significantly lower than control group. In 18 patients, the olfactory sulcus (OS) depth was similar to control group, but all the participants had a deeper right OS (right = 7.79 ± 1.31, left = 7.06 ± 1.44, p < 0.01). Olfactory ERPs (oERPs) could be evoked in 17 patients, but these signals showed longer latencies and lower amplitude than controls in the N1 (latency p < 0.05, amplitude p < 0.01) and P2 (latency p < 0.01, amplitude p < 0.05) waves. Nine traumatic anosmic patients had no identifiable oERPs; most of them had olfactory center injury. Trigeminal ERPs were detected in all anosmic patients and controls; patients had longer latencies for N1 (p < 0.05) and P2 (p < 0.05) waves, while there was no similar change in amplitude. Older subjects had smaller OB volume and OS depth. Closed head injury could induce anosmia; the severity extent, injury site and subsequent consciousness are related to the olfaction. oERP is the gold standard for olfactory subjective examination; MRI could indicate the lesions on the olfactory pathway and reflect the possibility of detectable oERPs.

[MRI evaluation of the olfactory pathway].

MRI scanning is an important technique to evaluate the olfactory system, special scanning parameters could reveal the fine structures of the olfactory pathway. Olfactory cleft, olfactory bulb/tract, olfactory sulcus and olfactory center are the main targets of the scanning. Chronic rhino-sinusitis, head trauma, congenital dysplasia and neural degenerative diseases are the primary causes of the olfactory dysfunction and have particular imaging presentations respectively. Besides indicating the olfactory pathway lesions, MRI could also present the etiology and the prognosis of the olfactory disorder.

[The normative combined therapy for recurrent sinusitis].

OBJECTIVE: To assess the treatment outcome after endoscopic sinus surgery (ESS) in patients with recurrent sinusitis and to research which factors could influence the clinical outcome. METHOD: Endoscopic sinus surgery was performed in 55 patients. The clinical outcome and epithelization of mucosa after ESS were evaluated by Chinese ENT Association criteria. RESULT: The total cure rate was 81.82%, effective rate was 92.73%. The mean period of epithelization after operation was 13.2 weeks. No serious complication occurred. CONCLUTION: The treatment efficacy can be greatly improved by the normative combined therapy which include the standard and orderly perioperative treatment ,the overall shape and nasalization of nasal cavity, postoperative follow-up and clearing cav ity after ESS.

[Canalplasty for stenosis or atresia of the external auditory canal].

OBJECTIVE: To report the experience of canalplasty in treatment of stenosis or atresia of the external auditory canal. METHOD: A retrospective review was performed on 10 patients (10 ears) that underwent canalplasty. The lesions located in bony segment in 1 case, cartilaginous segment in 3 cases, both in cartilaginous and bony segments in 6 cases, in which 4 cases accompanied with the middle ear diseases. All patients received the canalplasty surgery, and tympanoplasty was applied simultaneously if the patient had otitis media. RESULT: Follow-up was conducted for 8-50 months respectively, 8 of the external auditory canal was wide and tympanic membrane gained a good shape, 2 case had stenosis or atresia reoccurrence after the operation. CONCLUSION: Appropriate approach and elimination of the lesions thoroughly are key points for the canalplasty.

Clinical features of olfactory disorders in patients seeking medical consultation.

BACKGROUND: Olfactory disorders are common complaints in ENT clinics. We investigated causes and relevant features of olfactory disorders and the need for gustatory testing in patients with olfactory dysfunction. MATERIAL/METHODS: A total of 140 patients seeking medical consultations were enrolled. All patients were asked about their olfactory disorders in a structured interview of medical history and underwent thorough otolaryngologic examinations and imaging of the head. RESULTS: Causes of olfactory disorders were classified as: upper respiratory tract infection (URTI), sinonasal diseases (NSD), head trauma, idiopathic, endoscopic sinus surgery, congenital anosmia, and other causes. Each of the various causes of olfactory dysfunction had its own distinct clinical features. Nineteen of 54 patients whose gustation was assessed had gustatory disorders. CONCLUSIONS: The leading causes of olfactory dysfunction were URTI, NSD, head trauma, and idiopathic causes. Gustatory disorders were fairly common in patients with olfactory dysfunction. High priority should be given to complaints of olfactory disorders.

[Clinical observation of isolated congenital anosmia].

OBJECTIVE: To introduce 8 patients with isolated congenital anosmia and to discuss the clinical manifestations, imaging characteristics and family characteristics of this rarely seen disorder. METHODS: Eight patients with isolated congenital anosmia treated between April 2007 and April 2012 were reviewed retrospectively. There were 4 males and 4 females. A detailed medical history collection, physical examination, nasal endoscopy, T&T and Sniffin'Sticks subjective olfactory function tests, olfactory event-related potentials sinonasal computed tomography scan and sex hormones level monitoring were performed in all patients. Seven cases underwent magnetic resonance image of olfactory pathway examination. RESULTS: All patients were anosmia without evidence of other defects. ENT physical examination, nasal endoscopy and computed tomography scan were normal except 4 cases with obvious nasal septum deviation, 2 cases with concha bullosa. Subjective olfactory test indicated all of them were anosmia. Olfactory event-related potentials were obtained in only 1 patient. Magnetic resonance imaging revealed the smaller or atrophy olfactory bulb and olfactory tract in five cases, the absence of olfactory bulbs and tracts in two case. A female patient did not have MRI examination because of wearing IUDs. Detection of 8 patients of sex hormones were normal. Family characteristics: 3 patients showed family inheritance pattern. CONCLUSIONS: The diagnosis of isolated congenital anosmia should be based on chief complaint, medical history, physical examination, olfactory test, nasal endoscopy, olfactory testing, olfactory imaging and olfactory event-related potentials. Magnetic resonance image of olfactory pathway and olfactory event-related potentials have important value for the diagnosis. More attention should be paid to the genetic susceptibility of the family.

[Diagnosis and management of the acute attack of sphenoid and ethmoid fungal ball sinusitis].

OBJECTIVE: To improve the diagnosis and treatment of the acute attack of sphenoid and ethmoid fungal ball sinusitis based on the analysis of clinical features. METHOD: Eighteen patients with sphenoid and ethmoid fungal ball sinusitis were reviewed, and the main symptoms included headache and fever during acute attack. Endoscopy, nasal CT and MRI can provide useful information for diagnosis. Endoscopic sinus surgery was performed on thirteen patients after drug therapy, while the other 5 patients chose conservative therapy. RESULT: The pathological examination confirmed the fungal lesions and the 13 patients had a good recovery. The result of CT and MRI scanning had a good accordance with the intra-operative findings. One patient receiving conservative treatment had acute attack again 2.5 months later, and antibiotics and topical nasal drugs improved the symptoms. CONCLUSION: Clinical presentation and radiological imaging contribute to the differential diagnosis of the acute attack of sphenoid and ethmoid fungal ball sinusitis, then the targeted therapy can be taken.

[Expression of odorant receptor genes on the olfactory epithelium following olfactory nerve disconnection].

OBJECTIVE: To constitute the animal model of unilateral olfactory nerve transection and observe the expression level and distribution of odorant receptors. METHODS: Thirty-two rats were divided into two groups: the olfactory nerve transection group (20) and the control group (12). The former group received the operation to transect the left olfactory nerve following the left olfactory bulb was exposed under microscope and the latter group did not give any disposal. At every stage of five days, two weeks, four weeks and six weeks after the operation, five rats from the nerve transection group and three from the control group were anaesthetized simultaneously, and olfactory epithelium were taken out after transcardial perfusion, then paraffin imbedding. Coronal sections were sliced for HE staining to observe the thickness changes of the olfactory epithelium, and for in situ hybridization (ISHs) to investigate the expression of olfactory receptor genes (Olr287, Olr226, Olr1493 and Olr1654) in the epithelium, also to evaluate the changes of the expression level and location of the selected receptors during the regeneration of olfactory epithelium. RESULTS: HE staining showed that 5 days after the operation cell quantity and thickness of the olfactory epithelium decreased obviously, which increased gradually 2 or 4 weeks after operation. After 6 weeks' recovery, the thickness of the epithelium could reach the control level. The pattern of cell staining by ISH showed a specific spatial distribution along the anteroposterior (AP) and dorsoventral (DV) axis. Evidence suggested that odorant receptors were distributed in continuous and multiple overlapping bands in the normal or nerve transected-recovered epithelium rather than in the conventionally accepted three or four zones. The data also demonstrated that the distribution of sensory neuron types, as identified and defined by odorant receptor expression, was restored to normal or nearly so by 6 weeks after operation. Likewise, the numbers of probe-labeled neurons in the nerve transected-recovered had an obvious decrease 5 days after olfactory nerve transection. Reactive cells (x(-) +/- s) of Olr1493 in the operated side was (53.9 +/- 19.9), compared with (419.0 +/- 21.2) in the unoperated side, there was statistic significance between them (t = 63.960, P < 0.01). Reactive cells increased gradually according to the regeneration of the epithelium, and were nearly equivalent to the normal side 6 weeks later without significant differentiation (t = 2.600, P > 0.05), according to the absolute positive cells in the operated and unoperated side of (417.8 +/- 32.4) and (445.3 +/- 10.0) respectively. CONCLUSION: The regeneration of the sensory neurons and receptors, both the number and the distribution, can recover to normal after olfactory nerve transection.

[Experience in overlay tympanoplasty].

OBJECTIVE: To explore the experience and value of overlay tympanoplasty. METHODS: Sixty-three ears with overlay tympanoplasty were reviewed and followed up for the external auditory canal, tympanic membrane and hearing. RESULTS: The diseases of the patients included middle ear cholesteatoma in 25 ears and chronic suppurative otitis media in 38 ears. The surgical techniques involved three kinds: overlay tympanoplasty, overlay tympanoplasty with canal wall up mastoidectomy and overlay tympanoplasty with canal wall down mastoidectomy. In middle ear cholesteatoma and suppurative otitis media patients, the case received the three techniques are 4, 17, 4 ears and 19, 18, 1 ears respectively. All patients gained stage I incision cure. Followed up for 0.5 to 3.5 years respectively, the external auditory canal was wide and tympanic membrane gained a good shape. The hearing in all case kept intact or increased while hearing decrease did not occur. Complications were free in patients with punctual visit. CONCLUSIONS: Overlay tympanoplasty has positive significance in treating the chronic otitis media with the merits of standard procedure, sufficient operative field and thorough erosion elimination.

[Experience of canalplasty during the overlay tympanoplasty].

OBJECTIVE: To report the experience with canalplasty during the operation of overlay tympanoplasty. METHOD: A retrospective review was performed on 56 patients (59 ears) that underwent tympanoplasty and canalplasty (part with intact canal wall mastoidectomy). Transcanal and postauricular incisions were made, and the posterior canal skin flap was elevated and fixed with retractor, while the anterior flap was freed. A drill was used to remove the anterior and inferior bone bulges and the adjacent bone to expose the tympanic sulcus and annulus adequately, and the epithelium of tympanic membrane remnant was removed thoroughly. After the eradication of the middle ear disease, temporal fascia was used as an overlay graft and the canal skin was replaced, and the gel-foam soaked in antibiotic and Dexamethasone solution was used to compress the canal. The patients began to use ear drops 1 week after surgery, and the gelfoam in canal lasted for 4-6 weeks. RESULT: Follow-up was conducted for 0.5-3.5 years respectively, all patients gained stage I incision cure, the external auditory canal was wide and tympanic membrane gained a good shape, the complications of skin flap necrosis, external canal stenosis and cholesteatoma pearl were not occurred. CONCLUSION: Canalplasty was the necessary procedure in the operation of overlay tympanoplasty which could conduce to de-epithelization of the membrane, placement of fascia and prevention of the occurrence of cholesteatoma pearl.

Effects of glucocorticoid on cyclic nucleotide-gated channels of olfactory receptor neurons.

OBJECTIVE: Cyclic adenosine monophosphate (cAMP) and cyclic nucleotide-gated (CNG) channels play an important role in olfactory perception. The purpose of this study was to explore the effect of glucocorticoid on the CNG channels of olfactory receptor neurons (ORNs). METHODS: For in vivo studies, rats were injected with dexamethasone 1 mg/kg body weight intraperitoneally once or once a day for 2 weeks. After 24 hours or 2 weeks, the difference in CNGA2 (the principal subunit of CNG channels) messenger ribonucleic acid (mRNA) in the ORNs was detected. For in vitro studies, the ORN membrane was extracted and incubated with 0.1 or 1 mg/mL dexamethasone for 5 or 30 minutes, respectively, and then the concentrations of cAMP were measured. For all experiments, normal saline was used as the control. RESULTS: For in vivo studies, compared with the normal saline group, CNGA2 mRNA could be upregulated in the 2-week group (p < .01) but not in the 24-hour group (p > .05). For in vitro studies, dexamethasone of both 0.1 and 1 mg/mL raised the concentration of cAMP in the ORNs at 5 and 30 minutes, respectively (p < .05), and the concentration of cAMP was higher in the 1 mg/mL groups than in the 0.1 mg/mL groups (p < .05). However, there was no significant difference between the 5-minute and 30-minute groups with either concentration. CONCLUSIONS: Glucocorticoid enhanced both the mRNA expression of CNG channels and the production of cAMP, which might be a possible pathway for treating olfactory disorders. The effect of glucocorticoid was dose-dependent.

Effects of transplanting olfactory ensheathing cells on recovery of olfactory epithelium after olfactory nerve transection in rats.

BACKGROUND: Olfactory ensheathing cells (OECs) can remyelinate injured spinal cord and the peripheral nerve system, but little is known about its effect on the transected olfactory nerve. We investigated recovery of olfactory epithelium after transplanting allogeneic OECs in transected rat olfactory nerves. MATERIAL/METHODS: Olfactory ensheathing cells from the olfactory bulb were cultured in DMEM/F-12 medium and purified with cytosine arabinoside (Ara-c). Forty Sprague-Dawley rats were divided into 2 groups; the left olfactory nerve was transected in all animals. In the transplant group, DiI-labeled OECs were injected into the gap between the dura and the cribriform plate (n=24); DMEM/F-12 medium was injected in control animals (n=16). Rats were subsequently killed for histologic examination. Olfactory evoked potentials (OEPs) were used to evaluate nerve conduction. RESULTS: After transecting the olfactory nerve, there was no horseradish peroxidase staining in the olfactory bulb; some OEPs disappeared. Five days after surgery, there was no horseradish peroxidase staining in the olfactory bulb of any animal. Apoptotic cells appeared in the epithelium; the thickness and cell number of the olfactory epithelium were decreased. Two weeks later, the thickness and cell number of the olfactory epithelium increased gradually. Some horseradish peroxidase staining in the olfactory bulb and OECs was detected; more growth associated protein-43 marked olfactory receptor neurons were visible. Six weeks after surgery, the cell number was greater in the transplant group (P<0.05); there was no statistically significant between-group difference regarding olfactory epithelium thickness. CONCLUSIONS: Transplanted OECs may be used to treat transected olfactory nerves.

[Correlation between olfactory disorders and morphology of nasal cavity].

OBJECTIVE: To analyze the correlation between olfactory disorders and the morphology of nasal cavity in chronic rhinosinusitis (CRS). METHOD: One hundred and seventy-six patients with chronic rhinosinusitis and/or polyps were included. Olfactory function, the morphology of nasal cavity and nasal sinus, especially the morphology of olfactory cleft, were surveyed by T&T Olfactometer, nasal endoscope and computed tomography (coronal and horizontal position). All patients were divided into 5 groups by different olfaction level. Data was achieved by the scoring endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey and analyzed by SPSS 11.5. RESULT: (1) Among all patients, 61.9% accompanied with hyposmia, 21% with anosmia , the other 17.1% with normal olfaction; (2) There was positive correlation between the scores of staging system of Lund-Mackey and the olfactory function level (P < 0.01) (3) There was positive correlation between the scores of endoscopic appearances of Kennedy and the olfactory function level (P < 0.05). CONCLUSION: (1) Olfactory function were correlated with the severity of CRS; (2) As the determining methods of CRS, staging system of Lund-Mackey can be used to estimate the olfactory function generally and initially; (3) There was not significant difference between the scores of endoscopic appearances of Kennedy and the olfactory function level.

[Clinical features of primary ciliary dyskinesia].

OBJECTIVE: To investigate the clinical features, diagnosis and treatment of primary ciliary dyskinesia (PCD). METHODS: Three cases of PCD received endoscopic sinus surgery and were followed up for life quality and recovery. Among these 3 cases, two were twin brothers and the other girl was twin born with a healthy brother. The mucosa of inferior turbinate was extracted prior to the operation without narcotic and decongestant. The ultrastructure of mucosal cilia was detected with electron microscope. Nine exons of gene DNAH5 and chromosome in one case and her fraternal twin were evaluated. RESULTS: Nasal and sinus CT imaging of the 3 cases showed chronic pansinusitis (1 case accompanied with situs inversus according with the diagnosis of Kartagener syndrome). The nasal polyp was resected, and the sinuses were opened. The twin brothers received the adenoidectomy. All patients felt nasal ventilation improved while the surgical field still covered with thick discharges during follow-up for 2 - 4 years. Ciliary ultrastructures of the three cases showed lateral dynein absent, the sequence of 9 exons of DNAH5 and chromosome presented no change in the fraternal twins. CONCLUSIONS: Surgery could improve the symptoms of sinusitis in PCD. Change of ciliary ultrastructure was an important indication of its pathological changes and molecular biology evaluation needs further study.

[Effects of ischemia on olfactory bulb in rats].

OBJECTIVE: To observe the olfactory bulb's morphological change after ischemic injury in rats, and explore the role of vascular factor in olfactory disorders. METHOD: Forty adult SD rats (weighting 250-300 g) were used, 30 of which were treated with permanent bilateral occlusion of both common carotid arteries, and the others were served as the control. The olfactory bulbs were carefully taken out on the 1st week, 4th week, 2nd month post operation, respectively, then observed the morphological changes by light microscopy. The ultra structure of cells in olfactory bulbs were also observed by transmission electron microscope. RESULT: In rats with permanent bilateral occlusion of both common carotid arteries, the vascular pattern changed and the cell number decreased in olfactory bulbs by light microscopy. In the 1st week group, the mitral cells' mitochondria injury and metamorphism were found. In the 4th week group, the microvascular paramorphia, lipofuscin in mitral cells and metamorphic nerve fibers were found by transmission electron microscope. CONCLUSION: Ischemia could injure the neuron and nerve fiber. This may be one of the reasons of olfactory disorders.

[Effect of Betamethasone on the cAMP of olfactory receptor neurons in rat].

OBJECTIVE: To observe the effects of Betamethasone on the cyclic adenosine monophosphate (cAMP) in olfactory receptor neurons (ORNs) and explore the possible mechanisms of the recovery of olfactory disorders by steroid treatment METHODS: ORNs membrane was extracted and incubated with 0.1 mg/ml and 1.0 mg/ml Betamethasone. The concentrations of cAMP were measured by enzyme-linked immunosorbent assay at different times. RESULTS: Compared with the control group, all Betamethasone groups showed differences, indicating 0.1 mg/ml (P < 0.05) and 1.0 mg/ml (P < 0.01) Betamethasone could rise the concentration of cAMP. The Betamethasone had obvious effects on cAMP production in rat ORNs and there was a dose-dependent effect. There was no difference between 5 minutes groups and 30 minutes groups. CONCLUSIONS: Steroid hormone could enhance the production of cAMP of ORNs. Steroid hormone may thus contribute to the recovery of olfactory disorders partially, at least, through the effect on AC-cAMP in olfactory transduction.