Does hormone replacement therapy in post-menopausal women have any effect upon nasal physiology?

BACKGROUND: Previous studies have suggested that the female menstrual cycle, pregnancy and the oral contraceptive pill have an effect upon nasal physiology. OBJECTIVES: This study aimed to assess the effects upon nasal physiology of female hormone replacement therapy in post-menopausal women. This has not been previously studied. METHODS: Twenty post-menopausal women (age range 36 to 70 years; mean age 57.0 years) underwent measurements of the nasal airway, including anterior rhinoscopy, peak nasal inspiratory flow rate, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance time and rhinitis quality of life questionnaire. Measurements of nasal patency were recorded prior to commencing hormone replacement therapy and at a time point 77-195 days (mean 101.9 days) following commencement. RESULTS: There was no statistical difference found for any of the variables, using the paired t-test (p > 0.05 for all). CONCLUSIONS: Female hormone replacement therapy has no discernable effect upon nasal physiology and should not be considered a cause of rhinitic symptoms.

Olfactory clearance: what time is needed in clinical practice?

OBJECTIVE: To determine olfactory adaptation and clearance times for healthy individuals, and to assess the effect of common variables upon these parameters. STUDY DESIGN AND SETTING: Fourteen healthy volunteers were recruited for a series of tests. Their initial olfactory threshold levels for phenethyl alcohol were determined. After olfactory exposure to a saturated solution of phenethyl alcohol (i.e. olfactory adaptation), the time taken for subjects to return to their initial olfactory threshold was then recorded (i.e. olfactory clearance). Visual analogue scale scores for subjective variables were also recorded. RESULTS: The 14 subjects performed 120 tests in total. Despite consistent linear trends within individuals, olfactory clearance times varied widely within and between individuals. The mean olfactory clearance time for phenethyl alcohol was 170 seconds (range 81-750). Univariate analysis showed a relationship between olfactory clearance times and age (p = 0.031), symptoms (p = 0.029) and mood (p = 0.048). CONCLUSIONS: When testing a person's sense of smell in a clinical setting, recent exposure to similar smells should be noted, and a period of 15 minutes needs to be allowed before retesting if using phenethyl alcohol. Other variables need not be controlled, but greater clearance time may be needed for older patients.

Which variables matter in smell tests in the clinic?

BACKGROUND: Testing of olfactory thresholds in the clinic is becoming more common, with commercially produced tests now available. The effect of common potential variables in the clinic setting on these results is unclear. If many variables must be controlled, tests become more complex and a universally accepted olfactory test becomes less likely. OBJECTIVES: The aim of this study was to determine which potential variables the clinician needs to consider when testing olfaction in the out-patient clinic. METHODS: The study was conducted in a clinic setting at a university hospital, using 103 normal volunteers, comprising staff members and patients and relatives from the ENT clinic waiting room. The subjects recruited had no active rhinological complaints, were not taking any medications and were aged between 16 and 70 years. An olfactory threshold was established for each subject for the odour eucalyptol. Gender, smoking status, age, peak nasal inspiratory flow, ambient temperature and relative humidity were all recorded. RESULTS: For eucalyptol, the distribution of values for olfactory thresholds in the normal population lies around the concentration 10(-3) log vol/vol. There was no significant effect of smoking status, tester, ambient temperature or humidity on the thresholds obtained. CONCLUSIONS: The above variables do not have a significant effect on olfactory thresholds elicited in the clinic. The clinician therefore need not attempt to control these factors when testing olfaction in the out-patient setting. These findings bring the implementation of a universal, reliable and easily administered measurement of olfaction a step closer.

Which solvent for olfactory testing?

The physical properties of any carrier can deteriorate over time and thus alter the results in any olfactory test. The aim of this study was to evaluate clinically potential solvents as a clean odourless carrier for olfactory testing. Sweet almond oil, pure coconut oil, pure peach kernel oil, dipropylene glycol, monopropylene glycol, mineral oil and silicone oil were studied. The experimentation was conducted in two parts. First, an olfactory device was used to conduct air through the solvents on a weekly basis using a cohort of six volunteers to assess the perceived odour of each solvent at weekly intervals. Secondly a cross-reference test was performed using small bottled solutions of phenylethyl-alcohol and 1-butanol in 10-fold dilutions to compare any perceived difference in concentrations over a period of 8 weeks. We concluded that mineral oil is the most suitable carrier for the purpose of olfactory testing, possessing many desirable characteristics of an olfactory solvent, and that silicone oil may provide a suitable alternative for odorants with which it is miscible.