Improvement In Olfactory Function Research Articles

Assessing the Efficacy of Acupuncture in the Treatment of Olfactory Dysfunction: A Systematic Review.

This article seeks to systematically review existing literature on the use of acupuncture in treating olfactory dysfunction in order to better understand the methodology and efficacy of this alternative treatment modality. A comprehensive search of PubMed, Cochrane Library, Embase, Web of Science, and Google Scholar was conducted. The review was conducted by 2 independent reviewers that authored this article. Inclusion criteria included all studies analyzing the efficacy of acupuncture for treatment of olfactory dysfunction. Articles were excluded if they were duplicates, opinion or review papers, incomplete or unavailable papers, or if they were in a language other than English. The review found 10 articles matching the inclusion criteria that overall showed a positive improvement in olfactory dysfunction after acupuncture intervention in multiple settings. Challenges highlighted in this review include variability in acupuncture protocols, such as differences in point selection, session frequency, and overall treatment duration, as well as the lack of standardized outcome measures for assessing olfactory function. This systematic review suggests acupuncture may have therapeutic effect on improvement of olfactory function across various types of olfactory disorders, most notably seen in post-viral anosmia. Given the variability in acupuncture protocols and lack of standardized outcome measures, there is a need for further research with standardized methods and larger sample sizes. Olfactory dysfunction is fundamentally a quality-of-life issue; advancing research could solidify acupuncture as a valuable and cost-effective addition to treatment plans, optimizing patient well-being.

Effects of Mepolizumab in the treatment of type 2 CRSwNP: a real-life clinical study.

Mepolizumab was recently approved for treating Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) unresponsive to standard treatment or recurring after endoscopic sinus surgery (ESS). To date, few studies have assessed Mepolizumab's efficacy in severe type-2 CRSwNP. Our study aimed to analyze sinonasal outcomes in type-2 CRSwNP patients treated with 100mg Mepolizumab administered subcutaneously every four weeks. We conducted a retrospective study of patients with severe, recalcitrant CRSwNP treated with Mepolizumab. Demographic and clinical characteristics were collected, including age, sex, and comorbidities such as asthma, nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NERD), and allergic rhinitis (AR), as well as the number of previous ESS procedures and the interval since the last one. Patients were evaluated at baseline and after one year for blood eosinophil count, nasal polyp score (NPS), modified Lund-Kennedy score (mLKS), olfactory function (using a VAS scale and a 16-item Sniffin' identification test), SNOT-22, and sinus opacification on CT scans. The need for rescue ESS or systemic corticosteroids (SCS), response to treatment, and side effects were also recorded. Data from 27 patients were collected. After one year, all scores showed significant improvement. NERD was the only factor associated with a less favorable improvement in olfactory function. There were no side effects reported, although 2 patients discontinued Mepolizumab as they were considered "non-responders." Mepolizumab is safe and effective in reducing the clinical, endoscopic, and radiological burden of disease, as well as in decreasing the need for salvage ESS or systemic steroids.

Age-related differences in olfactory training outcomes: A prospective cohort study.

While olfactory function decreases with age, it is unknown how age affects olfactory training (OT) efficacy. This study compared OT in two cohorts of subjects: aged ≤50 (younger cohort) and aged 51+ (older cohort) with olfactory dysfunction (OD) primarily from COVID-19 infection. Subjects with OD primarily secondary to COVID-19 infection were prospectively recruited and enrolled into an OT registry. Baseline data were collected and they were provided with a training kit and asked to complete OT at home twice daily for 6 months. Participants were asked to follow-up at 3 and 6 months during training for olfactory testing and quality-of-life surveys (Sino-Nasal Outcomes Test-22 [SNOT-22] and Questionnaire of Olfactory Disorders Negative Statements [QoD-NS]). Fifty-six participants completed OT (younger cohort: n=26, older cohort: n=30). There were no significant differences between cohorts' Affordable Rapid Olfactory Measurement Array (AROMA), QoD-NS, or SNOT-22 scores at any time point. Both cohorts showed significant AROMA score improvement of more than 16 points from baseline to 3 months (younger cohort: p=0.001; older cohort: p=0.008). The younger cohort had significant improvements in QoD-NS (p=0.008) and SNOT-22 (p=0.042) between baseline and 3 months while the older cohort improved from 3 to 6 months (QoD-NS: p=0.027, SNOT-22: p=0.049). Both cohorts demonstrated similar significant improvement in olfactory function after 3 months of OT. The timeline of subjective improvement was different between cohorts, with younger patients experiencing earlier improvement.

Improvement of olfactory function in AD mice mediated by immune responses under 40 Hz light flickering

Background40 Hz light flickering has shown promise as a non-invasive therapeutic approach for alleviating both pathological features and cognitive impairments in Alzheimer’s disease (AD) model mice and AD patients. Additionally, vision may influence olfactory function through cross-modal sensory interactions. ObjectiveTo investigate the impact of 40 Hz light flickering on olfactory behavior in AD model mice and to explore the underlying mechanisms of this intervention. MethodsWe used immunofluorescence techniques to observe the activation of the olfactory bulb (OB) in C57BL/6J mice under 40 Hz light flickering. A buried food test was conducted to evaluate olfactory behavior in AD mice. Additionally, RNA sequencing technology was employed to detect transcriptional alterations in the OBs of AD mice following light stimulation. Results40 Hz light flickering was found to effectively activate the OB. This stimulation led to enhanced olfactory behavior and did not alter P-tau protein mRNA levels within the OBs of AD mice. RNA sequencing revealed significant transcriptional changes in the OBs under flickering, particularly related to immune responses. ConclusionVision can influence olfactory function through cross-modal sensory interactions in rodent models. 40 Hz light stimulation improved olfactory performance in AD mice. However, the improvement in olfaction in AD mice is not related to changes in P-tau mRNA levels. Instead, it may be associated with an altered immune response, providing a scientific basis for the clinical treatment of olfactory disorders in Alzheimer’s disease.

Structures and functions of the normal and injured human olfactory epithelium.

The olfactory epithelium (OE) is directly exposed to environmental agents entering the nasal cavity, leaving OSNs prone to injury and degeneration. The causes of olfactory dysfunction are diverse and include head trauma, neurodegenerative diseases, and aging, but the main causes are chronic rhinosinusitis (CRS) and viral infections. In CRS and viral infections, reduced airflow due to local inflammation, inflammatory cytokine production, release of degranulated proteins from eosinophils, and cell injury lead to decreased olfactory function. It is well known that injury-induced loss of mature OSNs in the adult OE causes massive regeneration of new OSNs within a few months through the proliferation and differentiation of progenitor basal cells that are subsequently incorporated into olfactory neural circuits. Although normal olfactory function returns after injury in most cases, prolonged olfactory impairment and lack of improvement in olfactory function in some cases poses a major clinical problem. Persistent inflammation or severe injury in the OE results in morphological changes in the OE and respiratory epithelium and decreases the number of mature OSNs, resulting in irreversible loss of olfactory function. In this review, we discuss the histological structure and distribution of the human OE, and the pathogenesis of olfactory dysfunction associated with CRS and viral infection.

Management of hyposmia through Ayurveda - A case study

Abstract Background: Hyposmia, a diminished sense of smell, can significantly impact one's quality of life. Despite its prevalence, it is often underestimated in large population studies. Various factors like chronic rhino-sinusitis and aging contribute to this condition. Objective: This case study aimed to evaluate the efficacy of Ayurvedic interventions, including Mukhabhyanga followed by Nasya therapy with Lasuna swara and Anu taila, along with Ekangveera rasa and Ksheerbala DS capsules, in managing hyposmia. Methods: A 49-year-old male with a 4-month history of decreased sense of smell and loss of taste was treated with the aforementioned Ayurvedic interventions for seven days. Clinical examination, smell tests, and PEA test were conducted before and after treatment to assess olfactory function. Results: After seven days of treatment, the patient showed significant improvement in olfactory function, as evidenced by the ability to detect odors in smell tests and reduced PEA detection threshold. No adverse effects were reported during or after treatment. Conclusion: This case study suggests that Mukhabhyanga followed by Nasya therapy along with Ekangveera rasa and Ksheerbala DS capsules may effectively manage hyposmia. Further research with larger sample sizes is warranted to validate these findings and explore long-term outcomes. Ayurvedic interventions offer a promising approach for addressing olfactory disorders and improving quality of life in affected individuals.

Platelet-Rich Plasma (PRP) in the Treatment of Long COVID Olfactory Disorders: A Comprehensive Review.

Background: Long COVID has brought numerous challenges to healthcare, with olfactory dysfunction (OD) being a particularly distressing outcome for many patients. The persistent loss of smell significantly diminishes the affected individual's quality of life. Recent attention has been drawn to the potential of platelet-rich plasma (PRP) therapy as a treatment for OD. This comprehensive review aims to evaluate the effectiveness of PRP therapy in ameliorating OD, especially when associated with long-term COVID-19. Methods: We executed a comprehensive search of the literature, encompassing clinical trials and observational studies that utilized PRP in treating OD limited to COVID-19. We retrieved and comprehensively discussed data such as design, participant demographics, and reported outcomes, focusing on the efficacy and safety of PRP therapy for OD in COVID-19 patients. Results: Our comprehensive analysis interestingly found promising perspectives for PRP in OD following COVID-19 infection. The collective data indicate that PRP therapy contributed to a significant improvement in olfactory function after COVID-19 infection. Conclusions: The evidence amassed suggests that PRP is a promising and safe therapeutic option for OD, including cases attributable to Long COVID-19. The observed uniform enhancement of olfactory function in patients receiving PRP highlights the necessity for well-designed, controlled trials. Such studies would help to refine treatment protocols and more definitively ascertain the efficacy of PRP in a broader, more varied patient cohort.

Surgery for chronic rhinosinusitis with nasal polyps: An update

This update aimed to evaluate surgical indications in the management of chronic rhinosinusitis with nasal polyps (CRSwNP). It was conducted and reported according to the criteria stipulated by the Synthesis Without Meta-analysis (SwiM) guidelines. From the PubMed-National Library of Medicine database, 1098 articles were identified for the period 2006–2021 using the key words “nasal polyps” and “surgery”. After screening and analysis, 39 publications were selected. The efficacy of surgery on functional improvement in CRSwNP, measured by the specific quality-of-life score SNOT-22, is established, and improvement in olfactory function is expected in 50% of patients. The rate of surgical revision is at least 10–15% at 4 years, but the disease can be controlled for several years, with the interval between primary surgery and symptomatic recurrence exceeding 10 years in some cases. The criteria for surgery are not clearly defined in the literature. However, several authors consider failure of ≥ 8 weeks’ well-conducted local medical treatment and use of more than 2 courses of systemic corticosteroids as a reliable indication. No studies or meta-analyses are currently available to determine the superiority of one surgical technique over another.

The effect of nasal surgeries on olfactory functional outcome

Abstract Background: Nasal pathologies can alter the olfactory function there by the quality of life. In this study, we did an olfactory assessment in patients undergoing nasal surgeries, and the preoperative values were compared with the postoperative values. Objective: The objective of the study is to assess the role of nasal surgeries on olfactory functions in patients with nasal pathologies. Materials and Methods: In total, 70 participants undergoing nasal surgeries were subjected to olfactory function assessment using the Modified I smell test, which comprises olfactory threshold testing and odor identification, and the Numerical Rating Scale. Olfactory assessment was done preoperatively, 4th week and 12th week after the surgery. Results: Among 70 cases, 18 were sinonasal polyposis (25.75%), 16 (22.85%) were chronic rhinosinusitis cases, 35 (50%) deviated nasal septum cases and only one (1.4%) bilateral inferior turbinate hypertrophy case. The overall mean preoperative combined olfactory score (COS) value was 16.03 ± 2.55, 18.06 ± 1.68 in the 4th week of the postoperative period, and in the 12th week, it was 17.99 ± 1.83. There was a significant improvement in olfactory function when preoperative COS was compared with postoperative COS in different nasal surgeries. The olfactory impairment in nasal polyposis and chronic rhinosinusitis was more when compared to other nasal pathologies like nasal obstructions due to deviated nasal septum and turbinate hypertrophy. Overall, 91.7% of participants who underwent functional endoscopic sinus surgery (FESS) and 90% of FESS + septoplasty cases showed improvement in olfactory function. Only 50% of septoplasty cases showed improvement. Conclusion: Nasal pathologies are more common among men of the age group 21–30 years. Olfactory impairment in nasal polyposis and chronic rhinosinusitis was more compared to other nasal pathologies like nasal obstructions due to deviated nasal septum. FESS significantly improves the olfactory function in chronic rhinosinusitis and sino-nasal polyposis patients.

Central Compartment Atopic Disease and Its Surgical Outcomes: Olfactory Changes and Technical Notes.

Central compartment atopic disease (CCAD) is a recent, novel phenotype of chronic rhinosinusitis. Only a few studies have assessed olfactory function in patients with CCAD. We aimed to investigate olfactory function changes after functional endoscopic sinus surgery (FESS) in patients with CCAD and proposed some surgical techniques to enhance the postoperative olfactory outcomes in such patients. A retrospective cohort study. We collected data from 23 patients (8 men and 15 women) with CCAD who underwent FESS performed by a surgeon in Taiwan, between June 2018 and December 2021. The demographic data, olfactory function, and serum and tissue eosinophil percentages of the included patients were analyzed. The Top International Biotech Smell Identification Test (TIBSIT; Top International Biotech, Taipei, Taiwan) was used to assess olfactory function. Of the 23 patients, most (95%) showed a positive reaction to aeroallergens, and 2 patients (8.7%) had asthma. Ten patients (43.5%) had peripheral eosinophilia, and 9 (39%) had eosinophilic nasal polyps. Moreover, the patients presented with variable olfactory dysfunction; the mean preoperative TIBSIT (pr-TIBSIT) score was 12.8 ± 2.3 (range: 0-43), whereas the mean postoperative TIBSIT (po-TIBSIT) score was 29.2 ± 1.9 (range: 16-44). The po-TIBSIT score was significantly better than the pre-TIBSIT score (paired t test, P < .0001). The improvement in olfactory function was not significantly correlated with the patients' age, serum eosinophil percentages, and nasal polyp eosinophil counts. Our findings indicate that CCAD is significantly associated with olfactory dysfunction and that FESS can effectively improve olfactory function. To optimize postoperative olfactory outcomes, precise removal of polyps from the olfactory cleft without damaging the neuroepithelium is recommended. Our study provides valuable insights into the management of CCAD patients undergoing FESS and can guide surgical decision-making to achieve optimal olfactory function outcomes.

Therapeutic options of post-COVID-19 related olfactory dysfunction: a systematic review and meta-analysis.

Olfactory dysfunction is a typical post-COVID-19 presentation, affecting patients' quality of life. There are currently multiple treatment options in this group of patients such as oral and intranasal corticosteroids, olfactory training, oral vitamin-mineral supplementation, amongst others. This meta-analysis aims to consolidate existing evidence for current therapies in patients with persistent olfactory dysfunction related to COVID-19 infection and evaluate the possible role of corticosteroid add-on therapy in olfactory training. A systematic review and meta-analysis to study current treatments/interventions for olfactory dysfunction in post-COVID-19 infection were conducted. Data were pooled for the meta-analysis. The outcomes include subjective or objective olfactory assessment major and minor adverse reactions. Eleven studies (1414 participants) were included in this review, with six studies (916 participants) then assessed for the meta-analysis. Combined treatment of intranasal corticosteroid (INCS) with olfactory training (OT) has no benefit over OT monotherapy from both a VAS score improvement and identification component of Sniffin' Sticks test standpoint. In addition, there were no differences in improvement of TDI score between combined oral corticosteroid (OCS) with OT therapy compared to OT alone. Olfactory function was, however, significantly improved after OT. There were no significant differences in the improvement of olfactory scores in combination INCS+OT or OCS+OT therapies compared to OT monotherapy. However, there is improvement in olfactory function after OT.

The effect of intra-nasal tetra sodium pyrophosphate on decreasing elevated nasal calcium and improving olfactory function post COVID-19: a randomized controlled trial

BackgroundOlfactory dysfunction is recognized as a symptom of COVID-19. Reports revealed the nasal calcium increase has adverse effects on olfactory function. Tetra sodium pyrophosphate, a chelating agent, can bind calcium and help improve olfaction.MethodsSixty-four patients with olfactory dysfunction persisting for more than 90 days after COVID-19 were recruited. Participants were divided into 2 groups that received either 0.9% sodium chloride or 1% tetra sodium pyrophosphate for topical application. Olfactory function was tested with the Sniffin' Sticks test before treatment and 1 month later. In addition, nasal calcium was determined with an ion-selective electrode.ResultsAfter topical application of tetra sodium pyrophosphate compared to sodium chloride, improvement from anosmia to hyposmia with decrease in calcium level was demonstrated. As for the results of tetra-sodium pyrophosphate, 81% showed improved olfactory function and 19% did not exhibit olfaction improvement.ConclusionsIntranasal application of tetra sodium pyrophosphate may be associated with improvement in olfactory function after COVID -19 infection.Trial registration Ethical Committee of Damietta Faculty of Medicine approved this study on January 2021 (approval number, IRB 00012367-21-03-010).

Mometasone Furoate in Non-Allergic Rhinitis: A Real-Life Italian Study

Background: In order to evaluate the efficacy of intranasal mometasone furoate in patients with non-allergic rhinitis (NAR), a real-life, observational, prospective study is performed. Methods: Thirty-one patients (age 18–64 years) receive intranasal (mometasone furoate, 200 µg b.i.d. for 15 consecutive days per month for 6 consecutive months), plus isotonic nasal saline. The cytologic pattern of local inflammation, nasal airflow, through peak nasal inspiratory flow (PNIF), quality of life (QoL), through the rhinitis quality of life questionnaire (RQLQ), the sinonasal outcome test (SNOT-22), the short-form 36-item health survey (SF-36v2), and the combined symptom medication score (CSMS), and, finally, olfactory function, through Sniffin’ sticks-16 identification test (SSIT-16), are evaluated at baseline and after treatment. Results: NARNE is the most frequent cytological pattern (48% of the total sample). The therapeutic response shows improvement in olfactory function and QoL. Conclusions: The results of this study confirm that intranasal mometasone furoate is an effective treatment for patients with NAR.

Symptoms of depression change with olfactory function

Olfactory loss is associated with symptoms of depression. The present study, conducted on a large cohort of mostly dysosmic patients, aimed to investigate whether improvement in olfactory performance would correspond with a decrease in depression severity. In 171 participants (157 dysosmic), we assessed olfactory function and severity of depression before and after an average interval of 11 months, with many patients showing improvement in olfactory function. Separate analyses were conducted for (a) the whole group of patients and (b) the group of dysosmic patients using both classic and Bayesian approaches. For odor identification, Student t test demonstrated that the whole sample improved consistently, especially within the group of dysosmic patients. The dysosmic group also improved in odor threshold and overall olfactory function. Pearson correlation showed that an increase in olfactory function was associated with a decrease in depression severity, particularly in dysosmic patients. To conclude, the present results indicate that symptoms of depression change with olfactory function in general and odor identification in particular.

Efficacy of olfactory training program in conjunction with nasal steroid irrigation in treating persistent smell loss in COVID-19 patients

Background: Smell loss is a challenging clinical problem. There is still no evidence-based medical intervention to treat patients with persistent smell loss as a result of Coronavirus Disease 2019 (COVID-19). The aim is to analyze the efficacy of treating patients with persistent smell loss due to COVID-19 using olfactory training (OT) combined with nasal steroid irrigation. Methods: A cross-sectional study enrolled 196 COVID-19 patients with persistent smell loss were recruited. All patients underwent two testing sessions. At the first session, patients were examined by a history taking followed by an Otorhinolaryngological examination including, a thorough nasal endoscopy. In addition, an olfactory performance assessment was performed to assess the severity of smell loss. All patients were then treated with OT and nasal steroid irrigation with budesonide for 12 weeks. The second session includes an olfactory performance assessment to assess if there is an improvement in olfactory function. Results: Patients after treatment showed improvement in overall Threshold-Detection-Identification (TDI) score, odor detection threshold score, odor discrimination score, and odor identification score, which were higher than before treatment. Statistically significant differences before and after treatment results were very pronounced for the overall TDI score (p = 0.014) and odor detection threshold score (p = 0.003). There was no significant difference in odor discrimination (p = 0.08) or odor identification (p = 0.126) scores before and after treatment. Conclusion: The results of this study support the efficacy of the combination of budesonide nasal irrigation and OT in treating persistent smell loss due to COVID-19 infection.

Prognostic value of olfactory bulb volume in patients with post-viral olfactory dysfunction

Objective:The purpose of this study was to compare the olfactory function examination results of patients with post-viral olfactory dysfunction（PVOD） in different prognostic groups and analyze prognostic factors, especially the influence of olfactory bulb volume（OBV） on prognosis, so as to provide objective basis for clinical diagnosis and treatment. Methods:After approval by the hospital ethics committee, the patients with PVOD admitted to Beijing Anzhen Hospital's outpatient department from January 2019 to December 2019 were followed up for at least 1 year. These patients completed the Sniffin' Sticks test and MRI examination of the olfactory pathway before treatment. According to the results of the Sniffin' Sticks test after 1 year follow-up（threshold-discrimination-identification（TDI） score of the patients was increased at least 6 points）, the patients were divided into two groups as the improvement group and the non-improvement group. The prognostic factors of PVOD patients were preliminarily determined by comparing the differences of various factors and the results of olfactory function examination between the two groups. Results:In this study, 47 patients with PVOD were included, with the smell improvement rate was 53.2%. Compared with the improvement group, the patients in the non-improvement group had longer duration, poorer initial olfactory function, higher olfactory threshold, and poorer olfactory discrimination and recognition ability（All P<0.01）. There was no statistical difference in terms of gender, age, allergic rhinitis and smoking between the two groups（All P>0.05）.The OBV of the non-improvement group was （59.48±23.92） mm³, which was significantly lower than that in the improvement group（[92.77±14.35]mm³, P<0.001）. Multiple logistic regression analysis showed that prognostic factors included course of disease（OR 0.677, 95%CI 0.461-0.993, P=0.046）, initial T value（OR 263.806, 95%CI 1.028-67 675.884, P=0.049） and OBV（OR 1.160, 95%CI 1.002-1.343, P=0.047）. The area under the receiver operating characteristic curve（ROC curve） of OBV was 0.888（0.797-0.979, P<0.001）. The correct diagnostic index of OBV≥78.50 mm³was used to determine the prognosis of olfactory function, with a specificity of 0.818 and a sensitivity of 0.840. The ROC curve analysis showed that the area under the ROC curve of duration was 0.822（0.703-0.940, P<0.001）. The correct diagnostic index of the duration ≤6 months was used to determine the prognosis of olfactory function, with a specificity of 0.727 and a sensitivity of 0.800. The area of T score was 0.793（0.662-0.924, P=0.001）. T score ≥1.25 was used as the correct diagnostic index to determine the prognosis of olfactory function. The specificity and sensitivity were 0.818 and 0.680, respectively. Conclusion:The prognosis of olfactory function in PVOD patients is related to the course of disease, the degree of olfactory loss and OBV. Those with no improvement in olfactory function have a longer disease course, aggravated olfactory damage and reduced OBV than those with improved olfactory function. The factors of Duration ≤6 months, T value ≥1.25 and OBV≥78.50 mm³suggested better prognosis, and the results of objective olfactory examination have greater value in evaluating the prognosis of olfactory function.

Stereotactic Radiosurgery for Olfactory Groove Meningiomas: An International, Multicenter Study.

Stereotactic radiosurgery (SRS) is increasingly considered for selected olfactory groove meningiomas (OGMs). To investigate the safety and efficacy of SRS for OGMs. From 20 institutions participating in the International Radiosurgery Research Foundation, we pooled patients who underwent SRS for histologically confirmed or radiologically suspected WHO grade I OGMs and were followed for 6 mo or more after the SRS. In total, 278 (median age 57 yr) patients underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) WHO grade I OGMs Median treatment volume was 4.60 cm3 (range: 0.12-27.3 cm3), median prescription dose was 12Gy, and median dose to the olfactory nerve was 11.20Gy. During median post-SRS imaging follow-up of 39 mo (range: 6-240 mo), 43% of patients had partial or marginal response, 54% of patients had stable disease, and 3% of patients experienced progression. During median post-SRS clinical follow-up of 51 mo (range: 6-240 mo), 36 (13%) patients experienced clinical and/or radiological adverse radiation events (AREs). Elevated risk of AREs was associated with larger OGM volume (P=.009) and pre-SRS peritumoral T2/fluid-attenuated inversion-recovery signal abnormalities (P<.001). After the SRS, olfaction remained stable, improved, or deteriorated in 90%, 8%, and 2% of patients, respectively. Complete post-SRS anosmia was predicted by partial/complete anosmia before the SRS (odds ratio [OR]=83.125; 95% CI [24.589-281.01], P<.001) and prior resection of OGM (OR=3.919; 95% CI [1.713-8.970], P=.001). SRS is associated with durable local control of the majority of OGM patients with acceptable safety profile. SRS allows preservation or improvement of olfactory function in the majority of OGM patients.

Adaptation of the Pediatric Smell WheelTM to evaluate olfactory function in Brazilian children

ObjectiveOlfaction influences nutrition, safety, and the cognitive development of children. Presently there are few olfactory tests for children, and normative reference values are generally lacking. In this study, we validate the Pediatric Smell WheelTM (PSW) to evaluate olfactory function in Brazilian children. MethodsWe modified and validated the PSW, a test developed in the United States, for administration in Brazil, and established normative data for Brazilian children. The validation process consisted of five phases. First, we identified odorants familiar to Brazilian children. Second, we established the test-retest reliability of the Brazilian PSW test that employed these odorants. Third, we compared the test scores of healthy children to those microsmic from adenoid hypertrophy. Fourth, we examined the test’s ability to detect improvement in olfactory function before and after adenoidectomy. Finally, we determined a normative 10th percentile cut point for defining microsmia in a sample of 169 healthy Brazilian children between 5 and 12 years of age. ResultsEleven odors were identified for inclusion in the test. The test-retest reliability was modest (r = 0.54, p < 0.001), although likely attenuated based on the inclusion of only data from children with normal function. The test clearly differentiated the olfactory function of children with adenoid hypertrophy from that of healthy children and demonstrated the return of function after adenoidectomy. An overall score <7 was found useful in defining hyposmia, although additional age-related cut-points were also defined. ConclusionA Brazilian version of the PSW was developed and validated and found to be efficacious in detecting smell dysfunction in children ranging in age from 5 to 12 years. Level of evidence1b (Diagnosis).

Bacterial biofilm in adults with ENT pathology

Introduction. Chronic rhinosinusitis, a very common inflammatory condition, is a main public health issue affecting the quality of life. Furthermore, some patients do not respond to either medical or surgical intervention, which could be explained by the presence of the bacterial biofilm in the rhinosinusal zone. Objectives. The aim of this study is to evaluate the influence of endoscopic sinus surgery on olfactory impairment caused by chronic sinusitis with and without nasal polyps (CRSNP and CRS), by testing the olfactory function and potential dysfunction before and after endoscopic sinus surgery. Another objective is to find a connection between the percentage of coverage with bacterial biofilm of the nasal mucosa from patients with CRSNP and CRS and to evidence the fountain of infection role of the bacterial biofilm, while demonstrating that antibiotic therapy is not efficient once the bacterial biofilm is formed in the nasal sinuses. Materials and methods. We investigated 123 patients with CRSNP and CRS, which underwent functional endoscopic sinus surgery (FESS). The olfactory function was tested pre and post FESS. We also analyzed and compared the scores of endoscopic images of Lund-Kennedy and CT staging scale of LundMackey for the two study groups. The degree of olfactory rehabilitation in patients with CRSNP and CRS was evaluated performing smell diskettes test. The presence of bacterial biofilm on the surface of the nasal mucosa extracted during FESS from patients with CRSNP and CRS was examined with the electronic microscope and the percentage of coverage with bacterial biofilm was measured with Carnoy software. Results. Bacterial biofilm was present in a higher percentage in patients with CRS vs. CRSNP. By comparing the level of olfactory function, significant improvement was found after FESS intervention in both study groups. Postoperatively, Lund-Kennedy scores decrease significantly for the whole group (Z = -9.66 at p &lt; 0.001, d Cohen = 4.40), indicating the major role of surgery in the treatment of CRS. The decrease in Lund-Kennedy score values is also significant for each group. In the case of subjects diagnosed with CRS, the mean values decrease from 6.57 (preoperative) to 0.90 (postoperative), respectively Z = -6.779 to p &lt; 0.001. In the case of subjects diagnosed with CRSNP, the mean values decrease from 9.03 (preoperative) to 1.44 (postoperative), Z = -6.927 at p &lt; 0.001. Out of the total number of patients included in the study, 59 patients tested positive with the Prick test for dust and mites and more than half of the patients with positive allergy test were from the lot diagnosed with CRSNP. Conclusions. FESS plays an important role in the improvement of olfactory function in patients with CRS. Bacterial biofilm was present in both study groups but in higher percentage in the CRS group and was found in lower percentage in the group with positive allergy tests. The CRSNP group presented a higher positive result regarding the allergy Prick test and a lower percentage of coverage with bacterial biofilm of the nasal mucosa. In conclusion, chronic rhinosinusitis with or without nasal polyps that is refractary to antibiotic therapy should be directed to the ENT department in order to receive surgical therapy in order to improve olfactory function.

Six-month smell and taste recovery rates in coronavirus disease 2019 patients: a prospective psychophysical study.

The long-term recovery rate for coronavirus disease 2019 related chemosensory disturbances has not yet been clarified. Olfactory and gustatory functions were assessed with psychophysical tests in patients in the first seven days from coronavirus disease 2019 onset and one, two, three and six months after the first evaluation. A total of 300 patients completed the study. The improvement in olfactory function was significant at the two-month follow up. At the end of the observation period, 27 per cent of the patients still experienced a persistent olfactory disturbance, including anosmia in 5 per cent of cases. As for taste, the improvement in the psychophysical scores was significant only between the baseline and the 30-day control. At the 6-month evaluation, 10 per cent of the patients presented with a persistent gustatory disturbance with an incidence of complete ageusia of 1 per cent. Six months after the onset of coronavirus disease 2019, about 6 per cent of patients still had a severe persistent olfactory or gustatory disturbance.