Olfactory Function In Patients Research Articles

Correlation of Molecular Status with Preoperative Olfactory Function in Olfactory Groove Meningioma.

The study aims to examine the possible correlation between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), due to the frequent presence of olfactory impairment. We utilised next-generation sequencing to analyse samples from 22 individuals with OGM in order to detect driver mutations. Tumour morphology was assessed using preoperative imaging, whereas olfactory function was examined using Sniffin' Sticks. In a study of 22 OGM patients, mutations were as follows: 10 with SMO/SUFU, 7 with AKT1, and 5 as wild type. Planum sphenoidale hyperostosis (PSH) was present in 75% of patients, showing significant variation by mutation (p = 0.048). Tumour volumes, averaging 25 cm3, significantly differed among groups. PSH negatively impacted olfaction, notably affecting odour threshold, discrimination, identification, and global olfactory performance score (TDI) (p values ranging from <0.001 to 0.003). Perifocal oedema was associated with lower TDI (p = 0.009) and altered threshold scores (p = 0.038). Age over 65 and female gender were linked to lower thresholds and discrimination scores (p = 0.037 and p = 0.019). The study highlights PSH and perifocal oedema's significant effect on olfactory function in OGM patients but finds no link between olfactory impairment and tumour mutations, possibly due to the small sample size. This suggests that age and gender affect olfactory impairment. Additional research with a larger group of participants is needed to explore the impact of OGM driver mutations on olfactory performance.

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.

One-year psychophysical evaluation of COVID-19-induced olfactory disorders: a prospective cohort study

BackgroundOlfactory disorders are common in COVID-19. While many patients recover within weeks, a notable number of patients suffer from prolonged olfactory disorders. Much research has focused on the acute phase of olfactory disorders in COVID-19; however, there is still inconsistency regarding the prognosis. We aim to assess both objective and subjective olfactory function in patients with persisting olfactory disorders following COVID-19, 1 year after diagnosis.MethodsWe objectively measured olfactory function in 77 patients who initially had COVID-19-induced smell disorders, 1 year after confirmed diagnosis. These patients previously underwent two objective measurements at approximately 3 and 6 months after COVID-19, in the context of the COCOS trial (COrticosteroids for COvid-19-induced loss of Smell). The main outcome measurement was TDI score (threshold-discrimination-identification) on Sniffin’ Sticks Test (SST). Secondary outcomes included objective gustatory function on Taste Strip Test (TST), self-reported olfactory, gustatory and trigeminal function on a visual analogue scale (VAS) and outcomes on questionnaires about quality of life, and nasal symptoms.ResultsThe findings of this study show that 1 year following COVID-19, the median TDI score increased to 30.75 (IQR 27.38–33.5), regarded as normosmia. The median TDI score started at 21.25 (IQR 18.25–24.75) at baseline and increased to 27.5 (IQR 23.63–30.0) at 6 months following COVID-19. The increase of 9.5 points on the TDI score between baseline and 1 year after COVID-19 marks a clinically relevant improvement. Regarding the self-reported VAS score (1–10) on sense of smell, it increased from 1.2 (IQR 0.4–3.0) at baseline to 3.2 (IQR 1.4–6.0) at 6 months and further improved up to 6.1 (IQR 2.7–7.5) after 1 year. Objective gustatory function increased with 2 points on TST a year after diagnosis. Self-reported olfactory, gustatory, and trigeminal functions also improved over time, as did quality of life.ConclusionsObjective and self-reported olfactory function continued to improve 1 year after COVID-19. The median TDI score of 30.75 (IQR 27.38–33.5) is regarded as normosmia, which is a favorable outcome. However, the rate of improvement on TDI score reduces over time.

The impact of postoperative topical corticosteroid irrigation on short-term efficacy and olfactory function in patients with chronic rhinosinusitis with nasal polyps following endoscopic sinus surgery

The impact of postoperative topical corticosteroid irrigation on short-term efficacy and olfactory function in patients with chronic rhinosinusitis with nasal polyps following endoscopic sinus surgery

Impaired olfactory function in bipolar disorder patients during acute episodes regardless of psychotic symptoms.

The aim of this study was to analyze whether the presence of psychotic symptoms affects olfactory function in patients with bipolar disorder (BD). We also compared olfactory function between the period of episode and remission in patients with BD. BD patients in the acute phase were tracked to the remission stage. The psychiatric symptoms and social function of the enrolled subjects were assessed using the Hamilton Rating Scale for Depression (HAMD), the Young Mania Rating Scale (YMRS), the Hamilton Rating Scale for Anxiety (HAMA), the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment Function (GAF). Olfactory sensitivity (OS) and olfactory identification (OI) was assessed using the Sniffin' Sticks test. Differences in OS and OI among the episodic group, the euthymic group, and the healthy control (HC) group were compared. According to whether BD is accompanied by psychotic symptoms, the OS and OI in the BD with psychotic symptoms group (P-BD), the BD without psychotic symptoms group (NP-BD), and the HC group were compared. The P-BD and NP-BD groups exhibited impaired OI compared with the HC group, but there was no significant difference in OI between the P-BD and NP-BD groups, or in OS among all three groups. All patients with episodic BD had significantly lower OS and OI compared with the HC group. OI in euthymic BD patients was still impaired; however, OS recovered, showing no significant difference compared with that in the HC group. The results indicate that patients with episodic BD have impaired OS and OI, regardless of psychotic symptoms. OI may be a characteristic marker of BD, and OS may be a state marker that can be used to distinguish between episodic and euthymic BD.

Olfactory dysfunction after autoimmune encephalitis depending on the antibody type and limbic MRI pathologies.

Patients' olfactory function after autoimmune encephalitis (AE) involving limbic structures may be impaired. This study aimed to characterize olfactory function in patients after autoimmune encephalitides. A case-control study was performed including 11 AE patients with antibodies against NMDAR (n = 4), GAD (n = 3), VGKC (n = 3) and antibody-negative AE (n = 1) and a control group of 12 patients with pneumococcal meningo-encephalitis (PC). In subgroup analyses, AE patients with and without NMDAR-antibodies were compared. Olfactory function was assessed using the Sniffin Sticks test and the resulting TDI-score (threshold, discrimination, identification). Involvement of limbic structures was evaluated on imaging data (MRI). Statistical analyses were performed to test for correlations of TDI-score and MRI results. The overall olfactory function of the AE-group and the PC-group was comparable (mean TDI 32.0 [CI 27.3-36.7], 32.3 [CI 28.5-36.0)]. The proportions of hyposmic patients were similar compared to the general population. However, AE patients of the non-NMDAR group had significantly lower TDI-scores (28.9 ± 6,8) than NMDAR patients (37.4 ± 3.5) (p = 0.046) and a significantly lower discrimination capability than the NMDAR patients (9.9 ± 2.0 vs. 14.5 ± 0.6) (p = 0.002). The non-NMDAR patients had significantly more limbic MRI pathologies (6/7) compared to the NMDAR patients (0/4) (p = 0.015). Furthermore, a correlation between limbic MRI pathologies and worse capability of smelling discrimination was found (p = 0.016, r = -0.704, n = 11). Our results indicate that patients with NMDAR autoimmune encephalitis have normal long term olfactory function. However, patients with non-NMDAR autoimmune encephalitis appear to have a persistently impaired olfactory function, probably mediated by encephalitic damage to limbic structures.

A prospective study of the effect of functional endoscopic sinus surgery on the recovery of olfactory function in patients with chronic rhinosinusitis with nasal polyposis

Objective:To investigate the efficacy of functional endoscopic sinus surgery（FESS） in the treatment of olfactory dysfunction in patients with chronic rhinosinusitis with nasal polyps （CRSwNP） , at the same time, it provides an evidence for the prognosis evaluation of olfaction and the clinical application of oERPs to evaluate the plasticity of olfaction cortex. Methods:From October 2021 to October 2022, 45 patients with CRSwNP who underwent FESS nine-step standardized treatment in our department were recruited as the research subjects, divided into 22 patients with eosinophilic CRSwNP（ECRS）and 23 patients with non-eosinophilic CRSwNP（nECRS）. VAS-olfactory dysfunction （VAS-OD） score, SNOT-22 olfactory score, Sniffin' Sticks test and oERPs collection and processing were performed before the operation. All items were evaluated again 3 months after the operation. Results:VAS-OD and SNOT-22 olfactory score were significantly lower in all CRSwNP patients after the operation than those before the operation[F（1, 43） =357.429, P<0.001; F（1, 43） =185.657, P<0.001], the scores of T, D, I and TDI scores in Sniffin' Sticks test were significantly higher than those before the operation[F（1, 43） =126.302, P<0.001; F（1, 43） =311.301, P<0.001; F（1, 43） =131.401, P<0.001; F（1, 43） =295.885, P<0.001]; The decrease of VAS-OD and SNOT-22 olfactory score in the ECRS group was smaller than that in the nECRS group[F（1, 43） =4.825, P=0.033; F（1, 43） =9.916, P=0.003], T, D and TDI scores were significantly lower in nECRS group than those in nECRS group[F（1, 43） =6.719, P=0.013; F（1, 43） =4.890, P=0.032; F（1, 43） =4.469, P=0.040]; There was a positive correlation between preoperative eosinophil-to-lymphocyte ratio（ELR） and SNOT-22 olfactory score and how much it changes（r=0.455, P=0.002; r=-0.414, P=0.005）, a negative correlation between T, TDI score and how much they change respectively（r=-0.431, P=0.003; r=-0.385, P=0.009; r=-0.383, P=0.010; r=-0.316, P=0.035）. The latency of P3 was significantly shorter after operation than that before operation in all CRSwNP patients[F（1, 14） =24.840, P<0.001], however, the amplitude has no significant surgical effect. Conclusion:FESS could significantly improve the olfactory function of CRSwNP patients, while changes in plasticity may occur in the olfactory cortex. In addition, the preoperative peripheral blood eosinophil granulocyte level can predict the postoperative olfactory improvement.

Olfactory function and olfactory bulbs in patients with Kallmann syndrome

BACKGROUND: The majority of Kallmann patients have anosmia or hyposmia. This is how the disease is diagnosed. Some of them don’t have such complaints but olfactory dysfunction is diagnosed via olfactometry. Nowadays there is the lack of information about correlation between olfactometry results and subjective complaints. Correlation between olfactory bulbs size and olfactory dysfunction has been little studied.AIM: To explore olfactory bulb size and olfactory function in patients with congenital isolated hypogonadotropic hypogonadism. To correlate olfactory bulb sizes and smell test scores.MATERIALS AND METHODS: Single-centre comparative study. 34 patients were included. The main group consisted of 19 patients with hypogonadotropic (15 –with Kallmann syndrome, 4 — with normosmic hypogonadism). Olfactory bulbs MRI were provided to all the patients, olfactory test (Sniffin’ Sticks Test) and molecular-genetic studies were provided in all patients with hypogonadism. Control group consisted of 15 patients who were provided with orbits MRI. Olfactory bulbs were evaluated additionally in them.RESULTS: Normal size of olfactory bulbs were only in 1 patient with hypogonadism. Olfactory bulbs height and width were significantly smaller in patients with hypogonadism in comparison with control group (p&lt;0.01). Height median of right bulb was 1.0 mm [0.2; 1.8] in patients from the main group vs. 3.0 [2.5; 3.2] in controls, width median of right bulb was 1.0 mm [0.2; 1.9] in patients from the main group vs. 2.5 [2.0; 3.0] in controls. Height median of left bulb was 0.8 mm [0.0; 1.2] in patients from the main group vs. 3.0 [2.7; 3.2] in controls, width median of left bulb was 0.8 mm [0.0; 1.2] in patients from the main group vs. 2.5 [2.0; 3.0] in controls. Correlation has been established between left bulb height (r=0.59) and width (r=0.67) and olfactometry results (p&lt;0.05). 4 patients had no anosmia complaints but had olfactory dysfunction according to Sniffin’ Sticks Tests.CONCLUSION: Olfactometry was able to diagnose olfactory dysfunction in 78.5% (i.e. in 15 out of 19 patients with congenital isolated hypogonadotropic hypogonadism. However, anosmia complaints had only 11 out of 19 patients. It is the first results of olfactory bulb sizes in patients with hypogonadotropic hypogonadism in Russia. Uni — or bilateral hypoor aplasia were diagnosed in 94.7% patients with hypogonadism regardless of olfactory dysfunction. Bilateral olfactory bulbs hypoplasia were the most common MRI-finding (36.8%). Unilateral hypoor aplasia was diagnosed in 31.6% patients.

Olfactory dysfunction in patients with Wilson's Disease.

Many neurodegenerative disorders are associated with olfactory dysfunction (OD), but little is known about OD in Wilson's Disease (WD). We evaluated olfactory function in patients with WD. OD was examined in 68 patients with WD and 70 sex- and age-matched healthy controls using subjective testing with 'Sniffin Sticks'. Threshold discrimination identification (TDI) score and its three components (odour detection threshold, discrimination, and identification) were assessed. Compared to controls, patients with WD had a significantly weaker sense of smell in terms of TDI (p < 0.01), odour discrimination (p < 0.01), and identification (p < 0.01), but not in terms of odour detection threshold (p = 0.27). Patients with predominantly neurological symptoms were characterised by greater OD by TDI (p < 0.01), odour detection threshold (p = 0.01), and discrimination (p = 0.03). The presence of pathological lesions (p = 0.04) in brain magnetic resonance imaging and generalised brain atrophy (p = 0.02) predisposed to worse TDI. In the WD group, weak inverse correlations between age and TDI score (r = -0.27), odour detection threshold (r = -0.3), and discrimination (r = -0.3) were found. Male gender was a risk factor for abnormal TDI in both WD and controls (both p = 0.02). Patients with WD, particularly older individuals, more frequently had OD than healthy volunteers. Predominantly neurological symptoms, and the presence of typical brain MRI changes, predisposed patients with WD to smell disorders.

The effects of cognition, quality of life, and fatigue on olfactory function in patients with multiple sclerosis

AimThe frequency of olfactory dysfunction in patients with Multiple Sclerosis (MS) has revealed very different results in studies. Some studies have shown that olfactory dysfunction may be associated with cognitive impairment and poor quality of life. In these studies, different odor tests and cognitive tests were used and different results were obtained. Materials and methodsForty literate patients over the age of 18 and 24 healthy volunteers of similar age and education were included in the study. Sniffin' Sticks Odor Test, California Verbal Learning Test II, Symbol Digit Modalities Test, Revised Brief Visuospatial Memory Test, Trail-Making Test, Quality of Life Short Form-36, Fatigue Impact Scale, Beck Depression Inventory, and Beck Anxiety Inventory were applied to the individuals. ResultsOlfactory dysfunction was detected in 50 % of the patients. High disability rate, low cognitive functions, low quality of life, and fatigue were identified as the factors affecting olfactory function negatively. Odor discrimination and identification abilities were associated with disability level and cognitive functions, whereas quality of life was linked to odor threshold scores. The olfactory function and cognitive abilities of patients with progressive MS (n = 5) were worse than those of patients with relapsing remitting MS (n = 35). ConclusionOlfactory dysfunction is common in patients with MS and is associated with disability and quality of life. Olfactory function can be used in the follow-up of patients and olfactory dysfunction deserves further study as a metric that might emerge as a biomarker.

Efficacy of pentasodium diethylenetriamine pentaacetate in ameliorating anosmia post COVID-19

BackgroundCOVID-19 has been frequently demonstrated to be associated with anosmia. Calcium cations are a mainstay in the transmission of odor. One of their documented effects is feedback inhibition. Thus, it has been advocated that reducing the free intranasal calcium cations using topical chelators such as pentasodium diethylenetriamine pentaacetate (DTPA) could lead to restoration of the olfactory function in patients with post-COVID-19 anosmia. MethodologyThis is a randomized controlled trial that investigated the effect of DTPA on post-COVID-19 anosmia. A total of 66 adult patients who had confirmed COVID-19 with associated anosmia that continued beyond three months of being negative for SARS-CoV-2 infection. The included patients were randomly allocated to the control group that received 0.9 % sodium chloride-containing nasal spray or the interventional group that received 2 % DTPA-containing nasal spray at a 1:1 ratio. Before treatment and 30 days post-treatment, the patients' olfactory function was evaluated using Sniffin' Sticks, and quantitative estimation of the calcium cations in the nasal mucus was done using a carbon paste ion-selective electrode test. ResultsPatients in the DTPA-treated group significantly improved compared to the control group in recovery from functional anosmia to hyposmia. Additionally, they showed a significant post-treatment reduction in the calcium concentration compared to the control group. ConclusionThis study confirmed the efficacy of DTPA in treating post-COVID-19 anosmia.

Variations in olfactory function among bipolar disorder patients with different episodes and subtypes.

Most studies on olfactory function in individuals with bipolar disorder (BD) have not distinguished between the different subtypes or between the acute phase (mania or depression) and euthymic state. In this study, we compared olfactory function among BD patients with different subtypes and episodes to explore the potential use of olfactory function as a biomarker for the early identification of BD. The study sample consisted of 117 BD patients who were hospitalized between April 2019 and June 2019, and 47 healthy volunteers as controls. The BD patients were divided into a bipolar I disorder (BD I) (n = 86) and bipolar II disorder (BD II) group (n = 31) according to the different subtypes, and divided into depressive BD (n = 36), manic BD (n = 44), or euthymic BD (n = 37) groups according to the types of episodes they experienced. We assessed olfactory sensitivity (OS) and olfactory identification (OI) via the Sniffin' Sticks test and used the Hamilton Depression Rating Scale (HAMD) and Young Manic Rating Scale (YMRS) to evaluate BD characteristics among all subjects. Compared with controls, the participants with BD showed decreased OS and OI. We found statistically significant differences in OS and OI between the BD I group and controls, as well as differences in OS between the BD I and BD II group. Least-significant difference multiple comparisons revealed statistically significant differences in OS between the depressive BD group, manic BD group and controls and also between the manic BD and euthymic BD group. OI was positively correlated with the YMRS score in the BD I group and OS was negatively correlated with the HAMD score in the BD II group. This may be the first study to compare olfactory function in patients with BD I vs. BD II via pairwise comparisons. Our findings suggest that OS may have potential as a biomarker for distinguishing the different subtypes of BD and as a state-related biomarker for differentiating the acute phase from the euthymic state of BD. However, further prospective research is warranted.

Olfactory function in patients undergoing hemodialysis as assessed by Sniffin' Sticks testing.

This study evaluated olfactory function in patients undergoing hemodialysis. The evaluation utilized the Sniffin' Sticks test. The study enrolled 56 individuals undergoing hemodialysis for chronic renal failure alongside 54 healthy controls. The Sniffin' Sticks battery was used to assess olfactory function in all subjects. The battery included 12 separately identifiable odors. A score below 6 was considered anosmia, whilst scores ranging from 7 to 10 were classed as hyposmia. A score of at least 11 indicated normal olfaction. There was a statistically significant difference in scores between the two groups. The hemodialysis patients scored 9.12±2.77 compared to 10.72±1.94 in the controls. In the hemodialysis patients, scores for males and females did not differ significantly. Furthermore, there was no correlation between score and age, sex or length of renal failure. Some 12.5% of hemodialysis patients were anosmic, whilst 50% were hyposmic. The corresponding rates in the control group were 7.4% and 20.4%. Undergoing hemodialysis is associated with a decreased total score on the Sniffin' Sticks battery, with anosmia in 12.5% of patients and hyposmia in 50.0%. Thus, olfactory impairment is present in 62.5% of hemodialysis patients. According to previous research, renal transplantation results in an improved ability to smell, depending on how plastic the neurons involved in olfaction are.

Relationship between the severity of olfactory dysfunction and serum zinc levels.

Although the association between zinc deficiency and olfactory dysfunction is inconclusive, zinc deficiency causes apoptosis of the olfactory ensheathing cells which is involved in olfactory nerve turnover and axon regeneration, thereby suggesting a possible relationship. We investigated the relationship between serum zinc levels and olfactory function in patients with olfactory dysfunction. Ninety patients who had been diagnosed with post-infectious, posttraumatic, drug-induced, neurological and idiopathic olfactory dysfunction were included. Patients were divided into zinc normal group and zinc deficiency groups according to three reference values for serum zinc levels (60, 65, 70µg/dL). The results of olfactory tests and patient backgrounds were used to compare the differences between the two groups. There were significantly worse detection and recognition thresholds in the T&T olfactometer and Open Essence (odor identification test) results in the zinc deficiency group (< 60µg/dL). In addition, significant correlations between olfactory tests (detection/recognition thresholds in the T&T olfactometer and Open Essence results) and serum zinc levels < 65µg/dL were observed. The zinc deficiency group < 70µg/dL with idiopathic olfactory dysfunction had significantly worse olfactory tests (detection/recognition thresholds in the T&T olfactometer and Open Essence). In addition, there was a significant correlation between the detection/recognition thresholds in the T&T olfactometer and serum zinc levels in idiopathic olfactory dysfunction. Our findings suggest that zinc deficiency may exacerbate the severity of olfactory dysfunction. Furthermore, idiopathic olfactory dysfunction may be partly caused by zinc deficiency.

Olfactory function in laryngectomised patients: tracheo-oesophageal versus oesophageal speech.

This study aimed to evaluate olfactory function in patients rehabilitated with oesophageal (ES) voice or tracheo-oesophageal (TES) prosthesis to further verify whether there were differences in smell alterations depending on voice rehabilitation modality. A total of 40 patients who had undergone total laryngectomy participated in the study. Speech rehabilitation was achieved through TES in 20 patients (Group A) or ES in 20 patients (Group B). Olfactory function was evaluated using the Sniffin' Sticks test. At olfactory evaluation, in Group A, 4/20 patients (20%) were anosmic, whereas 16/20 patients (80%) were hyposmic; in Group B, 11/20 patients (55%) were anosmic whereas 9/20 patients (45%) were hyposmic. A significant difference (p = 0.04) was found at global objective evaluation. The study shows that the rehabilitation with TES contributes to maintaining a functioning, albeit limited, sense of smell.

ОЦЕНКА ЭФФЕКТИВНОСТИ МЕТОДА ЛАЗЕРНОЙ ФОТОКОАГУЛЯЦИИ ДИСТАЛЬНЫХ ВЕТВЕЙ ВИДИЕВА НЕРВА ПРИ ЛЕЧЕНИИ ПОСТНАЗАЛЬНОГО СИНДРОМА, ОБУСЛОВЛЕННОГО ВАЗОМОТОРНЫМ РИНИТОМ НА ОСНОВАНИИ СУБЪЕКТИВНЫХ КРИТЕРИЕВ

Purpose. Determination of the effectiveness of the treatment of postnasal syndrome caused by vasomotor rhinitis using the method of laser photocoagulation of the distal branches of the vidian nerve based on subjective criteria. Materials and methods. The work is based on the results of examination and treatment of 89 patients with postnasal syndrome caused by vasomotor rhinitis. The study group consisted of 45 patients (22 men and 23 women), these patients, along with laser photocoagulation of the inferior turbinates, underwent photocoagulation of the distal branches of the vidian nerve. The comparison group consisted of 44 patients (20 men and 24 women) who underwent only laser photocoagulation of the inferior turbinates. The evaluation of the results of surgical treatment of patients with postnasal syndrome caused by vasomotor rhinitis was performed on the basis of objective criteria for the following indicators: • Assessment of the quality of life of patients using the SNOT-22 questionnaire (RUS); • Evaluation of the quality of life of patients using a visual analogue scale (VAS – 10-point subjective scale). Results. In the preoperative period, the quality of life of patients was assessed using a specialized questionnaire SNOT-22 (RUS) and VAS. Based on the data obtained, the effect of vasomotor rhinitis with a postnasal component on the quality of life of patients in the study group and the comparison group corresponds to a moderately disturbing scale (the study group – 40.6 ± 3.35 points, the comparison group – 42.8 ± 6.5 points, statistically significant there was no difference between the groups p&gt;0.05, breathing through the nose and smell before surgery in the study group according to VAS – 10.0 [9.0; 10.0] points, in the comparison group – 10.0 [9.0; 10.0] points. Complaints about the flow of mucus along the back of the throat in the study group – 9.0 [9.0; 9.0] points, in the comparison group – 9.0 [8.75; 9.0] points), a statistically significant difference between the groups not detected p&gt;0.05. The use of surgical methods of treatment made it possible to improve the quality of life of patients, a progressive decrease in indicators was noted (1 month after the operation, the respiratory and olfactory function in patients of the study group was 2.0 [1.0; 2.0] points, in the comparison group – 2.0 [2.0;3.0] points Complaints about mucus flow down the posterior pharyngeal wall patients of the study group – 1.0 [0.0;1.0] points, comparison group – 4.0 [4.0;4.0 ] points, a statistically significant difference between the groups p&lt;0.05 was revealed. The quality of life of patients using a specialized questionnaire SNOT-22 (RUS) 1 month after surgery in the study group – 7.95±1.46 points, in the comparison group – 14.3±2.55 points, a statistically significant difference between the groups was revealed p&lt;0.05. Conclusions. In the treatment of postnasal syndrome caused by vasomotor rhinitis, the developed method of surgical treatment using laser photocoagulation of the distal branches of the vidian nerve allowed a statistically significant improvement in the quality of life of patients, thereby proving its effectiveness, which is confirmed by the assessment of subjective criteria.

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.

Evaluation of the Effect of Nasogastric Intubation on Olfactory Function

Aim: To evaluate the olfactory functions in patients having had nasogastric intubation.&#x0D; Material and Methods: The study included 40 adult patients who underwent general anesthesia&#x0D; between January 2021 and June 2021 for elective abdominal surgery requiring a nasogastric tube&#x0D; (NGT) insertion. Olfactory function [Brief Smell Identification Test (B-SIT)] was evaluated prior to surgery&#x0D; and four weeks post-surgery in all the patients. The demographic characteristics of the patients, duration&#x0D; of NGT application, and B-SIT scores before and after NGT application were recorded. B-SIT scores&#x0D; were recorded separately for the NGT-applied and non-NGT-applied nasal side.&#x0D; Results: The mean NGT application time was 3.4 ± 1.5 (3-7) days. The mean preoperative and&#x0D; postoperative B-SIT scores of the NGT-applied side were 5.20 ± 2.06 and 5.01 ± 2.02, respectively.&#x0D; There was no statistically significant difference between the mean preoperative and postoperative B-SIT&#x0D; scores of the NGT-applied side (p = 0.421). The mean pre- and postoperative B-SIT scores of the&#x0D; patients in the non-NGT-applied nasal side group were 5.28 ± 2.16 and 5.11 ± 2.07, respectively. No&#x0D; statistically significant difference was found in the mean preoperative and postoperative B-SIT scores in&#x0D; the non-NGT-applied nasal side (p = 0.370). No statistically significant difference was found in the mean&#x0D; preoperative and postoperative B-SIT scores between the NGT-applied and non-NGT-applied nasal&#x0D; sides, respectively (p = 0.890, p = 0.654).&#x0D; Conclusion: The result of our study showed that there was no change in the olfactory function of&#x0D; patients after nasogastric intubation.

Republication de : Endoscopic modified transseptal bi-nostril approach for pituitary tumors. Efficacy of complex preservation of every turbinate and olfaction: A STROBE analysis

Endoscopic modified transseptal bi-nostril approach minimizes turbinate and olfactory mucosal invasion and ensures preservation of the turbinates and bilateral olfaction. The main objective of this study was to investigate the pre- and postoperative variations in olfactory function in patients using this approach, and the secondary objective was to investigate the complications associated with the surgical procedure. This study is a single-center prospective cohort study using STROBE analysis. To completely protect the bilateral turbinates and olfactory epithelium, this procedure provided access to the sphenoid sinus by a transseptal approach via the left nasal cavity and by the olfactory cleft approach via the right nasal cavity without any turbinate resection. A T&T olfactometer was used to assess the mean recognition threshold of the left, right, and bilateral nasal passages before and after surgery, and complications associated with the surgical approach were investigated. We included 27 patients who underwent endoscopic modified transseptal pituitary surgery with an olfactory and turbinate preservation approach at our hospital between April 2018 and December 2019. The mean postoperative recognition threshold of the right, left, and bilateral nasal cavities did not worsen (P < 0.001 for all) relative to the preoperative values, and there was no difference in values between the right and left nasal cavities (P = 0.85). The nasal turbinates were preserved in all patients during the study period, and no recurrence was observed. Our modified EETSA could be implemented as an approach for turbinate and olfaction preservation.

Improvement of Subjective Olfactory Dysfunction in Chronic Rhinosinusitis With Nasal Polyps After Endoscopic Sinus Surgery.

ObjectiveOlfactory impairment is a common complaint in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), but the influence of endoscopic sinus surgery (ESS) on olfaction and the factors predicting olfactory impairment are not fully understood. This study aimed to assess the effect of ESS on improving olfactory dysfunction in patients with CRSwNP and to identify factors that predict prognosis.MethodsA total of 56 patients with CRSwNP reported their self-evaluated olfactory dysfunction score preoperatively and 1 month, 3 months, and 12 months after ESS. Preoperative clinical characteristics, computed tomography (CT) scan, and sinonasal endoscopy examination results were collected before surgery. Additionally, factors that predicted olfactory loss and affected the improvement of olfaction after ESS were evaluated.ResultsOlfactory improvement can be observed 1 month after ESS. A total of 73.2% (41/56) subjects experienced sustained recovery of subjective olfaction with the self-evaluated olfactory dysfunction score improving from 2.04 to 0.64 (P < 0.001) after 12 months. The Lund–Mackay scores (r = 0.593, P < 0.001) and Lund–Kennedy scores (r = 0.265, P < 0.05) correlated with the preoperative olfactory dysfunction score. Multivariate logistic regression analysis revealed that longer duration of olfactory dysfunction, blood eosinophilia, lower Lund–Mackay scores, and peripheral distribution of CT opacification were risk factors that adversely affected the recovery of olfactory function (P < 0.05).ConclusionESS improved self-evaluated olfactory function in patients with CRSwNP. Lund–Mackay scores and Lund–Kennedy scores were correlated with olfactory function prior to surgery, while a longer course of the disease, higher blood eosinophilia, lower Lund–Mackay scores, and peripheral distribution of CT opacification were risk factors for poor olfactory prognosis.