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Staufenberg AR, Frankenberger HK, Förster-Ruhrmann U, Spahn FC, Klimek L, Fruth K, Stihl C, Matthias C, Gröger M, Hagemann J. [Biologic therapy in patients with severe NSAID-exacerbated respiratory disease and previous aspirin desensitization : Results of a multicentric study]. HNO 2024; 72:473-483. [PMID: 38466409 PMCID: PMC11192825 DOI: 10.1007/s00106-024-01433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type‑2 inflammatory disease of the upper airways, with severe impairment of quality of life. Persons affected by NSAID-exacerbated respiratory disease (NERD) usually present with highly dynamic recurrence of polyps and disease despite prior treatment with sinus surgeries, oral corticosteroids, and aspirin desensitization (ATAD). Biologic therapy has fundamentally changed the choice of therapeutic concept; however, limited data exist on subgroups such as NERD patients. The aim of the current article is to report on a multicenter retrospective study on add-on therapy with dupilumab, omalizumab, and mepolizumab in patients with NERD. METHODS This is a retrospective cohort study of patients (NERD+, status after ATAD) in three reference centers in Germany (Munich, Mainz, Berlin). Subjective and objective parameters were collected at 4, 8, and 12 months after biologic therapy initiation in accordance with current EPOS/EUFOREA (European Position Paper on Rhinosinusitis and Nasal Polyps/European Forum for Research and Education in Allergy and Airway Diseases) guidelines. Biologic agents were chosen depending on availability and patient characteristics. RESULTS Treatment was commenced in 122 patients meeting the criteria for CRSwNP and NERD. The endoscopic polyp score, SNOT-22 questionnaire score, visual analogue scoring of total symptoms/severity of disease, and sense of smell (psychophysical testing with Sniffin'Sticks/Brief Smell Identification Test, B‑SIT; Sensonics, Inc., Haddon Heights, NJ, USA) improved significantly after 4 and 12 months of add-on therapy (p < 0.0001). All three biologic agents significantly improved one or more disease parameter. Adverse events were not life threatening but led to change of biologic agent in 4 cases. Patients rated biologic therapy significantly better than ATAD, with improved long-term disease control. CONCLUSION Add-on biologic therapy is effective, safe, and widely accepted among CRSwNP + NERD patients. Future studies might allow for personalized algorithms with sequential surgery, ATAD, and/or biologic therapy.
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Affiliation(s)
- Anna-Rebekka Staufenberg
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Hanna K Frankenberger
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland
| | - Ulrike Förster-Ruhrmann
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Franziska C Spahn
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Ludger Klimek
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Zentrum für Rhinologie und Allergologie, An den Quellen 10, Wiesbaden, Deutschland
| | - Kai Fruth
- HNO Zentrum Mainz, Emmeransstr. 9, 55161, Mainz, Deutschland
| | - Clemens Stihl
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland
| | - Christoph Matthias
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Moritz Gröger
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland
| | - Jan Hagemann
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
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Schmidt F, Azar C, Goektas O. Treatment of Olfactory Disorders After SARS - CoViD 2 Virus Infection. EAR, NOSE & THROAT JOURNAL 2024; 103:48S-53S. [PMID: 36976171 PMCID: PMC10051008 DOI: 10.1177/01455613231168487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/21/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE The benefit of a nasal corticosteroid in the treatment of persistent post-infectious smell disorders is not as clear in previous studies as is assumed for olfactory training. This study would therefore like to describe the treatment strategies using the example of a persistent olfactory dysfunction as a result of a proven infection with SARS-CoViD-2-virus. METHODS Twenty patients (average age of 33.9 ± 11.9 years) with hyposmia were included in this study from December 2020 to July 2021. Every second patient received additionally a nasal corticosteroid. The two resulting randomized groups of equal size were screened with the TDI test, a 20-item taste powder test for the assessment of retronasal olfaction and otorhinolaryngological examination. The patients were asked to train twice daily using a standardized odor training kit and followed up after 2 months and 3 months, respectively. RESULTS We documented a significant overall improvement in olfactory ability over the investigation period in both groups. While the TDI score steadily increased on average under the combination therapy, the rise under olfactory training alone was initially steeper. This short-term interaction effect over mean two months was not statistically significant. According to Cohen, however, a moderate effect (eta2 = 0.055, Cohen`s d = 0.5) can still be assumed. This effect could be explained by a possibly higher compliance at the beginning of the sole olfactory training due to the lack of further drug treatment offers. When the training intensity decreases, the recovery of the sense of smell stagnates. Adjunctive therapy ultimately outweighs this short-term benefit. CONCLUSIONS The results reinforce the recommendation of early and consistent olfactory training on patients with dysosmia due to COVID-19. For continuous improvement of the sense of smell, an accompanying topical treatment seems at least to be worth consideration. The results should be optimized with larger cohorts and using new objective olfactometric methods.
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Affiliation(s)
- F. Schmidt
- Departement of ENT Practice, ENT Center, HNO Zentrum am Kudamm, Berlin, Germany
| | - C. Azar
- Departement of ENT Practice, ENT Center, HNO Zentrum am Kudamm, Berlin, Germany
| | - O. Goektas
- Departement of ENT Practice, ENT Center, HNO Zentrum am Kudamm, Berlin, Germany
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Lötsch J, Wolter A, Hähner A, Hummel T. Odor dilution sorting as a clinical test of olfactory function: normative values and reliability data. Chem Senses 2024; 49:bjae008. [PMID: 38401152 DOI: 10.1093/chemse/bjae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Indexed: 02/26/2024] Open
Abstract
Clinical assessment of an individual's sense of smell has gained prominence, but its resource-intensive nature necessitates the exploration of self-administered methods. In this study, a cohort of 68 patients with olfactory loss and 55 controls were assessed using a recently introduced olfactory test. This test involves sorting 2 odorants (eugenol and phenylethyl alcohol) in 5 dilutions according to odor intensity, with an average application time of 3.5 min. The sorting task score, calculated as the mean of Kendall's Tau between the assigned and true dilution orders and normalized to [0,1], identified a cutoff for anosmia at a score ≤ 0.7. This cutoff, which marks the 90th percentile of scores obtained with randomly ordered dilutions, had a balanced accuracy of 89% (78% to 97%) for detecting anosmia, comparable to traditional odor threshold assessments. Retest evaluations suggested a score difference of ±0.15 as a cutoff for clinically significant changes in olfactory function. In conclusion, the olfactory sorting test represents a simple, self-administered approach to the detection of anosmia or preserved olfactory function. With balanced accuracy similar to existing brief olfactory tests, this method offers a practical and user-friendly alternative for screening anosmia, addressing the need for resource-efficient assessments in clinical settings.
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Affiliation(s)
- Jörn Lötsch
- Goethe-University, Medical Faculty, Institute of Clinical Pharmacology, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Anne Wolter
- Smell & Taste Clinic, Department of Otorhinolaryngology, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
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Li S, Boscolo-Rizzo P, Uderzo F, Tirelli G, Whitcroft KL, Hummel T. Orthonasal and retronasal odor identification in patients with parosmia. Eur Arch Otorhinolaryngol 2023; 280:4933-4938. [PMID: 37338584 PMCID: PMC10562280 DOI: 10.1007/s00405-023-08072-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/12/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To compare retronasal and orthonasal perception in parosmic COVID-19 patients, in order to determine whether COVID-19 has a differential effect on these functions. METHODS Using the Sniffin Sticks test battery orthonasal function was examined for odor threshold, discrimination and identification. Retronasal function was assessed using 20 tasteless aromatized powders. Gustatory function was measured using the Taste Strips test. RESULTS This study included 177 patients (127 women, 50 men; mean age 45 years), of whom 127 (72%) were hyposmic and 50 (28%) normosmic. Compared to patients without parosmia, parosmic patients performed worse in odor identification for both orthonasal (F = 4.94, p = 0.03) and retronasal tests (F = 11.95, p < 0.01). However, an interaction effect between route of odor identification (orthonasal or retronasal) and parosmia status was found (F = 4.67, p = 0.03): patients with parosmia had relatively lower retronasal scores than patients without parosmia. CONCLUSION Our results suggest that COVID-19 may affect the olfactory mucosa differently along the anterior-posterior axis, thereby possibly contributing to the pathophysiology of parosmia. Patients with parosmia also exhibit a higher degree of impairment when odors are presented through the retronasal route during eating and drinking.
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Affiliation(s)
- Shubin Li
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse. 74, 01307 Dresden, Germany
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Francesco Uderzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Katherine L. Whitcroft
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse. 74, 01307 Dresden, Germany
- UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse. 74, 01307 Dresden, Germany
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5
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Boscolo-Rizzo P, Hummel T, Invitto S, Spinato G, Tomasoni M, Emanuelli E, Tofanelli M, Cavicchia A, Grill V, Vaira LA, Lechien JR, Borsetto D, Polesel J, Dibattista M, Menini A, Hopkins C, Tirelli G. Psychophysical assessment of olfactory and gustatory function in post-mild COVID-19 patients: A matched case-control study with 2-year follow-up. Int Forum Allergy Rhinol 2023; 13:1864-1875. [PMID: 36852674 DOI: 10.1002/alr.23148] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND The aim of this study was to psychophysically evaluate the prevalence of smell and taste dysfunction 2 years after mildly symptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection compared to that observed at 1-year follow-up and while considering the background of chemosensory dysfunction in the no-coronavirus disease 2019 (COVID-19) population. METHOD This is a prospective case-control study on 93 patients with polymerase chain reaction (PCR)-positive SARS-CoV-2 infection and 93 matched controls. Self-reported olfactory and gustatory dysfunction was assessed by 22-item Sino-Nasal-Outcome Test (SNOT-22), item "Sense of smell or taste." Psychophysical orthonasal and retronasal olfactory function and gustatory performance were estimated using the extended Sniffin' Sticks test battery, 20 powdered tasteless aromas, and taste strips test, respectively. Nasal trigeminal sensitivity was assessed by sniffing a 70% solution of acetic acid. RESULTS The two psychophysical assessments of chemosensory function took place after a median of 409 days (range, 366-461 days) and 765 days (range, 739-800 days) from the first SARS-CoV-2-positive swab, respectively. At 2-year follow-up, cases exhibited a decrease in the prevalence of olfactory (27.9% vs. 42.0%; absolute difference, -14.0%; 95% confidence interval [CI], -21.8% to -2.6%; p = 0.016) and gustatory dysfunction (14.0% vs. 25.8%; absolute difference, -11.8%; 95% CI, -24.2% to 0.6%; p = 0.098). Subjects with prior COVID-19 were more likely than controls to have an olfactory dysfunction (27.9% vs. 10.8 %; absolute difference, 17.2%; 95% CI, 5.2% to 28.8%) but not gustatory dysfunction (14.0% vs. 9.7%; absolute difference, 4.3%; 95% CI, -5.8% to 14.4% p = 0.496) still 2 years after the infection. Overall, 3.2% of cases were still anosmic 2 years after the infection. CONCLUSIONS Although a proportion of subjects recovered from long-lasting smell/taste dysfunction more than 1 year after COVID-19, cases still exhibited a significant excess of olfactory dysfunction 2 years after SARS-CoV-2 infection when compared to matched controls.
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Affiliation(s)
- Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - Sara Invitto
- INSPIRE LAB-Laboratory of Cognitive and Psychophysiological Olfactory Processes, DiSTeBA, University of Salento, Lecce, Italy
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
- Unit of Otolaryngology, Azienda Unità Locale Socio Sanitaria 2-Marca Trevigiana, Treviso, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Enzo Emanuelli
- Unit of Otolaryngology, Azienda Unità Locale Socio Sanitaria 2-Marca Trevigiana, Treviso, Italy
| | - Margherita Tofanelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Angelo Cavicchia
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Vittorio Grill
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Luigi Angelo Vaira
- Department of Medicine, Surgery and Pharmacy, Maxillofacial Surgery Operative Unit, University of Sassari, Sassari, Italy
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS. Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Daniele Borsetto
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Michele Dibattista
- Department of Translational Biomedicine and Neuroscience, University of Bari A. Moro, Bari, Italy
| | - Anna Menini
- Neurobiology Group, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste, Italy
| | - Claire Hopkins
- Ear, Nose and Throat Department, Guy's and St Thomas' Hospitals, London, UK
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
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Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S. Olfactory Function and Olfactory Disorders. Laryngorhinootologie 2023; 102:S67-S92. [PMID: 37130532 PMCID: PMC10184680 DOI: 10.1055/a-1957-3267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The sense of smell is important. This became especially clear to patients with infection-related olfactory loss during the SARS-CoV-2 pandemic. We react, for example, to the body odors of other humans. The sense of smell warns us of danger, and it allows us to perceive flavors when eating and drinking. In essence, this means quality of life. Therefore, anosmia must be taken seriously. Although olfactory receptor neurons are characterized by regenerative capacity, anosmia is relatively common with about 5 % of anosmic people in the general population. Olfactory disorders are classified according to their causes (e. g., infections of the upper respiratory tract, traumatic brain injury, chronic rhinosinusitis, age) with the resulting different therapeutic options and prognoses. Thorough history taking is therefore important. A wide variety of tools are available for diagnosis, ranging from short screening tests and detailed multidimensional test procedures to electrophysiological and imaging methods. Thus, quantitative olfactory disorders are easily assessable and traceable. For qualitative olfactory disorders such as parosmia, however, no objectifying diagnostic procedures are currently available. Therapeutic options for olfactory disorders are limited. Nevertheless, there are effective options consisting of olfactory training as well as various additive drug therapies. The consultation and the competent discussion with the patients are of major importance.
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Affiliation(s)
- T Hummel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - N Power Guerra
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Medizinische Universität Rostock, Rostock
| | - N Gunder
- Universitäts-HNO Klinik Dresden, Dresden
| | - A Hähner
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - S Menzel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
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7
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Retronasal olfaction is relatively less affected in older individuals with subjectively normal olfactory function. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fahmy M, Whitcroft K. Psychophysical Testing in Chemosensory Disorders. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022; 10:393-404. [PMID: 36120187 PMCID: PMC9468236 DOI: 10.1007/s40136-022-00429-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 12/02/2022]
Abstract
Purpose of Review To provide an overview of psychophysical testing in olfaction and gustation. Recent Findings Subjective patient report correlates poorly with objective assessment of olfaction and gustation. It is therefore important that clinicians and researchers perform psychophysical testing during chemosensory assessment. There are several validated psychophysical tests of olfaction and gustation, with ongoing developments accelerated by the COVID-19 pandemic. These tests have been culturally and linguistically adapted globally. Screening tests have been developed with careful consideration to distinguish normosmics from those with olfactory dysfunction. Summary Validated chemosensory tools are available for use by the clinician to support screening, diagnosis, or monitoring. There are promising advances in self-assessment and screening that provide avenues for the development of a standardised pathway for identification and formal assessment of patients with smell and taste disorders.
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Affiliation(s)
- Miriam Fahmy
- ENT Department, Pinderfields Hospital, Mid Yorkshire Hospital NHS Trust, Wakefield, UK
- Wrexham, UK
| | - Katherine Whitcroft
- ENT Department, Pinderfields Hospital, Mid Yorkshire Hospital NHS Trust, Wakefield, UK
- UCL Ear Institute, London, UK
- Centre for Olfactory Research Applications, Institute of Philosophy, School of Advanced Study, London, UK
- Smell and Taste Clinic, Techniche Universität Dresden, Dresden, Germany
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9
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James J, Palte IC, Vilarello BJ, Axiotakis LG, Jacobson PT, Gudis DA, Overdevest JB. Beyond aroma: A scoping review on the impact of chronic rhinosinusitis on retronasal olfaction. FRONTIERS IN ALLERGY 2022; 3:969368. [PMID: 36118172 PMCID: PMC9470759 DOI: 10.3389/falgy.2022.969368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background Retronasal olfaction (RNO) refers to the perception of odorants inhaled through the mouth and carried through the nasopharynx to olfactory receptors within the olfactory cleft, enabling the perception of flavor. Although orthonasal olfactory dysfunction in chronic rhinosinusitis (CRS) has been widely described, the impact of CRS on RNO is less clear. In this study, we systematically review available literature to provide an update on RNO in the setting of CRS. Methods We systematically searched PubMed, Ovid Embase, Web of Science, and the Cochrane Library for studies examining RNO in patients with documented CRS. The primary outcome of interest was objective psychophysical measurement of olfaction, including characterization of RNO. Results We identified 404 unique references that underwent title and abstract review by two independent reviewers, with 52 articles undergoing full-text review, where 10 relevant studies underwent data extraction. Although outcome measures varied, all included studies demonstrated diminished RNO in patients with CRS. Of six studies evaluating the relationship between retronasal and orthonasal olfactory test scores in CRS patients two out of six (33%) demonstrated a correlation between both forms of olfaction and CRS, and two out of six studies (33%) found significantly lower orthonasal olfactory test scores compared to retronasal olfactory test scores. Two of three found significant improvement in RNO with treatment of underlying CRS. Of three studies examining patient reported outcome measures (PROMs) in CRS, two found significant associations between retronasal olfactory test scores and PROMs. Conclusions Based on the current literature, CRS patients appear to have diminished RNO, which may be associated with orthonasal olfactory dysfunction and decreased quality of life in this population. Higher level of evidence studies are required to further elucidate these relationships and the impact of medical and surgical CRS management on RNO.
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Affiliation(s)
- Joel James
- Department of Medical Education, CUNY School of Medicine, New York, NY, United States
| | - Ilan C. Palte
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, United States
| | - Brandon J. Vilarello
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Lucas G. Axiotakis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
| | - Patricia T. Jacobson
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
| | - David A. Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
| | - Jonathan B. Overdevest
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States
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10
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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11
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Hernandez AK, Juratli L, Haehner A, Hsieh JW, Landis BN, Hummel T. Assessment of olfactory fluctuations in a clinical context. Eur Arch Otorhinolaryngol 2022; 279:5685-5690. [PMID: 35661914 PMCID: PMC9649505 DOI: 10.1007/s00405-022-07462-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/18/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE The aim of the study was to investigate whether olfactory fluctuations (OF) are pronounced in patients with sinonasal olfactory dysfunction (OD). METHODS The retrospective investigation included patients aged 18 years or older, who consulted a tertiary referral center for olfactory loss. Patients with normal smell function were excluded. Patients answered a structured questionnaire about their olfactory symptoms, with specific questions related to the presence of OF and its average frequency, amplitude, duration, time since most recent OF, and associated symptoms of self-reported OF. Patients also underwent clinical evaluation including a structured medical history and physical examination including nasal endoscopy. In addition, we assessed orthonasal olfactory function using Sniffin' Sticks, and gustatory function using "taste sprays". RESULTS Participants included 131 men and 205 women (n = 336), aged 18 to 86 years (mean 50, SD 16). Patient-reported fluctuations occurred most frequently in sinonasal (38%), idiopathic (29%), and postviral (29%) OD. Amplitude of OF was highest in postviral OD (p = 0.009). Average frequency, duration, and the time since the most recent fluctuation were not significantly different between groups (all p's > 0.42). Odor discrimination (p = 0.002) and identification (p = 0.017) scores were higher among those individuals with OF. CONCLUSION Amplitude of OF may help distinguish postviral from other causes of OD, especially in patients presenting with equivocal symptoms of sinonasal disease.
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Affiliation(s)
- Anna Kristina Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Lena Juratli
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany ,University of Michigan Medical School, Ann Arbor, MI USA
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Julien W. Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University of Geneva, Geneva, Switzerland
| | - Basile N. Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University of Geneva, Geneva, Switzerland
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Haus 5, Fetscherstrasse 74, 01307 Dresden, Germany
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12
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Pieniak M, Oleszkiewicz A, Klockow M, Yoshino A, Haehner A, Hummel T. q-Powders: a quick test for screening retronasal olfactory disorders with tasteless powders. Eur Arch Otorhinolaryngol 2021; 279:779-784. [PMID: 33948681 PMCID: PMC8096134 DOI: 10.1007/s00405-021-06849-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/23/2021] [Indexed: 01/06/2023]
Abstract
Purpose To investigate the clinical utility of q-Powders—a retronasal identification screening test. Methods A total of 156 subjects (92 females, mean age: 54.5 years ± 17.3 years) completed a 3-item q-Powders retronasal identification test and a 16-items Sniffin’ Sticks orthonasal identification test. We analyzed whether the q-Powders test could differentiate between subjects with normosmia and subjects with an olfactory disorder. Results Our data indicated that subjects with an olfactory disorder scored lower in the q-Powders test than subjects with normosmia. The analyses revealed q-Powders test sensitivity of 84% and a test specificity of 64.9% with a score of 2 points taken as a cutoff for olfactory disorders. Conclusion The 3-item q-Powders retronasal test may be used for screening purposes in clinical research. Level of evidence 4
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Affiliation(s)
- Michal Pieniak
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527, Wroclaw, Poland.
| | - Anna Oleszkiewicz
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527, Wroclaw, Poland
| | - Marie Klockow
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Ayaho Yoshino
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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13
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Yoshino A, Pellegrino R, Luckett CR, Hummel T. Validation study of a novel approach for assessment of retronasal olfactory function with combination of odor thresholds and identification. Eur Arch Otorhinolaryngol 2021; 278:3847-3856. [PMID: 33606083 PMCID: PMC7893845 DOI: 10.1007/s00405-021-06687-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/08/2021] [Indexed: 02/06/2023]
Abstract
Purpose The present study aimed to establish a test battery for the clinical assessment of retronasal odor thresholds and retronasal odor identification. Study design Prospective case–control series. Methods Sixty participants (36 women, 24 men, mean age 37.6 ± 19.4 years) were enrolled in this study; 36 were healthy controls and 24 were patients with olfactory dysfunction. Orthonasal olfactory function was assessed with the “Sniffin’ Sticks” test battery. Retronasal olfaction was assessed with oral odorant delivery using special containers for threshold function, and with oral tasteless powders for odor identification. Results Retronasal and orthonasal olfaction were significantly correlated for threshold scores, identification score, and the sum of threshold and identification score (TI score). Validity analyses showed that the retronasal TI score was able to discriminate between healthy controls and patients with olfactory dysfunction. Conclusions Normosmic participants can be distinctly differentiated from patients with olfactory dysfunction using a valid test battery comprised of retronasal threshold and identification tests. Based on the current findings, we advocate a TI score of 16 as a cut-off between patients and controls. Therefore, TI scores of 17 and above would indicate retronasal normosmia.
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Affiliation(s)
- Ayaho Yoshino
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan.
| | - Robert Pellegrino
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- Department of Food Science, University of Tennessee, Knoxville, TN, USA
| | - Curtis R Luckett
- Department of Food Science, University of Tennessee, Knoxville, TN, USA
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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14
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Özay H, Çetin AÇ, Ecevit MC. Determination of Retronasal Olfactory Threshold Values. Laryngoscope 2021; 131:1608-1614. [PMID: 33533495 DOI: 10.1002/lary.29395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/27/2020] [Accepted: 01/02/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVES/HYPOTHESIS The aim of this study was to generate normative data of retronasal olfactory threshold values for normosmic and hyposmic individuals and to test the validity of that data by determining the discriminative power for normosmic/hyposmic differentiation. STUDY DESIGN Prospective, descriptive and methodological study. METHODS The orthonasal olfactory function of 20 normosmic and 20 hyposmic cases was evaluated using the Sniffin' Sticks Olfactory test. Sniffin' Sticks odor threshold, odor discrimination, and odor identification values and threshold discrimination identification (TDI) scores were recorded. A 13-item test battery previously prepared in our Rhinology Laboratory for retronasal olfactory threshold test that consisted of concentrated solutions prepared from 2:1 diluted 99% phenylethyl alcohol (PEA) and water was used. Each concentration was evaluated with water control, and if not answered correctly, the same process was continued by moving to a higher concentration series. Four consecutive correct answers were determined as the patient's retronasal olfactory threshold. RESULTS A strong correlation was found between Sniffin' Sticks TDI scores and retronasal odor threshold values in the normosmic group (P < .001, r:0.67). A very strong correlation was found between Sniffin' Sticks TDI scores and retronasal olfactory threshold values in the hyposmic group (P < .001, r:0.81). Furthermore, receiver operating characteristic (ROC) analysis revealed that the sensitivity and the specificity of normosmic/hyposmic differentiation of retronasal olfactory threshold test was 95% and 100%, respectively. The diagnostic cutoff value was 8.5. CONCLUSIONS This study shows that the retronasal olfactory test, a psychophysical odor test performed using an orally presented stimulus, can be used to differentiate normosmic and hyposmic cases. LEVEL OF EVIDENCE 3 Laryngoscope, 131:1608-1614, 2021.
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Affiliation(s)
- Hüseyin Özay
- Department of Otorhinolaryngology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Aslı Çakır Çetin
- Department of Otorhinolaryngology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Mustafa Cenk Ecevit
- Department of Otorhinolaryngology, Dokuz Eylül University School of Medicine, İzmir, Turkey
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15
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Abstract
Approximately 5% of the general population is affected by functional anosmia with approximately additional 15% exhibiting decreased olfactory function. Many of these individuals ask for help. Because the subjective rating of olfactory function is biased, assessment of olfactory function is important. Olfactory measurements are needed for patient counseling and the tracking of changes in the sense of smell over time. The present review provides an overview of frequently used psychophysical tests for olfactory function, discusses differences between threshold and suprathreshold aspects of olfactory function, and gives examples on how to apply psychophysical tests.
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Affiliation(s)
- Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, "Technische Universität Dresden", Dresden, Germany
| | - Dino Podlesek
- Department of Neurosurgery, "Technische Universität Dresden", Dresden, Germany
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16
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Yan X, Whitcroft KL, Hummel T. Olfaction: Sensitive indicator of inflammatory burden in chronic rhinosinusitis. Laryngoscope Investig Otolaryngol 2020; 5:992-1002. [PMID: 33364387 PMCID: PMC7752087 DOI: 10.1002/lio2.485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/14/2020] [Accepted: 10/16/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Olfactory dysfunction has a high prevalence in chronic rhinosinusitis (CRS) patients and significantly affects quality of life. CRS is recognized as a complex disorder encompassing heterogeneous inflammatory processes in the nose and paranasal sinuses. Olfactory dysfunction in CRS patients is associated with the level of inflammatory mediators and the efficiency of inflammatory control. Learning about the association between CRS-related inflammation and olfactory function will provide clues to the pathogenesis of CRS. STRUCTURE The first section of this review describes the assessment of olfactory function using various measures, from ratings to MR based imaging. Then, we discuss the conductive and inflammatory mechanisms related to olfactory dysfunction in CRS: olfaction is associated with certain inflammatory patterns and is potentially a marker of CRS subtype. Finally, we review anti-inflammatory therapies including conservative and surgical approaches, and their effectiveness in olfactory dysfunction in CRS. CONCLUSION Assessment of olfactory function should be considered in the clinical evaluation of CRS patients, not only for detecting and quantifying patients' symptom, but also because it appears to be useful to objectively assess the efficacy of CRS treatment over time. In addition, olfaction can be expected to expand the library of CRS phenotypes and endotypes and, hence, pave the way for more precise, tailored treatment options.
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Affiliation(s)
- Xiaoguang Yan
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
| | - Katherine Lisa Whitcroft
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
- UCL Ear Institute, University College LondonLondonUK
| | - Thomas Hummel
- Smell and Taste Clinic, Department of OtorhinolaryngologyTU DresdenDresdenGermany
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17
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The Aetiology of Olfactory Dysfunction and Its Relationship to Diet Quality. Brain Sci 2020; 10:brainsci10110769. [PMID: 33114032 PMCID: PMC7690664 DOI: 10.3390/brainsci10110769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/25/2022] Open
Abstract
People with olfactory loss may choose foods rich in sugar, salt and fat to compensate their loss—foods that constitute a Western-style diet (WSD). However, olfactory dysfunction has not been consistently linked to any particular type of dietary change. Here we considered whether the aetiology of olfactory dysfunction may affect consumption of a WSD. Two-hundred and twenty-two people with olfactory dysfunction of varying cause, were tested for chemosensory performance and their frequency of consumption of a WSD. There was no evidence of a link between a WSD and olfactory dysfunction at the aggregate level, but an aetiology-based approach revealed various patterns, showing both positive and negative associations between olfactory performance and consumption of a WSD. We suggest a number of reasons why, in certain cases, greater olfactory dysfunction may be linked to lower intakes of a WSD, and the role that different aetiologies may have in affecting choices for foods that may appeal following olfactory impairment.
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