Smell and taste disorders

Impact of Weight Loss on Olfaction in Patients Undergoing Bariatric Surgery

PURPOSE

Olfaction plays a vital role in regulating nutrition, avoiding potentially dangerous situations, and modulating behavior along with interpersonal relationships. Many common disorders can have a negative impact on olfaction; one of these is obesity. Bariatric surgery induces weight loss, and current evidence suggests that it can cause improvement in olfaction. However, more information is needed regarding this topic.

MATERIALS AND METHODS

One hundred eighty-five patients who underwent bariatric surgery and 184 age- and gender-matched control group who did not undergo any surgery have completed a questionnaire including items from the validated Self-Reported Mini Olfactory Questionnaire.

RESULTS

Final analysis was based on 369 patients. There was a statistically significant difference between patients before and after surgery (p < 0.05). However, there was a statistically significant difference between people who underwent surgery with < 50% excess body weight loss and the control group but none with those > 50% excess body weight loss. No significant differences were found when comparing people with and without chronic illnesses, head and neck surgery, anti-allergy drug use, and COVID-19. Before surgery, there were statistically significant differences between patients with allergic rhinitis and polyps and those without, but no significant differences were observed after surgery.

CONCLUSION

Patients had significantly improved olfactory scores post-surgery compared to before surgery. Patients who had > 50% excess body weight loss after surgery showed olfactory function as good as the general population represented by the control group. However, those with < 50% excess body weight loss had significantly worse olfactory scores compared to the general population.

Platelet-rich Plasma in Management of Anosmia (Single Versus Double Injections)

Background

Anosmia is a common problem with a significant impact on quality of life and increased mortality. People with anosmia may not be able to fully taste foods and may lose interest in eating. This can lead to weight loss or malnutrition. Anosmia can also lead to depression because it may impair one's ability to smell or taste pleasurable foods. Platelet-rich plasma (PRP) is an autologous biologic product with anti-inflammatory and neuroprotective effects. This prospective study evaluated the role of PRP on olfactory neuroregeneration in patients with anosmia and compare the results of single and double injections.

Methods

54 patients were included in the study who had olfactory loss greater than 6 months in duration, no evidence of sinonasal inflammatory disease, and no improvement with olfactory training and topical steroids. 27 patients received a single intranasal injection of PRP into the mucosa of the olfactory cleft and 27 patients received a double injections with 3 weeks interval between them. The Q-Sticks Test was administered at the beginning of the study and at 1 and 3 months.

Results

All patients reported a subjective improvement of their smell shortly after injection but then stabilized. At 3-month post-treatment, 16 patients improved significantly after single injection and 19 patients improved significantly after double injections. There were no adverse outcomes from intranasal PRP injections.

Conclusion

PRP appears safe for use in the treatment of olfactory loss, and preliminary data suggest possible efficacy, especially for those with persistent loss. Further studies will help determine optimal frequency and duration of use.

Ablation of AQP5 gene in mice leads to olfactory dysfunction caused by hyposecretion of Bowman's gland

Smell detection depends on nasal airflow, which can make absorption of odors to the olfactory epithelium by diffusion through the mucus layer. The odors then act on the chemo-sensitive epithelium of olfactory sensory neurons (OSNs). Therefore, any pathological changes in the olfactory area, for instance, dry nose caused by Sjögren's Syndrome (SS) may interfere with olfactory function. SS is an autoimmune disease in which aquaporin (AQP) 5 autoantibodies have been detected in the serum. However, the expression of AQP5 in olfactory mucosa and its function in olfaction is still unknown. Based on the study of the expression characteristics of AQP5 protein in the nasal mucosa, the olfaction dysfunction in AQP5 knockout (KO) mice was found by olfactory behavior analysis, which was accompanied by reduced secretion volume of Bowman's gland by using in vitro secretion measure system, and the change of acid mucin in nasal mucus layer was identified. By excluding the possibility that olfactory disturbance was caused by changes in OSNs, the result indicated that AQP5 contributes to olfactory functions by regulating the volume and composition of OE mucus layer, which is the medium for the dissolution of odor molecules. Our results indicate that AQP5 can affect the olfactory functions by regulating the water supply of BGs and the mucus layer upper the OE that can explain the olfactory loss in the patients of SS, and AQP5 KO mice might be used as an ideal model to study the olfactory dysfunction.

Assessment of Smell and Taste Disturbances among COVID-19 Convalescent Patients: A Cross-Sectional Study in Armenia

BACKGROUND AND OBJECTIVES

Neurological manifestations of Coronavirus Disease 2019 (COVID-19) such as olfactory and gustatory disturbance have been reported among convalescent COVID-19 patients. However, scientific data on the prevalence of smell and taste disturbance are lacking. Therefore, we present findings on the degree of smell and taste disturbances among the Armenian population.

METHODS

Study participants were randomly recruited and then categorized into two groups based on their course of the disease. A cross-sectional study was performed to assess participants' sensitivity to smell triggered by the olfactory and the trigeminal nerves; their ability to differentiate between various odors; and to evaluate their gustatory perception.

RESULTS

The smell test revealed that the degree of olfactory nerve disturbance was different by 30.7% in those participants of the early group as compared to those of the late group, and the degree of trigeminal nerve disturbance was different by 71.3% in the early group as compared to the late group. A variation of the differentiating ability among the participants of the early and late groups was detected. Gustatory disturbances for all flavors were also found to be different in both the groups. A moderate positive correlation (0.51) was found between the overall sensitivity of smell and the ability to differentiate between various odors as cumulatively stimulated by both the olfactory and trigeminal nerves. Also, a moderate positive correlation (0.33) was found between headache and smell sensitivity through the olfactory nerve and a high negative correlation (-0.71) was found between headache and smell sensitivity through the trigeminal nerve.

CONCLUSION

Pathological changes in the olfactory and trigeminal perceptive abilities caused disturbances in smell sensation, with the trigeminal nerve being more affected. The capacity to differentiate fragrances did not improve with time and the disturbance severity of bitter taste perception was higher among the study participants.

International consensus statement on allergy and rhinology: Olfaction

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.

Anosmia e ageusia em pessoas após a COVID-19: análise entre tipo e tempo de hospitalização

RESUMO Objetivo: analisar o tipo e tempo de hospitalização em pessoas que relataram anosmia e ageusia após a COVID-19. Métodos: estudo transversal com pacientes que foram encaminhados pelo hospital após a alta médica. Um questionário padronizado foi aplicado presencialmente contendo dados referentes a idade, sexo, antropometria, necessidade de internação, anosmia e ageusia. Estatística não-paramétrica foi utilizada para analisar os dados. Os testes de Mann Whitney e Kruskal-Wallis foram utilizados para comparação dos grupos. Considerou-se significante um p<0,05. Resultados: foram analisadas as respostas de 201 participantes com média de idade de 44,7 ± 12,7 anos, 52,2% (n = 105) eram do sexo masculino, 67,7% foram internados (n = 136), 60,2% (n = 121) relataram ageusia e 55,7% (n = 112) informaram anosmia. Houve diferença em relação aos dias de permanência em Unidade de terapia intensiva (UTI) para o grupo Ageusia (p = 0,004), sendo que estes apresentaram menor tempo de internação. Quanto aos que relataram anosmia, houve diferença e menor tempo de internação para ambos, enfermaria (p = 0,001) e UTI (p = 0,004). Os dados categóricos demonstraram associação entre anosmia e internação (sim e não) (p = 0,018; phi = -0,167), sendo que, entre os que não foram internados, 67% (n = 44) relataram anosmia. Conclusão: aqueles que relataram anosmia e ageusia apresentaram menor tempo de internação, quando necessário.

Anosmia and ageusia in people after COVID-19: an analysis between the type and length of hospital stay

ABSTRACT Purpose: to analyze the type and length of hospital stay in people who reported anosmia and ageusia after COVID-19. Methods: a cross-sectional study with patients who were referred by the hospital after medical discharge. They answered a standardized in-person questionnaire on age, sex, anthropometry, need for hospitalization, anosmia, and ageusia. Nonparametric statistics were calculated to analyze the data. The Mann-Whitney and Kruskal-Wallis tests were used to compare the groups. Significance was set at p<0.05. Results: the responses of 201 participants with a mean age of 44.7 ± 12.7 years were analyzed, 52.2% (n = 105) were males, 67.7% had been hospitalized (n = 136), 60.2% (n = 121) reported ageusia, and 55.7% (n = 112) reported anosmia. There was a difference in days spent in the Intensive Care Unit (ICU) for the Ageusia group (p = 0.004), which had a shorter length of stay. As for those who reported anosmia, there was a difference and shorter length of stay for both the ward (p = 0.001) and ICU (p = 0.004). Categorical data showed that anosmia was associated with hospitalization (yes or no) (p = 0.018; phi = -0.167). Among those who were not hospitalized, 67% (n = 44) reported anosmia. Conclusion: those who reported anosmia and ageusia had shorter hospital stays, when necessary.

Dysgeusia: A review in the context of COVID-19

Background

Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During the COVID-19 pandemic, taste disorders have found their way into the realm of general as well as specialty dentistry, with significance in screening for patients who potentially may have the virus.

Types of Studies Reviewed

The authors searched electronic databases (PubMed, Embase, Web of Science, Google Scholar) for studies focused on dysgeusia, ageusia, and other taste disorders and their relationship to local and systemic causes.

Results

The authors found pertinent literature explaining the normal physiology of taste sensation, proposals for suggested new tastes, presence of gustatory receptors in remote tissues of the body, and etiology and pathophysiology of taste disorders, in addition to the valuable knowledge gained about gustatory disorders in the context of COVID-19. Along with olfactory disorders, taste disorders are one of the earliest suggestive symptoms of COVID-19 infection.

Conclusions

Gustatory disorders are the result of local or systemic etiology or both. Newer taste sensations, such as calcium and fat tastes, have been discovered, as well as taste receptors that are remote from the oropharyngeal area. Literature published during the COVID-19 pandemic to date reinforces the significance of early detection of potential patients with COVID-19 by means of screening for recent-onset taste disorders.

Practical Implications

Timely screening and identification of potential gustatory disorders are paramount for the dental care practitioner to aid in the early diagnosis of COVID-19 and other serious systemic disorders.

What about using sniffin' sticks 12 items test to screen post-COVID-19 olfactory disorders?

Background

Post-COVID-19 Olfactory impairment has a negative impact on quality of life. The Sniffin Sticks test 12 items (SST-12) can be used in quick olfactory disorders screening. Its evaluation in a post-covid-19 situation was the main objective of this work.

Methods

All patient impaired with a post-COVID olfactory loss were included while consulting to the ENT department. The clinical examination included an olfaction recovery self-assessment (VAS), a nasofibroscopy, a quality of life (QoL) assessment, the complete Sniffin’ Sticks Test (SST), and the SST-12.

Results

Among the 54 patients included, 92% (n = 50) were correctly screened as olfactory impaired by SST-12. We report excellent correlations between SST-12 and SST (rho ₍₅₂₎ = 0.98, p < 0.001), QoL(rho₍₅₂₎ = 0.33 p = 0.016), or VAS (rho₍₅₂₎ = 0.49, p < 0.001) assessments.

Conclusions

SST-12 is a quick and reliable tool to screen large-scale population of post-COVID-19 olfactory impaired patients and could be used in a general daily clinical practice.

Correlation of olfactory dysfunction with lung involvement and severity of COVID-19

Background

Olfactory dysfunction (OD) is a significant symptom of COVID-19 and may be the earliest symptom, or it may sometimes be the only manifestation of the disease.

Aims

To investigate whether OD is correlated with chest computed tomography (CT) findings, blood test parameters, and disease severity in COVID-19 patients.

Methods

The files of COVID-19 patients were retrospectively reviewed, and the ones who had information about smelling status and CT were taken into consideration. A total of 180 patients were divided into two groups: the OD group consisted of 89 patients with self-reported OD, and the No-OD group consisted of 91 subjects who did not complain of OD. The two groups were compared for the amount of lung consolidation on CT, intensive care unit (ICU) admission, and blood test parameters (complete blood count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, D-dimer, interleukin-6 (IL-6)).

Results

The amount of lung consolidation and ICU admission were significantly higher in the No-OD group (p < 0.001 for both). White blood cell (p = 0.06), monocyte (p = 0.26), and platelet (p = 0.13) counts and hemoglobin (p = 0.63), ALT (p = 0.89), and D-dimer (p = 0.45) levels of the two groups were similar. Lymphocyte count (p = 0.01), neutrophil count (p = 0.01), and AST (p = 0.03), CK (p = 0.01), LDH (p < 0.001), CRP (p < 0.001), ESR (p < 0.001), ferritin (p < 0.001), and IL-6 (p < 0.001) levels were significantly higher in the No-OD group.

Conclusions

The patients presenting to the hospital with self-reported OD may have less lung involvement and a milder disease course compared to patients without OD on admission.

Insulin fast-dissolving film for intranasal delivery via olfactory region, a promising approach for the treatment of anosmia in COVID-19 patients: Design, in-vitro characterization and clinical evaluation

The present work aimed to formulate intranasal insulin fast-dissolving films for treatment of anosmia in patients post COVID-19 infection. Variant films were prepared employing the casting method and using hydroxypropyl methyl cellulose and polyvinyl alcohol. The formulated films were investigated for insulin content, weight variation, surface pH, thickness, folding endurance and disintegration time. In vitro release study was conducted for the selected formulations (F6, F7, F8). A drug/polymer interaction was investigated in the optimized formulation (F7) employing Fourier transform infrared spectroscopy. Clinical study was accomplished for F7 on 20 patients. Sniffin's and olfactory discrimination tests were used for assessing patients. The formulated films displayed appropriate physical characteristics. F7 showed the shortest disintegration time (50 ± 7 s) and fastest release. It displayed compatibility between the drug and the used polymers. The results of the clinical study revealed a significant increase in the olfactory detection scores and olfactory discrimination values in the intervention group (7.9 ± 1.2, 6.7 ± 0.5 respectively) compared to placebo group (3 ± 0.8, 2.8 ± 1).. Intervention group showed significant differences between these scores before and after treatment while the placebo group did not display any significant differences. Thus, the optimized film can be considered as an auspicious approach for managing post COVID-19 anosmia.

Persistent olfactory complaints after COVID-19: a new interpretation of the psychophysical olfactory scores

Background: Sudden olfactory loss is a major symptom of SARS-CoV-2 infection and has a negative impact on daily life quality. Almost 80% of disorders regress spontaneously. No precise characterization of the medium- and long-term olfactory symptoms has been carried out yet, apart from self-assessments. The main objective of this work was to characterize persistent smell disorders in this population. Methodology: Consecutive patients consulting to the ENT department with post-Covid19 olfactory loss were included. The clinical examination included an analog scale for the self-assessment of olfactory recovery), a nasofibroscopy, the Sniffin’ Stick Test and the short version of the Questionnaire of olfactory disorders. Results: Among the 34 patients included, based on the Sniffin’ Sticks Test, 29.4% (n=10) could be classified as normosmic, 55.9% (n=19) as hyposmic and 14.7% (n=5) as functional anosmic). Only olfactory identification impairment was significantly correlated with olfactory complaint and daily anxiety and annoyance related to lack of olfaction recovery. This identification disorder seemed to worsen over time. Conclusions: It is crucial to assess odor identification disorders in case of persistent olfactory complaints after COVID-19. It is fundamental to target this disorder, as it does not improve spontaneously and negatively impact quality of life.

Olfactory and taste disorders in COVID-19: a systematic review

INTRODUCTION

The SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases.

OBJECTIVE

To identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19.

METHODS

A systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine and Reasearch Gate.

INCLUSION CRITERIA

(1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions.

EXCLUSION CRITERIA

(1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale.

RESULTS

Six articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders.

CONCLUSION

Olfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.

Autistic traits impact on olfactory processing in adolescent girls with Anorexia Nervosa restricting type

The correct functioning of the chemosensory pathway is pivotal for the attitude towards feeding. In some neuropsychiatric disorders, abnormalities of the sensory processing dramatically affect feeding behavior; however, evidences for an olfactory involvement in Anorexia Nervosa (AN) are still controversial. We administered a complete olfactory testing battery, the Sniffin' Sticks Extended Test, to a cohort of 19 girls with Restrictive Anorexia Nervosa (AN-R) and 19 healthy controls. A battery of questionnaires aiming to evaluate eating attitude, psychopathologic disorders and autistic traits was also administered. No difference was found between the two groups in any of the olfactory tasks. Despite the lack of correlation between olfaction and disease severity, however, olfactory performances were related to autistic traits in anorectic girls (r = -0.489, p = 0.039). Girls with AN-R do not appear to have an impaired olfactory function with respect to controls. However, a possible correlation between olfactory ability and autistic traits was discovered. In light of such findings, the role of possible relations between social functioning-related features and olfactory processing in AN-R is discussed.

Diseases of the nasal cavity

Despite garnering minimal attention from the medical community overall, olfaction is indisputably critical in the manner in which we as humans interact with our surrounding environment. As the initial anatomical structure in the olfactory pathway, the nasal airway plays a crucial role in the transmission and perception of olfactory stimuli. The goal of this chapter is to provide a comprehensive overview of olfactory disturbances as it pertains to the sinonasal airway. This comprises an in-depth discussion of clinically relevant nasal olfactory anatomy and physiology, classification systems of olfactory disturbance, as well as the various etiologies and pathophysiologic mechanisms giving rise to this important disease entity. A systematic clinical approach to the diagnosis and clinical workup of olfactory disturbances is also provided in addition to an extensive review of the medical and surgical therapeutic modalities currently available.

Gross Olfaction Before and After Laparoscopic Gastric Bypass

BACKGROUND

Obesity leads to olfaction alterations, and this can further impact food choices, appetite, and nutritional status. Bariatric procedures induce weight loss and change in taste and smell perception, but more information is needed, especially using objective olfaction tests.

METHODS

A prospective study was conducted during 6 months, with candidates to laparoscopic gastric bypass at a single institution. A preoperative nasofibroscopy and gross smell identification test (The Pocket Smell Test ®) were performed in those meeting the inclusion criteria. After 6 months, a new test was performed, and the primary objective was to determine if there was an improvement in the olfaction score. Weight loss and comorbidities improvement were also analyzed.

RESULTS

From the 30 patients with morbid obesity enrolled, 21 met the inclusion criteria and ENT evaluation. At baseline, 42.8% of patients scored 3 points, 53.3% scored 2 points, and 4.7% scored 1 point. After 6 months, there was a -81.1% of change. Seventeen patients scored 3 points (p = 0.002 vs initial) and two scored 2 points (p = 0.006 vs initial). There were no patients with less than 2 points. Weight and comorbidities had a significant improvement as well.

CONCLUSION

Laparoscopic gastric bypass improves the olfaction scores of the Pocket Smell Test in morbidly obese patients 6 months after their procedure. More complex tests can be used in candidates to bariatric surgery if low scores are detected initially. Other causes of olfaction dysfunctions should be determined if there is no improvement after weight loss.

Evaluation of the effect of denture adhesives on surface roughness of two chemically different denture base resins

Objective:

To evaluate the effect of four commercially available denture adhesives (DAs) on surface roughness of two chemically different denture base materials.

Materials and Methods:

Fifty specimens of heat-cured polymethyl methacrylate, and another fifty specimens of light-cured urethane dimethacrylate were divided into five groups (n = 10), each was immersed in four prepared DAs (Corega Super Cream, Corega Ultra Powder, Olivafix Cream, Protefix Cream) as well as distilled water (control group). The mean surface roughness (R_a) of the polished and unpolished surfaces of the specimens was recorded using profilometer device. T-test for paired observation was used to indicate any changes in surface roughness between the baseline and after 30 days of immersion in the DA.

Results:

Almost all the tested DAs had no significant effect on the roughness of polished and unpolished surfaces of both denture base materials. The Corega super cream DA produced significant increase in the roughness of the polished surfaces of both types of acrylic specimens (P < 0.05).

Conclusion:

The majority of the investigated DAs appears not to affect the surface roughness of denture base materials. Only Corega super cream DA produced detectable increase in the roughness of polished surfaces of denture base specimens.

Reduced amount of olfactory receptor neurons in the rat model of depression

Reduced olfactory sensitivity has been reported in depressive disorder. However, the pathological mechanism is still unclear. The reduced olfactory bulb (OB) volume and reduced hippocampal neurogenesis has been unraveled in major depressive disorder (MDD). However, changes in olfactory epithelium (OE) have not been reported, which might contribute to olfactory deficits in MDD. In the context, we investigated the thickness of OE in a chronic unpredictable mild stress (CUMS) rat model of depression using hematoxylin and eosin (HE) staining. Simultaneously, the basal cells (labeled by nerve growth factor receptor (p75NGFR)), immature olfactory receptor neurons (ORNs) (marked by growth-associated protein 43 (GAP43)) and mature ORNs (labeled by olfactory marker protein (OMP)) in OE were detected by immunohistochemistry. The results showed that the thickness of OE, the number of basal cells, immature ORNs as well as mature ORNs decreased dramatically in the OE of CUMS rats. Those findings indicate that the reduced number of ORNs might induce OE atrophy in CUMS rats and the abnormalities of the OE may be partially responsible for the reduced olfactory sensitivity in MDD.

Higher Body Mass Index Is Associated with Subjective Olfactory Dysfunction

BACKGROUND

Morbidly obese patients demonstrate altered olfactory acuity. There has been no study directly assessing Body Mass Index (BMI) in patients with olfactory dysfunction. Our purpose was to compare BMI in a group of patients with subjective olfactory dysfunction to those without subjective olfactory complaints.

METHODS

Retrospective matched case-control study. Sixty patients who presented to a tertiary care otolaryngology center with subjective smell dysfunction over one year were identified. Neoplastic and obstructive etiologies were excluded. Demographics, BMI, and smoking status were reviewed. Sixty age, gender, and race matched control patients were selected for comparison. Chi-square testing was used.

RESULTS

48 out of 60 patients (80%) in the olfactory dysfunction group fell into the overweight or obese categories, compared to 36 out of 60 patients (60%) in the control group. There was a statistically significant difference between the olfactory dysfunction and control groups for this stratified BMI (p = 0.0168).  

CONCLUSION

This study suggests high BMI is associated with olfactory dysfunction. Prospective clinical research should examine this further to determine if increasing BMI may be a risk factor in olfactory loss and to elucidate what role olfactory loss may play in diet and feeding habits of obese patients.

[Methods for evaluating of olfactory function in patients with Parkinson's disease]

Olfactory disorder takes a special place among non-motor symptoms of Parkinson's disease (PD) as one of earliest signs of the disease. Based on literature data, authors suggest that simple and structured tests for detection of olfactory disorders should be part of diagnostic algorithm for early detection of PD) and occupy a special place in differential diagnosis of diseases of the extrapyramidal system. Literature on the methods of study of olfactory function recommended as an additional instrument for PD diagnosis is presented.

Does imaging of the olfactory tract change the clinical management of patients with olfactory disturbance? A case series of 100 consecutive patients

Background:

Isolated olfactory dysfunction is a common complaint; the vast majority of cases are benign and untreatable. A common dilemma is whether to image the olfactory tract of affected patients.

Methods:

A case review of 100 consecutive patients who underwent magnetic resonance imaging for the primary complaint of olfactory dysfunction was performed. Patients with a diagnosis of chronic rhinosinusitis, with or without nasal polyps, were excluded.

Results:

Magnetic resonance imaging abnormalities that were considered clinically relevant to the presentation of olfactory dysfunction were found in only seven patients (7 per cent). Of these, only one patient (1 per cent) had an abnormality found that altered their clinical management. A comparison of the findings for children (less than 16 years old,n = 5) with those for adults (equal to or more than 16 years old,n = 95) revealed that 4 per cent of adults scanned had olfactory-related pathology diagnosed, as opposed to 60 per cent of children.

Conclusion:

Cross-sectional imaging may not be necessary in most patients with olfactory dysfunction. Imaging adds little to the patient history and clinical examination findings.

Closed rhinoplasty with open approach advantages: extended intranasal incisions and tip rearrangement sutures

BACKGROUND

Two main well-known approaches are used in rhinoplasty: open and closed techniques. This study aimed to define two new tip suture modifications that enhance and stabilize tip shape, projection, and position through an extended infracartilaginous incision with an open rhinoplasty exposure.

METHODS

This study investigated 56 consecutive primary rhinoplasty patients 18-51 years of age (mean age 27.8 years) who underwent surgery between June 2011 and June 2012 and had at least a 1-year postoperative follow-up period. Rhinoplasty was performed through an extended infracartilaginous incision with an open exposure. Transdomal suture modification for columella-lobular angle augmentation and a footplate repositioning suture for tip projection (and position) enhancement also were defined. A postoperative satisfaction survey was applied to all the patients at their 1-year follow-up visit.

RESULTS

The postoperative satisfaction rate was 96 %. The nasal tip positions and projections of the patients were fine and stable in all the patients after a 1-year postoperative period. At this writing, no over- or underprojection, supratip deformity, saddle-nose deformity, or dorsal-surface irregularities have been encountered. Representative cases are displayed.

CONCLUSION

This study defined two new tip suture techniques and combined them with an extended infracartilaginous incision. Also, control of the entire nose and nasal valve area was possible through this incision.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The effect of cleaning substances on the surface of denture base material

Bakcground

The aim of this study was to evaluate the effect of substances used for hygienic cleaning of dentures on the surface of the denture base material.

Material/Methods

Meliodent Heat Cure (Heraeus-Kulzer, Germany) heat-polymerized acrylic resin was used to produce plates with all the characteristics of removable denture bases (subsequently, “plates”). Oral-B Complete toothbrushes of various brush head types were fixed to a device that imitated tooth brushing movements; table salt and baking soda (frequently used by patients to improve tooth brushing results), toothpaste (“Colgate Total”), and water were also applied. Changes in plate surfaces were monitored by measuring surface reflection alterations on spectrometry. Measurements were conducted before the cleaning and at 2 and 6 hours after cleaning.

Results

No statistically significant differences were found between the 3 test series. All 3 plates used in the study underwent statistically significant (p<0.05changed) – the reflection became poorer. The plates were most affected by the medium-bristle toothbrush with baking soda – the total reflection reduction was 4.82±0.1%; among toothbrushes with toothpaste, the hard-type toothbrush had the greatest reflection-reducing effect – 4.6±0.05%, while the toothbrush with table salt inflicted the least damage (3.5 ± 0.16%) due to the presence of rounded crystals between the bristles and the resin surface. Toothbrushes with water had a uniform negative effect on the plate surface – 3.89±0.07%.

Conclusions

All substances used by the patients caused surface abrasion of the denture base material, which reduced the reflection; a hard toothbrush with toothpaste had the greatest abrasive effect, while soft toothbrushes inflicted the least damage.