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Ishikawa Y, Suzuki M. Changes in olfactory identification function in total laryngectomy patients - A retrospective study focusing on nasal airflow-inducing maneuver usage, Open Essence misreactions, and odor cluster. Am J Otolaryngol 2023; 44:103778. [PMID: 36586314 DOI: 10.1016/j.amjoto.2022.103778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE We aimed to examine how the olfactory identification function of laryngectomy patients is altered by nasal airflow-inducing maneuver (NAIM), a method of olfactory rehabilitation, by analyzing incorrect and correct responses to olfactory identification tests to achieve odor classification. METHODS Olfactory identification test (Open Essence [OE]) was administered to 46 patients who had undergone a total laryngectomy [Start group (NAIM was initiated from this study) = 17; (already) Using group = 19; and Nonuse group = 10]. The tests were immediately performed after the NAIM and after a mean duration of 8 months. RESULTS In the Start group, changes in OE correct and incorrect responses showed a significant increase and decrease in the number of correct (p < 0.01) and "detectable but not recognizable" responses (p < 0.05), respectively. In the Using group, errors related to "same cluster" and "detectable but not recognizable" increased and decreased significantly (p < 0.05), respectively. The Nonuse group showed a trend of demonstrating a relatively lower number of correct responses (p < 0.1). Results of odor classification showed that only "putrefaction and sulfur" did not have any significant positive responses in the Start group. DISCUSSION Evidently, the possibility of capturing changes in olfactory identification function by performing a false response analysis was observed, even if recovery appears to have stalled after long-term use of NAIM. Furthermore, including the "putrefaction and sulfur" cluster in the olfactory rehabilitation of laryngectomy patients and teaching them to consciously sniff "putrefaction and sulfur" in their daily lives is necessary.
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Affiliation(s)
- Yukinobu Ishikawa
- Department of Speech and Hearing Sciences at Ookawa, International University of Health and Welfare, Enokizu, Ookawa, Fukuoka, Japan.
| | - Michi Suzuki
- Department of Rehabilitation, International University of Health and Welfare Narita Hospital, Hatakeda, Narita, Chiba, Japan
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Fujio H, Inokuchi G, Kuroki S, Tatehara S, Katsunuma S, Kowa H, Nibu KI. Three-year prospective study on olfaction of patients with Parkinson's disease. Auris Nasus Larynx 2019; 47:899-904. [PMID: 31506174 DOI: 10.1016/j.anl.2019.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 08/03/2019] [Accepted: 08/21/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We conducted a 3-year prospective study on olfaction of patients with Parkinson's disease (PD) in order to examine the severity and frequency of smell disorder in PD using odor identification test, Open Essence (OE) and to verify the validity of olfactory tests as a predictor of cognitive symptom onset of PD. PATIENTS AND METHODS We conducted a prospective study by performing an annual examination over a 3-year period. For 56 cases diagnosed with PD by the Department of Neurology at our hospital, OE and Jet Stream Olfactometry (JSO) were performed to assess the olfactory function, and Mini-Mental-State Examination (MMSE) was conducted to measure cognitive impairment. RESULTS At the beginning, 56 cases were examined, of which 42 remained to be followed up for 3 years. Based on the results of baseline, we found a correlation between OE and the average cognitive thresholds of JSO, but did not find any correlation between OE and MMSE. OE (median 4.0→4.0) and the average cognitive thresholds of JSO (median 2.2→1.6) decreased after 3 years, and MMSE (median 29→29) also declined, but not significantly. At the 3rd year, 6 cases with MMSE score of 23 or less were identified as suspected dementia and 36 cases with more than 24 points were defined as an invariant group. In order to distinguish these two groups, OE scores of baselines were evaluated with a combination of 12 odors. Sensitivity 1.0 and specificity 0.722 were obtained and the sensitivity+specificity value (1.722) was the highest when the number of correct answers was 4 or less using an odor combination of lumber, menthol, Japanese orange, gas for household use, Hinoki cypress and condensed milk. CONCLUSION When the number of correct answers of 6 odors (lumber, menthol, Japanese orange, gas for household use, Hinoki cypress and condensed milk) is 4 or less in patients with PD, there is a possibility that MMSE declines in 3 years.
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Affiliation(s)
- Hisami Fujio
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Go Inokuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Shunsuke Kuroki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sayaka Katsunuma
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisamoto Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Fujio H, Inokuchi G, Tatehara S, Kuroki S, Fukuda Y, Kowa H, Nibu KI. Characteristics of Smell Identification Test in Patients With Parkinson Disease. Clin Exp Otorhinolaryngol 2018; 12:206-211. [PMID: 30586953 PMCID: PMC6453781 DOI: 10.21053/ceo.2018.01116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 11/01/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Parkinson disease (PD) is frequently associated with olfactory disorder at early stage, which is caused by deposition of Lewy bodies emerging from the olfactory bulb to higher olfactory centers. Early detection of olfactory disorder in the patients with PD may lead to the early diagnosis and treatment for this refractory disease. METHODS Visual analog scale (VAS), Jet Stream Olfactometry, and Japanese smell identification test, Open Essence (OE), were carried out on 39 patients with PD. Thirty-one patients with postviral olfactory disorder (PVOD), which was caused by the olfactory mucosal dysfunction, were also enrolled in this study as control. RESULTS There were no significant differences in detection thresholds (2.2 vs. 1.4, P=0.13), recognition thresholds (3.9 vs. 3.5, P=0.39) and OE (4.8 vs. 4.2, P=0.47) between PVOD and PD, while VAS scores of PVOD and PD were significantly different (2.0 and 6.2, P<0.01). In OE, significant differences were observed in the accuracy rates of menthol (68% vs. 44%, P=0.04) and Indian ink (42% vs. 15%, P=0.01) between PVOD and PD. Of particular interest, patients with PVOD tended to select "no detectable," while patients with PD tended to select wrong alternative other than "no smell detected." CONCLUSION Discrepancy between VAS and OE, and high selected rates of wrong alternative other than "undetectable" in OE might be significant signs of olfactory dysfunction associated with PD.
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Affiliation(s)
- Hisami Fujio
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Go Inokuchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shunsuke Kuroki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuriko Fukuda
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisamoto Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Watanabe Y, Suzuki K, Miyamoto T, Miyamoto M, Numao A, Fujita H, Uchiyama T, Kadowaki T, Matsubara T, Hirata K. A Card-type Odor Identification Test for Japanese Patients with Parkinson's Disease and Related Disorders. Intern Med 2017; 56:2871-2878. [PMID: 28943542 PMCID: PMC5709629 DOI: 10.2169/internalmedicine.8565-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective The characteristics of olfactory impairment in Parkinson's disease (PD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) have not been determined in detail. We assessed the olfactory function among PD, MSA and PSP patients. Methods A card-type odor identification test, Open Essence (OE, Wako, Japan), which consists of 12 different odorants familiar to Japanese subjects, was administered to 98 PD patients, 32 MSA patients, 17 PSP patients and 96 control subjects ≥50 years of age. Results The PD patients had significantly lower OE scores than the other groups. The OE scores of the MSA and PSP patients fell between those of the PD patients and the control subjects. A cut-off OE score of 6 was beneficial for differentiating PD patients from controls with 84.7% sensitivity and 85.4% specificity. A cut-off OE score of 4 had 60.2% sensitivity and 77.6% specificity for differentiating PD patients from MSA and PSP patients. The correct answer rates for the curry, Japanese orange and perfume odorants in the PD patients were lower than those in the MSA and PSP patients and controls. The PD patients also had the highest ratio of "not detected" choices across the 12 odors. Conclusion Marked olfactory impairment was a feature of the patients with PD, while mild olfactory impairment was observed in those with MSA or PSP. The answer patterns and the specific odorants may also be useful in differentiating PD from related disorders.
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Affiliation(s)
- Yuji Watanabe
- Department of Neurology, Dokkyo Medical University, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Japan
| | - Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Koshigaya Hospital, Japan
| | - Masayuki Miyamoto
- Department of Clinical Medicine for Nursing, Dokkyo Medical University School of Nursing, Japan
| | - Ayaka Numao
- Department of Neurology, Dokkyo Medical University, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Japan
| | - Tomoyuki Uchiyama
- Department of Neurology, Dokkyo Medical University, Japan
- Neuro-urology and Continence Center, Dokkyo Medical University Hospital, Japan
| | - Taro Kadowaki
- Department of Neurology, Dokkyo Medical University, Japan
| | | | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Japan
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Shiga H, Yamamoto J, Kitamura M, Nakagawa H, Matsubasa T, Seo A, Miwa T. Combinations of two odorants of smell identification test for screening of olfactory impairment. Auris Nasus Larynx 2014; 41:523-7. [PMID: 25193286 DOI: 10.1016/j.anl.2014.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 08/12/2014] [Accepted: 08/13/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine whether combinations of two odorants of the Open Essence smell identification test can be used to screen for olfactory impairment in Japanese people. METHODS A total of 243 Japanese subjects (142 males, 101 females; mean age, 37.5 years; age range, 20-62 years) were enrolled in the study. The main outcome measures were the results of olfactory testing by using the full 12 odorants (condensed milk, cooking gas, curry, cypress wood (Japanese cypress, hinoki), India ink, Japanese orange (mikan), menthol, perfume, roasted garlic, rose, sweaty-smelling clothes, and wood) of the Open Essence test as well as combinations of two odorants of the Open Essence test, and the results of self-reported questionnaires addressing awareness of a smell disorder, history of sinunasal disease, self-reported nasal obstruction, and history of smoking. RESULTS In screening with combinations of two odorants, the highest positive likelihood ratio (19.1) was obtained with the cypress wood and India ink odorants. All subjects correctly identified the curry odorant. Combinations of other odorants also had high positive likelihood ratios (India ink and sweaty-smelling clothes, 17.6; perfume and sweaty-smelling clothes, 14.7; cypress wood and roasted garlic, 14.1; cypress wood and rose, 13.2; cypress wood and perfume, 11.0; cypress wood and wood, 10.7). CONCLUSION The combination of cypress wood and India ink odorants may be useful for detecting individuals with olfactory impairment among subjects who can correctly identify the curry odorant.
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Affiliation(s)
- Hideaki Shiga
- Department of Otorhinolaryngology, Kanazawa Medical University, Ishikawa 920-0293, Japan.
| | - Junpei Yamamoto
- Department of Otorhinolaryngology, Kanazawa Medical University, Ishikawa 920-0293, Japan
| | - Miwa Kitamura
- Department of Otorhinolaryngology, Kanazawa Medical University, Ishikawa 920-0293, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa 920-0293, Japan; Health Control Center, Kanazawa Medical University Hospital, Ishikawa 920-0293, Japan
| | | | - Atsuko Seo
- Tokyo Gas Corporation Ltd., Tokyo 105-8527, Japan
| | - Takaki Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Ishikawa 920-0293, Japan
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