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1.
Phleboid olfactory test has wide clinical application for olfactory disturbance. Many unclarified aspects still remain concerning the mechanism of smell after an intravenous infusion of Alinamin. It is believed that when Alinamin is infused intravenously and byproducts are discharged from the blood into the alveoli, odorous substances reach the nasal cavity through exhalation. In order to clarify the mechanism of smell in more detail, we conducted the following experiments: 1) Cases of laryngectomy were examined to determine if intravenous infusion of Alinamin affected the olfactory organ. 2) Saliva specimens in healthy subjects were collected before and after intravenous infusion of Alinamin and examined for the presence of a secreted odorous substance using a functional test. 3) Healthy subjects who were inhibited in their sense of smell were examined for the presence of garlic odor after intravenous infusion of Alinamin. The results were as follows: 1) 80% of subjects of laryngectomy without cotton in the nares and 20% of subjects of laryngectomy with cotton in the nares perceived the garlic odor. 2) Garlic odorous substance was not recognized in saliva specimens collected before and after intravenous infusion of Alinamin. 3) The healthy subjects inhibited in their sense of smell and intravenously infused with Alinamin perceived the odor at the same time as exhalation. The above results indicated that the mechanism of smell after intravenous infusion of Alinamin occurred via exhalation, but not through the other routes.  相似文献   

2.
The sense of smell provides people with valuable input from the chemical environment around them. The human sense of smell generally fails in three ways; one is an intensity reduction and the other two are the quality of changes. Smell disorders can be classified into central or peripheral depending on their origin. Central causes can be related to an area of hyper-functioning brain cells generating this odor perception, thus olfactory distortions have also been observed with epilepsy and migraine. In this paper, we present a review of the current clinical understanding of olfactory distortions and discuss how they can be evaluated and therapies to treat this debilitating condition.  相似文献   

3.
Patients who undergo laryngectomy typically lose their sense of smell. One device that has been used to rehabilitate olfactory function in these patients is the larynx bypass. We conducted a long-term study of the larynx bypass in 16 laryngectomized patients. After undergoing objective and subjective baseline evaluations, patients were asked to use the device at home for at least 30 minutes each day for 3 months. They were also asked to record in a diary subjective ratings of their sense of smell and the practicability of using the device every day. At study's end, patients experienced a statistically significant improvement (p < 0.001) in olfactory function on objective measurement (Sniffin' Sticks testing). Subjective improvement was seen after 1 week (p < 0.001) and maintained throughout the study. Practicability scores improved statistically (p = 0.003), but the device remained difficult to use. The long-term use of the larynx bypass has not been studied previously, and we hope that our findings will serve as a basis for further investigation.  相似文献   

4.
The aim of the present study was to assess the effect of smell tests experience and education during residency or in general practice on ENT specialists’ attitudes toward smell disorders in concern of their management strategies. Methodology included a voluntary and anonymous self-administered questionnaire survey conducted in Turkey and responses from 218 questionnaires were pooled and evaluated. Results stated that only 7.3% of the respondents reported currently using smell tests in their practice, and most of those had observed a smell test during their residency (p < 0.05) and received education on the olfactory disorders (p < 0.01). Furthermore, these doctors were more likely to manage patients with no assistance from other doctors or institutions (p < 0.01). Moreover, the doctors with more knowledge of smell disorders rated the symptom of smell loss as more important. We concluded that doctors who had training in smell disorders were confident in diagnosing and treating patients with smell disorders and were more likely to perform smell tests and assume all responsibility for diagnostic and treatment procedures. These results demonstrate the importance of both the residency and continuing medical education in training doctors who are confident to treat smell disorders.  相似文献   

5.
Hyposmia, the decreased sense of smell, and anosmia, the loss of sense of smell, may be unilateral or bilateral. If the olfactory acuity examined by means of bilateral test is normal, olfactory disorders are not found; unilateral examination is therefore necessary for definite evaluation of olfactory acuity. As evidence, 7 cases out of 94 patients with chronic rhinosinusitis and 6 cases out of 12 patients who received the surgery of anterior cranial fossa showed definite different olfactory threshold between nasal cavities, and there were no patients who recognized the diminished sense of smell in spite of unilateral high olfactory threshold. Additionally, we have experienced that a patient with brain tumor was diagnosed by the help of unilateral olfactory test. We thus strongly recommend the unilateral olfactometry as a method for simple and reliable test in clinical measurement of the sense of smell.  相似文献   

6.
IntroductionThe real number of COVID-19 cases may be underestimated since several countries have difficulty offering laboratory tests for all the population. Therefore, finding a symptom with a high predictive value would help in diagnostic and isolation strategies.ObjectiveTo correlate the sudden loss of the sense of smell in the context of the COVID-19 pandemic with results of diagnostic tests for COVID-19.MethodsThis is a cross-sectional observational study. An online questionnaire was digitally addressed to 725 outpatients in Brazil who reported partial or total sudden loss of the sense of smell from March to April 2020.ResultsTotal or partial sudden loss of the sense of smell showed high positive predictive value for COVID-19 diagnosis, during the COVID-19 pandemic in Brazil (88.8%). There were no differences between groups tested positive and negative in regard to demographic and clinical characteristics such as presence of allergy, rhinitis, neither to olfactory recovery time.ConclusionThe identification of sudden loss of the sense of smell during COVID-19 pandemic may serve as a sentinel symptom and may be a warning to establish measures to prevent the transmission of the disease.  相似文献   

7.
Effects of middle turbinate medialization on olfaction.   总被引:6,自引:0,他引:6  
OBJECTIVE/HYPOTHESIS: Turbinate medialization techniques have gained popularity in an attempt to prevent turbinate lateralization. Theoretically, adhesions between the septum and middle turbinate will prevent lateralization but may compromise airflow to the olfactory neuroepithelium and affect the sense of smell. No studies have addressed this issue. The objective of this study is to evaluate effects of middle turbinate medialization on olfaction. STUDY DESIGN: A prospective controlled study of olfaction before and after middle turbinate medialization using the University of Pennsylvania Smell Identification Test (UP-SIT) and patient questionnaires. METHODS: Fifty patients underwent endoscopic sinus surgery (ESS) with middle turbinate medialization and preservation. The caudal end of the middle turbinate and the opposing septal mucosa were abraded with a microdebrider for iatrogenic synechia formation in an attempt to avoid lateralization of the middle turbinate. Each of the patients underwent preoperative assessment with a questionnaire and UPSIT. All patients were reevaluated approximately 5 weeks after surgery by endoscopic examination, questionnaire, and the UPSIT. The preoperative and postoperative questionnaire responses were compared for subjective analysis. Objectively, the preoperative and postoperative UPSIT scores were compared using the Student t test. RESULTS: The questionnaires showed that the study population's subjective sense of smell either did not change or improved compared with the preoperative state. Objectively, there was a mean increase of UPSIT scores after surgery. This difference was not statistically significant (P = .4). CONCLUSION: Middle turbinate medialization has no detectable adverse effect on olfaction.  相似文献   

8.
Twenty patients who had disturbance of the sense of smell caused by localized inflammation of the ethmoid sinus were studied to determine the effects of endonasal ethmoidectomy on olfaction. The patients were evaluated pre and post-operatively regarding their subjective olfaction, and with the T&T olfactometry and the Alinamine intravenous administration test, both of which are widely used in Japan. The improvement rate was 70.0% subjectively and 80.0% with T&T olfactometry 6 months after surgery. It is concluded that surgery is worthwhile treatment for olfactory disturbances caused by localized ethmoiditis.  相似文献   

9.
Normal human olfactory function is subject to a wide variety of factors. Although biopsy of human olfactory neuroepithelium has been reported by several researchers, there are no studies which have evaluated the effect of this procedure on olfactory function. In this retrospective study, we sought to determine if tissue removal from the olfactory cleft has an adverse influence on the sense of smell. Nineteen subjects underwent bilateral olfactory testing and subsequent endoscopic olfactory mucosal biopsy. All subjects were retested 6 weeks to 1 year after olfactory neuroepithelial biopsy. No statistical difference was found between olfactory tests performed before or after biopsy. These data suggest that biopsy of human olfactory neuroepithelium has no discernible adverse effect on the ability to smell.  相似文献   

10.
AimAltered sense of smell and/or taste is a leading symptom of SARS-CoV-2 infection, but its prevalence at a population-level is unknown.MethodsFrom a questionnaire addressed to a representative subset of the French general adult (≥ 18-year) population over a 6-week period during the first French lockdown (April 7 to May 19 2020), self-reported new cases of altered sense of smell and/or taste were collected.ResultsFrom 29,660 participants, new altered sense of smell and/or taste was 2.18% and 2.11% after direct standardization on the French population representing more than 1,110,000 subjects in France. Moreover, 0.5% of participants reported a positive SARS-CoV-2 test, among which 47.4% reported a newly altered sense of smell and/or taste. Male participants, younger ones together with those presenting with chronic condition had higher odds of reporting a newly altered sense of smell and/or taste.ConclusionThis study provides an accurate estimate of new cases of altered sense of smell and/or taste in the general population at a nationwide level during the Covid-19 first wave.  相似文献   

11.
Simmen D  Briner HR 《Rhinology》2006,44(2):98-101
Olfactory disorders frequently occur in rhinological disease. Different subjective and objective test methods are available to assess the sense of olfaction. Among the subjective methods, screening tests and threshold measurements are commonly used to quantify hyposmia or anosmia. Qualitative methods are available using discrimination and identification tests. Objective methods are used in research and in some medicolegal situations. Objective tests include olfactory evoked potentials, functional Magnetic Resonance Imaging and functional Positron Emission Tomography. The measurement of the sense of smell helps to assess the whole spectrum of the effects of nasal disease. This is especially important before rhinological surgery, because a non-detected smell disorder in patients with rhinological disease is common. The assessment of a pre-existing hyposmia or anosmia helps to avoid a postoperative claim that this was caused by surgery. A variety of validated screening tests for olfaction is available and they are a useful tool to document whether a patient is able to smell.  相似文献   

12.
Objective/Hypothesis: Self‐ratings of olfactory function often correlates poorly with results of objective smell tests. We explored these ratings relative to self‐rating of odor annoyance, to odor identification ability, and to mean perceived intensity of odors, and estimated relative genetic and environmental contributions to these traits. Participants and Methods: A total of 1,311 individual twins from the general population (62% females and 38% males, aged 10–83 years, mean age 29 years) including 191 monozygous and 343 dizygous complete twin pairs from Australia, Denmark, Finland, and the United Kingdom rated their sense of smell and annoyance caused by ambient smells (e.g., smells of foods) using seven categories, and performed odor identification and evaluation task for six scratch‐and‐sniff odor stimuli. Results: The self‐rating of olfactory function correlated with the self‐rating of odor annoyance (r = 0.30) but neither correlated with the odor identification score. Quantitative genetic modeling revealed no unambiguously significant genetic contribution to variation in any of the studied traits. Conclusion: The results suggest that environmental rather than genetic factors modify the self‐rating of olfactory function and support earlier findings of discrepancy between subjective and objective measures of olfactory function. In addition, the results imply that the self‐rating of olfactory function arises from experienced odor annoyance rather than from actual olfactory acuity.  相似文献   

13.
The aim of this study was to investigate the impact of high altitude on nasal and lower airway parameters in a healthy population. This was a prospective study of 61 individuals who climbed to the summit of Mount Kackar, at 3,937 m. Peak nasal inspiratory flow rates were recorded in all participants at sea level and at the summit. In 32 participants who ascended to the summit, sea-level and summit peak expiratory flow rates and olfactory function were evaluated. A rise in altitude significantly decreased peak nasal inspiratory flow by a mean of 27.43%. Mean peak expiratory flow values measured at the summit were 8.94% lower than basal values. Between-value differences were statistically significant (p < 0.001, p < 0.05). At high altitude, there was a significant decrease in olfactory function, as determined by a significant reduction in smell detection (p < 0.05) and smell identification (p < 0.05). The effect of high altitude on nasal function was found to parallel that of the effect on lower airway function, together accounting for an adverse effect on airway flow rates. The nasal mucosa responded to high altitude with an increase in airway resistance and a consequent impaired sense of smell.  相似文献   

14.
Introdution: After total laryngectomy the absence of a nasal airflow results in a decrease in olfaction and perception of flavors. Materials and Methods: Odor perception was assessed in 63 laryngectomized patients with two different olfactory tests. The methods used by patients to smell were observed during olfactory testing. Patients' judgment about their olfaction and gustation was assessed by means of a structured questionnaire, semistructured interview, and self-rating. Results: Based on the results of the olfactory tests, patients were categorized as “smellers” and “nonsmellers.” Approximately one third of the patients were able to smell the odorous substances used in the olfactory tests. The smellers more often used a variety of methods to smell than the nonsmellers (P > .002); in most patients the method consisted of active use of facial muscles. Patients appeared well able to judge their own odor perception. Compared with the smellers, the nonsmellers judged their odor perception as worse (P > .003) and reported a more severe decrease in gustation after the operation (P > .033). The results of this study in laryngectomized patients confirm the interrelation between olfaction and gustation: the nonsmellers reported a poorer gustation and a more severe decrease in gustation and appetite than both the smellers and a reference group of elderly persons (P > .05). Patients who reported a deterioration of olfaction and gustation tended to experience negative consequences such as the inability to smell smoke, leaking gas, or agreeable odors. Conclusion: Olfaction and odor-related flavor sensation are seriously deteriorated after total laryngectomy.  相似文献   

15.
OBJECTIVE: To investigate differences between orthonasal and retronasal olfaction in patients with loss of the sense of smell without taste complaints. DESIGN: Electrophysiological and psychophysical testing of orthonasal and retronasal olfactory functions. SETTING: Outpatient clinics. PATIENTS: A series of 18 patients who had olfactory loss due to various reasons but no "taste" complaints. MAIN OUTCOME MEASURES: Orthonasal and retronasal olfactory functions assessed by olfactory event-related potentials and psychophysical smell tests. RESULTS: Psychophysical testing revealed retronasal olfaction to be normal or slightly altered, whereas orthonasal olfaction was either absent or severely compromised. Findings from nasal endoscopic examinations and computed tomographic scans were within the reference range in all subjects. In response to orthonasal stimulation there were neither detectable olfactory event-related potentials nor any with small amplitudes, whereas olfactory event-related potentials in response to retronasal stimulation were clearly present in some patients. CONCLUSION: These clinical observations, together with the psychophysical and electrophysiological findings, suggest that orthonasal and retronasal olfaction might be processed differently.  相似文献   

16.
The main objective of this study was to establish the degree of influence of various illicit drugs, taken into the body in different ways, on the senses of smell and taste. Other possible factors, that might have caused disturbances in normal functioning of both senses, were outlined. The studied group consisted of 48 drug addicts, between the age of 16 and 48 years, addicted to various illicit drugs for several years. Olfactory testing included two methods. First quantitative method described by Elsberg and Levy, modified by Pruszewicz, was used to establish the smell detection threshold. Then the University of Pennsylvania Smell Identification Test was used as a method for odor identification. The sense of taste was tested with the use of method described by Krarup and modified by Pruszewicz. The results showed disturbances in olfactory performance (combined in both method) in 52.1% of all drug abusers, and 16.7% of them were diagnosed with ageusia when the sense of taste was tested. The route of administration of illicit drugs proved to be a statistically significant factor that might have caused disturbances of smell perception and identification in the study group. Drug abusers who were taking drugs intravenously and those who smoked and inhaled various drugs had the most significant olfactory problems. Both means for assessing smell function were statistically compared and the results showed that approximately 75% of drug users with olfactory disturbances had olfactory problems in both tests.  相似文献   

17.
The aim of the study was to determine the incidence of olfactory disorders before and following nasal and paranasal sinus surgery. It was a prospective observational study. Over a 6-month period, all patients who had been listed for nasal and paranasal sinus surgery underwent preoperative and postoperative evaluation of their sense of smell. A questionnaire and the 'Smell Diskettes Test' were used to assess olfaction. One hundred and eighty-four patients were studied. Preoperatively, 19 patients (10.3%) had an impaired sense of smell (8.1% before septoplasty, 6.1% before rhinoplasty and 17.1% before endoscopic sinus surgery). Only 16 (84%) of these patients were aware of their impaired sense of smell. Following surgery, four patients (2.5%) who were normal preoperatively developed impaired olfaction on questioning, and this was supported by testing it. In the subgroup that had a septoplasty, no patient developed hyposmia compared to one patient (2.6%) after rhinoplasty and one patient (3%) after endoscopic sinus surgery. No patient developed anosmia. Preoperatively, 10.3% of patients had an altered sense of smell, making it desirable that this is documented in order to avoid postoperative claims that this was caused by surgery. It also helps to audit the results of surgery.  相似文献   

18.
Jankowski R  Bodino C 《Rhinology》2003,41(4):220-230
AIM: In this prospective study the effect of medical and surgical treatment on subjective olfaction was studied in patients with nasal polyposis (NPS). The effects on nasal obstruction, anterior and posterior rhinorrhea, sneezing and itching are reported in another article in this issue. PATIENTS AND METHODS: Protocol 1. Twenty-four patients with NPS who complained about anosmia were treated with a 7-days course of systemic steroids. Their subjective overall sense of smell was determined with a visual analog scale (VAS) before treatment, immediately after treatment, and two months later. Subsequently all patients underwent surgery bilaterally according to the nasalization principles. The sense of smell was re-evaluated at 1, 3, 6, 9, and 12 months postoperatively. Protocol 2. Thirty-two patients with NPS not responding to medical therapy who, for different reasons, did not receive oral steroid treatment, received surgery only and were followed up during one year after nasalization. Of these patients, 25 were anosmic and 7 normosmic. RESULTS: Protocol 1. Following the 7-day treatment with systemic steroids the olfactory score increased significantly. During the waiting time for surgery (64 +/- 39 days) this score deteriorated again in a significant way. One month after nasalization which included a depot injection of triamcinolone 80 mg the day after surgery, the olfactory score ameliorated again and remained stable at 3, 6, 9, and 12 months. None of the patients reported any intake of systemic steroids during the one-year of follow-up. Statistically, there was a trend suggesting that the 12 month post-nasalization score was better than the immediate post-oral steroid score. A good correlation between the improvement of the sense of smell after 7 days of systemic steroids and one year after nasalization was found. Protocol 2 One month after the nasalization protocol, olfaction in patients of the hypo-anosmic group had improved considerably. Scores at 3, 6, 9, and 12 remained very stable. The sense of smell in the normosmic group did not change after surgery and remained stable during the year of follow-up. In total, 49 patients with a severe loss of smell showed a significant improvement at 12 months after surgery. CONCLUSION: The present study shows that 1) long-lasting correction of olfactory dysfunction produced by nasal polyposis can be achieved through the combination of nasalization and low dose of nasal steroids, 2) middle turbinate resection does not alter the possibilities to restore the sense of smell.  相似文献   

19.
The sense of smell is largely taken for granted by laypersons and medical professionals alike. Indeed, its role in determining the flavor of foods and beverages, as well as in warning of, or protecting against, environmental hazards, often goes unrecognized. This is exemplified, in part, by the fact that most patients presenting to medical clinics with “taste” problems are typically subjected to complex brain imaging and gastroenterological tests without the sense of smell even being tested or considered as a basis of the problem. Aside from frank deficiencies in sweet, sour, bitter, salty and savory (umami) sensations, “taste” disorders most commonly reflect inadequate stimulation of the olfactory receptors via the retronasal route; i.e., from volatiles passing to the receptors from the oral cavity through the nasal pharynx. This article describes the two most common procedures for measuring the sense of smell in the clinic and provides examples of the application of these tests to diseases and other disorders frequently associated with smell loss. Basic issues related to olfactory testing and evaluation are addressed. It is pointed out that smell loss, particularly in later life, can be a harbinger for not only a range of neurodegenerative diseases, but can be a prognostic indicator of early mortality.  相似文献   

20.
The ability to smell is important for protection from danger and quality of life, even in children. Although smell loss is rare in children, it can be indicative of some childhood disorders and may be useful for understanding some disorders. This paper reviews the methods and results of behavioral testing olfaction in children, with an emphasis on odor identification, the most common method of assessing the sense of smell in both children and adults. The Pediatric Smell Wheel® is described as a relatively new and powerful tool for testing olfaction in children as young as 4 years of age. An example of its use in testing children with a childhood disorders (autism spectrum disorder, ASD) is provided in addition to a review of the literature on smell function in ASD. It is possible to reliably test sense of smell in children as young as 4 years old and many studies have shown that performance improves with age and can be impacted by childhood disorders. Sex differences in children are briefly discussed. Finally, the paper suggests other methods of testing olfaction in children, such as odor discrimination, that depend less on cognitive factors, which may enhance our understanding of the olfactory capabilities of young children.  相似文献   

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