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Purpose: This study aims to highlight the feasibility of an olfactory training program entirely monitored through online media in COVID-19 patients. Methods: Classic olfactory training was performed with a sample with olfactory loss due COVID-19 (n = 11). Participants were engaged on a weekly video call in order to improve adherence and collect information regarding the number of correct answers and the individuals' perception of olfactory function. The olfactory status after training was compared to two groups, one composed of participants who contracted COVID-19 but did not report olfactory loss (n = 11) and a sample composed of healthy participants (n = 11). Results: The experimental group showed improvements throughout the training period (TDI score on week 0 was 20.3 (5.6) and 24.6 (4.3) for week 12, and on week 24 was 25.4 (6.2) (F = 5.115, df = 2, 20, p = 0.016), and post hoc tests showed that participants significantly improved their TDI score in W12 compared to W0 (SMD = 0.869, p = 0.041) and in W24 compared to W0 (SMD = 0.859, p = 0.041). The experimental group showed lower scores when compared with both groups, and the no OT COVID-19 group showed lower scores than the healthy control group, even though they did not report olfactory alterations. Conclusions: Findings suggest that the strategies applied to improve adherence were successful since 100% of the sample completed the training adherence, offering a valuable framework for future olfactory training studies. [ABSTRACT FROM AUTHOR]

• Post-viral hyposmia has been shown to have a long-term impact on quality of life. • Impacts from COVID-19 on olfactory functions were unclear at the time of the pandemic. • Budesonide acts by reducing edema, which can help restore olfactory function. • This is the first trial of local budesonide therapy for COVID-19 related hyposmia. • Efficacy of local budesonide was not found with persistent COVID-19 related hyposmia. Consequences of COVID-19 on olfactory functions remained unclear during the pandemic. We assessed the efficacy of local budesonide in addition to olfactory rehabilitation when managing non-severe COVID-19 patients with persistent hyposmia. A multicentric, randomized, superiority trial was conducted (ClinicalTrials.gov NCT04361474). The experimental group (EG) received budesonide and physiological saline nasal irrigations administered via three syringes of 20 ml in each nasal cavity in the morning and evening for 30 days. The control group (CG) received a similar protocol without budesonide. Patients were included if they were >18 years old, with a SARS-CoV-2 infection and presenting an isolated hyposmia persisting 30 days after symptom onset. The primary endpoint was the percentage of patients with improvement of more than two points on the ODORATEST score after 30 days of treatment. In total, 123 patients were included and randomized (EG: 62 vs CG: 61). Two patients from the EG met the primary endpoint with no statistical difference between the two groups (P = 0.5). To our knowledge, this is the first study evaluating local budesonide for COVID-19 related hyposmia treatment even though previous trials were performed with other local corticosteroids. Local budesonide efficacy was not demonstrated for persistent hyposmia related to COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: The olfactory system can be successfully rehabilitated with regular, intermittent stimulation during multiple daily exposures to selected sets of odors, i.e., olfactory training (OT). OT has been repeatedly shown to be an effective tool of olfactory performance enhancement. Recent advancements in studies on OT suggest that its beneficial effects exceed olfaction and extend to specific cognitive tasks. So far, studies on OT provided compelling evidence for its effectiveness, but there is still a need to search for an optimal OT protocol. The present study examined whether increased frequency of OT leads to better outcomes in both olfactory and cognitive domains. Method: Fifty-five subjects (28 females; Mage = 58.2 ± 11.3 years; 26 patients with impaired olfaction) were randomly assigned to a standard (twice a day) or intense (four times a day) OT. Olfactory and cognitive measurements were taken before and after OT. Results: OT performed twice a day was more effective in supporting olfactory rehabilitation and interventions targeted to verbal semantic fluency than OT performed four times a day, even more so in subjects with lower baseline scores. Conclusions: OT is effective in supporting olfactory rehabilitation and interventions targeted to verbal semantic fluency. However, it may be prone to a ceiling effect, being efficient in subjects presenting with lower baseline olfactory performance and lower verbal semantic fluency. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to demonstrate the effectiveness of spraying odor particles using sinus rinse kits for olfactory rehabilitation in patients with total laryngectomy. Methods: Olfactory rehabilitation was performed by applying four different odorant particles orthonasally using a sinus rinse kit pump for 30 min each day for a duration of 6 months. Olfactory function was evaluated by performing olfactory tests before the rehabilitation and at sixth month after the rehabilitation process. Results: The average CCCRC score prior to olfactory rehabilitation was 2.28 ± 0.79 (between 1.50 and 3.75), while it was 4.46 ± 0.5 (between 3.50 and 5.25) out of a maximum score of 7 after 6 months of olfactory rehabilitation (p value < 0.0001) Conclusion: Our results suggest that the use of sinus rinse kits is very simple, inexpensive, easy-to-use, and effective in providing passive olfaction to patients requiring olfactory rehabilitation. [ABSTRACT FROM AUTHOR]

It is estimated that around 25% of adults over 40 years have some form of smell disorder. The primary taste disfunctions are less frequent and they are usually caused by some olfactory alteration. They both have an important impact on the quality of life of people who suffer from them, predisposing to depression, isolation and vulnerability. The degree of smell and taste dysfunction have been used as mortality predictor and prognosis in certain diseases. The etiologies go from sinonasal causes to neurodegenerative diseases. There are multiple identification tests that let us objectively know the magnitude of these disorders. The objective of these article is to show the healthcare personnel the importance of these senses, how to explore their alterations, how to approach them and their possible management and rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: We used a questionnaire to investigate olfactory function and the present state of olfactory rehabilitation for laryngectomized patients in Japan.Methods: This study was conducted using a questionnaire survey. We mailed questionnaires to 190 members of a Japanese laryngectomized patient group (the nonprofit organization YOUSAY-KAI). The survey queried the following items: (1) basic information (age, sex, alaryngeal speech method, etc.); (2) questions about olfactory rehabilitation, such as the individual's experience of olfactory rehabilitation, the number of days from laryngectomy to the start of olfactory rehabilitation, and the location of rehabilitation (i.e., hospital or patient association); (3) free comments; and (4) the self-administered Odor Questionnaire (SAOQ).Results: We received 121/190 questionnaires by the submission deadline. Of these, 105 questionnaires were valid. All 105 responders used the Provox voice prosthesis as the alaryngeal speech method. Only 4.7% (5/105) of the patients received olfactory rehabilitation in hospitals. Many comments in the free comment column included demands for olfactory rehabilitation such as "I want to know where we can have olfactory rehabilitation" and "I want to have rehabilitation if olfaction recovers." The SAOQ score was significantly higher in the rehabilitation group (mean, 42.5%) compared to the nonrehabilitation group (mean, 22.1%) (p<0.05). There was no correlation between the SAOQ score and the number of days from laryngectomy to the start of rehabilitation (r=0.08, p=0.76)． CONCLUSION: Patient demand for olfactory rehabilitation is strong, but this therapy is not widely offered to laryngectomized patients in Japan. Notably, the SAOQ scores showed that olfactory rehabilitation may have an effect, even if it is initiated after laryngectomy. We believe that when patients choose voice prosthesis for speech, their olfaction deteriorates unless they undergo olfactory rehabilitation separately from speech rehabilitation. It is therefore necessary to administer olfactory rehabilitation for laryngectomized patients who have never received olfactory rehabilitation, as well as for patients scheduled to undergo laryngectomy. [ABSTRACT FROM AUTHOR]

The sense of smell is interrelated with psychosocial functioning. Olfactory disorders often decrease quality of life but treatment options for people with olfactory loss are limited. Additionally, olfactory loss accompanies and precedes psychiatric and neurodegenerative diseases. Regular, systematic exposure to a set of odors, i.e., olfactory training (OT) has been offered for rehabilitation of the sense of smell in clinical practice. As signals from the olfactory bulb are directly projected to the limbic system it has been also debated whether OT might benefit psychological functioning, i.e., mitigate cognitive deterioration or improve emotional processing. In this review we synthesize key findings on OT utility in the clinical practice and highlight the molecular, cellular, and neuroanatomical changes accompanying olfactory recovery in people with smell loss as well as in experimental animal models. We discuss how OT and its modifications have been used in interventions aiming to support cognitive functions and improve well-being. We delineate main methodological challenges in research on OT and suggest areas requiring further scientific attention. • Olfaction is connected with social functioning. Smell loss may lower life quality. • Regular exposure to odors (olfactory training, OT) is used in smell rehabilitation. • We review OT effects on behavioral, neuroanatomical, cellular and molecular levels. • We discuss OT utility in supporting cognitive and emotional functioning. • We delineate main methodological challenges of research on OT. [ABSTRACT FROM AUTHOR]

Total laryngectomy or laryngopharyngectomy remains the procedure of choice for advanced-stage (UICC T3 and T4) laryngeal carcinoma around the world despite advances in conservative laryngeal surgery and radiotherapy. However, it has profound effects on respiration and deglutition, in addition to the most disabling effect--the loss of verbal communication. Successful voice restoration can be attained with any of three speech options, namely esophageal speech, electrolarynx, and tracheoesophageal (TO) speech using an artificial valve. Although, no single method is considered the best for every patient, the tracheoesophageal puncture has become the preferred method in the past decade. Several types of voice prostheses have been produced since the first prosthesis was introduced in 1980 by Blom and Singer. However, eventually all prostheses are confronted by the same problem, i.e., the development of a biofilm, leading to deterioration and ultimately to dysfunction of the prostheses, necessitating replacement. This article attempts to sum up the historical background as well as the current state of surgical voice rehabilitation following laryngectomy; we review the recent major advances as well as the future prospects. Data was collected by conducting a computer-aided search of the MEDLINE and PubMed databases, supplemented by hand searches of key journals. Over 50 articles published in the last three decades on the topic have been reviewed, out of which about 20 were found to be of relevance for this article. [ABSTRACT FROM AUTHOR]

Introduction. Current recommendations in medicine emphasise not only medical treatment of the neoplastic diseases but also a need of complex rehabilitation of the patients. Although the olfaction is always impaired after laryngectomy, the rehabilitation of the patients after that type of surgery rarely includes methods that are aimed at restoring the ability to smell. Aim. Subjective assessment of the olfactory organ in patients after larygectomy and an analysis of the course and success rate of rehabilitation of the olfactory sense carried out as a part of routine post-operative care of these patients. Material and methods. The study group included 80 patients (20 women and 60 men), mean age 62,1±8,6 years, after total laryngectomy. All patients filled the questionnaire and underwent both laryngological examination and a 2-week rehabilitation of the olfactory sense intended to enforce air infl ow through the nasal cavity. Results. Seventy two patients (90%) reported a partial or complete loss of smell after laryngectomy. After the rehabilitation, 35 patients (43.8%) noticed an improvement of smelling. The results of olfaction rehabilitation were found to be unaff ected by age, gender, type of voice rehabilitation or chemotherapy. The only factors that adversely aff ected the rate of success of the rehabilitation were radiotherapy and long time since the surgery till the commencement of rehabilitation procedures. Conclusions. Disorders of the olfactory organ are frequent after laryngectomy and could be easily diagnosed by medical interview. Olfactory sense rehabilitation in the patients after laryngectomy should be an obligatory part of the full postlaryngectomy medical care. [ABSTRACT FROM AUTHOR]