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Olfactory dysfunction is common. Otorhinolaryngologists can perform examinations, but GPs can also provide treatment where the cause is known.

The validity of the united airway disease concept for rhinosinusitis (RS) and chronic obstructive pulmonary disease (COPD) has been questioned because of methodological limitations in previous studies. In this study we investigated the prevalence of RS without nasal polyps (RSsNP) and the severity of sinonasal symptoms in COPD and a corresponding control group. We also evaluated the diagnostic accuracy of these symptoms for RSsNP in COPD. 90 COPD patients and 93 controls were included in an observational cross-sectional study where globally accepted diagnostic criteria of RS and COPD (EPOS 2012 and GOLD) were incorporated; symptomatic and endoscopic criteria for the diagnosis of RS, and spirometry with reversibility for diagnosis of COPD. RS symptoms were identified by responses to the sinonasal outcome test (SNOT-22), nasal endoscopy identified signs of sinonasal disease and discriminated between RS with and without nasal polyps, and visual analogue scales (VAS) rated the severity of sinonasal symptoms. We found RSsNP in 51% of our COPD patients which is threefold greater than in the control group (p, Rhinosinusitis is associated with COPD and is significantly more prevalent (51%) compared to controls https://bit.ly/2YrIsmm

Background: Multiple sclerosis (MS) is a chronic disease characterized by CNS lesions causing physical and cognitive impairment. Using psychophysical testing, an olfactory disorder is diagnosed in 15-38.5% of patients with MS. Olfactometry permits objective testing of the sensory nerve function. Methods: The study looked at 20 patients with MS. Clinical, olfactory (chemosensory evoked potentials), and MRI data (volume of the bulbus olfactorius (BO), olfactory brain (OB), lesions in the CNS) were analyzed. Results: 25 percent of patients were hyposmic, exhibiting higher OB lesion volumes and smaller bulb volumes. H2S and CO2 latencies and the BO volume (inversely) correlated with the volume and number of MS lesions of the olfactory brain in all patients. Patients with a smaller olfactory bulb volume exhibited longer H2S latencies (p = 0.025). Conclusion: A relationship between olfactory bulb volume, olfactory brain lesion load, and objective olfactory function testing in MS patients was investigated in all patients. Our data shows that brain damage characteristic of MS, including reduced bulb volume, causes an increase in chemosensory potential latencies and an olfactory function deficit.

Background The olfactory function (OF) and gustatory function in patients with multiple sclerosis (MS) can be limited. Methods We performed the testing of orthonasal (Threshold Discrimination Identification [TDI] score with Sniffin’ Sticks) and retronasal (Taste Powder) OF and gustatory function (Taste Strips; Burghart, Wedel, Germany) in patients diagnosed with MS and healthy controls matching in age, sex, and smoking habits. Results Eight of 16 MS patients (50%) displayed hyposmia (TDI score, 28.75 ± 1.28; p = 0.06); the identification subtest significantly was restricted (12.63 ± 1.67; p = 0.001). Four of 16 MS patients (25%) had limited retronasal OF with a Taste Powder score of 4.5 ± 1.29. The gustatory function in 19% of MS patients was significantly limited (Taste Strip score, 5.33 ± 2.52; p = 0.02). Patients who estimated their ability to smell as diminished performed more poorly on retronasal OF testing (r = 0.657; p = 0.046). Conclusion This study confirms the incidence of olfactory disorder in MS patients that has been reported in the literature. Interestingly, a significant correlation between orthonasal and retronasal OF testing was not shown. A higher incidence of gustatory dysfunction was shown and might serve as another potential marker for this disease.

To investigate diffusion tensor abnormalities, e.g. fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD), in olfactory structures of multiple sclerosis (MS) patients using diffusion tensor imaging (DTI).Institutional review board-approved prospective study on 30 MS patients and 12 healthy controls investigated with MRI including DTI. Central olfactory structures were labelled on each patient's and healthy contro''s DTI volume. The diffusion tensor was determined in the central olfactory structures in MS patients. Tract-based spatial statistics (TBSS) was used to quantify the streamlines outgoing from the olfactory structures and to quantify changes in FA, MD, and RD within olfactory structures. These brain changes were correlated with olfactory function measured as TDI (Threshold, Discrimination, Identification) scores in patients and compared to our own reference group of 30 healthy volunteers.Central olfactory structures in the MNI (Montreal Neurological Institute) data volume comprise 4808 voxels (4808 mm(3)). TFCE (Threshold-free cluster enhancement) and cluster analysis of patients identified a total of 127 voxels in one cluster with a significantly decreased FA (p0.05) and none for MD and RD within olfactory structures compared to healthy controls. The correlation with the age-normalised Identification subscore of the TDI score increased the significant number of voxels with decreased FA to 208 voxels, with increased MD to 370 and with increased RD 364 voxels at the same region.The decrease in FA and increase of MD and RD correlate with the degree of identification impairment of olfactory function in MS patients and clusters of abnormalities were identified on a MNI data volume.

The olfactory (OF) and gustatory function in multiple sclerosis (MS) patients and possible influencing variables of the disease, such as depression or fatigue, were determined. In an open prospective controlled clinical study 30 patients with MS and 30 healthy controls matched for age, sex and smoking-habits were investigated. With Mini Mental State Examination cognitive dysfunction was excluded, with Expanded Disability Status Scale the patient’s ability to accomplish the tests was ensured. The severity of depression was measured with the self-reported Beck Depression Inventory. The orthonasal olfactory function was derived with olfactory event related potentials (OERP) and TDI-score (Threshold, Discrimination and Identification, Sniffin’ Sticks). Retronasal olfactory function was tested with Taste-Powder-score, gustatory function with Taste-strip-score. There was a significant loss of olfactory function measured with TDI-score [12/30 (40%), p = 0.002] and gustatory function [5/23 (21.7%), p < 0.001] in MS-patients, 23.8% (5/21) of MS-patients showed hyposmia with OERPs, significantly correlating with the TDI-score (p = 0.03). The Expanded Disability Status scale score inversely correlated with the TDI-score (p = 0.002). This study confirms the incidence of olfactory disorder in MS-patients and reveals a frequent gustatory deficit. The Identification subtest can be proposed as a marker of the OF in MS-patients: it includes complex cognitive tasks and may be influenced by depression and fatigue, which are common symptoms of MS. It inversely correlates with the disability status.