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Aim: Smell and taste are senses that contribute to a child's overall well-being. Disorders affecting these senses can impact a child's daily life from enjoying meals to detecting potential dangers through scent. The aim of this study is to describe patient characteristics and etiological causes of olfactory (OD) and/or gustatory disorders (GD) in children referred to a smell and taste clinic. Secondly, we aim to suggest a clinical work up., Methods: Retrospective study where data were collected from 57 children who were referred consecutively to the University Clinic for Flavour, Balance, and Sleep; Department of Otorhinolaryngology (ORL), Head and Neck Surgery; Goedstrup Hospital, Denmark, for assessment due to OD/GD from January 2017 to May 2023., Results: Most of the children had anosmia (60 %), whereas sensation of the basic tastes was intact in all but eight children (16 %). The lowest TDI scores were in children with congenital OD. The underlying etiology was congenital followed by postinfectious mostly related to Covid-19. Picky eating including anorectic traits were seen in 16 % of patients., Conclusion: The focus on smell loss in pediatric population is low, and probably does not adequately reflect either underlying prevalence in this group or the possible consequences on a child's well-being. Moreover, increased awareness of children's smell and taste loss is needed, as it may be associated with eating disturbances., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Aim: To explore the association between periodontitis and olfactory disorders., Methods: Clinical data were collected from 198 individuals between the ages of 18 and 60 years living in Denmark. The exposure was periodontitis, and the outcome was olfactory function (Threshold, Discrimination, Identification - TDI score), both measured clinically. Covariates included sex, age, education level, income, usage of nasal spray, tongue coating, halitosis, xerostomia, smoking, and history of COVID-19. Structural equation modeling was used to estimate the association between periodontitis and olfactory function. Periodontitis was defined using the AAP/EFP classification and dichotomized into "no" (healthy subjects) and "yes" (Stages I, II, and III). Olfactory function was treated as a one-factor latent variable, including the different olfactory scores. In addition, extra models were performed considering each olfactory component as a separate outcome and the TDI Global Score., Results: The results showed that periodontitis was associated with a lower olfactory function [standardized coefficient (SC) -0.264, 95% CI -0.401, -0.118]. Additionally, periodontitis was also associated with a lower olfactory Threshold (odorant concentration required for detection) (SC -0.207, 95% CI -0.325, -0.089), Discrimination (ability to discriminate between odorants) (SC -0.149, 95% CI -0.270, -0.027), Identification (ability to identify odorants) scores (SC -0.161, 95% CI -0.277, -0.045), and TDI Global Score (SC -0.234, 95% CI -0.370, -0.099)., Conclusions: This study suggests that periodontitis is associated with olfactory impairment., (© 2024 The Author(s). Journal of Periodontal Research published by John Wiley & Sons Ltd.)

Smell loss affects around 15-20% of the population, with a major effect on the quality of life. The most common complaint is the impairment of the eating experience, with around 90% of patients reporting this issue. A study conducted at a specialised Taste and Smell Clinic investigated if food and cooking can positively affect the enjoyment of food, subjective cooking skills, and quality of life in patients with smell loss. The 49 participants in the study received a 5-week cooking school course that focused on emphasizing the other senses to regain the enjoyment of food. Participants gained more confidence in cooking, and their quality of life improved significantly. Positively evaluated recipes were adjusted based on feedback and published as free e-books in Danish, German, and English. Eating and cooking are multisensory experiences, and the perception of food depends on the complex interaction of senses and surroundings. If the olfactory input is reduced or absent, both the enjoyment and cooking experience can be negatively affected. Therefore, focusing on food and cooking can have a positive impact on patients with smell loss.

Purpose: The Sino-Nasal-Outcome-Test 22 (SNOT-22) questionnaire assesses treatment outcome and health-related quality of life (HRQOL) in patients with chronic rhinosinusitis (CRS). However, given the overlap between CRS and olfaction in terms of nasal function and the definition of CRS, a fundamental question arises: can patients with olfactory dysfunction (OD) stemming from other causes attain SNOT-22 scores similar to those seen in CRS, even in the absence of CRS? Our study aimed to explore whether OD arising from various postinfectious mechanisms challenges the disease-specificity of SNOT-22 for CRS. If so, could focus on scores within specific symptom domains of SNOT-22 prove valuable in distinguishing between different etiologies., Methods: The study adopted an observational, retrospective cohort design based on prospectively registered patients and related variables using the REDCap platform. 460 patients experiencing OD due to either (1) simple or (2) complex post-COVID-19, (3) postinfectious non-COVID-19, and (4) CRS, were included in the analysis., Results: The study revealed that the total SNOT-22 score lacks disease-specificity for CRS. This is evident, because complex postinfectious mechanisms resulting from COVID-19 can produce similar symptoms in patients. Notably, elevated total scores were primarily driven by high subdomain scores within the "sleep and cognition" domain., Conclusions: The application of SNOT-22 as a screening tool needs to be approached with caution, as the total score alone does not provide disease-specific insights. A more thorough exploration of the four symptom domains and the identification of distinctive scoring patterns within the clinical context may prove pivotal in effectively differentiating between various underlying causes., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Olfactory dysfunction (OD) is common and carries significant personal and societal burden. Accurate assessment is necessary for good clinical and research practice but is highly dependent on the assessment technique used. Current practice with regards to UK/international clinical assessment is unknown. We aimed to capture current clinical practice, with reference to contemporaneously available guidelines. We further aimed to compare UK to international practice., Design: Anonymous online questionnaire with cross-sectional non-probability sampling. Subgroup analysis according to subspeciality training in rhinology ('rhinologists' and 'non-rhinologists') was performed, with geographical comparisons only made according to subgroup., Participants: ENT surgeons who assess olfaction., Results: Responses were received from 465 clinicians (217 from UK and 17 countries total). Country-specific response rate varied, with the lowest rate being obtained from Japan (1.4%) and highest from Greece (72.5%). Most UK clinicians do not perform psychophysical smell testing during any of the presented clinical scenarios-though rhinologists did so more often than non-rhinologists. The most frequent barriers to testing related to service provision (e.g., time/funding limitations). Whilst there was variability in practice, in general, international respondents performed psychophysical testing more frequently than those from the UK. Approximately 3/4 of all respondents said they would like to receive training in psychophysical smell testing. Patient reported outcome measures were infrequently used in the UK/internationally. More UK respondents performed diagnostic MRI scanning than international respondents., Conclusions: To our knowledge, this is the most comprehensive UK-based, and only international survey of clinical practice in the assessment of OD. We present recommendations to improve practice, including increased education and funding for psychophysical smell testing. We hope this will promote accurate and reliable olfactory assessment, as is the accepted standard in other sensory systems., (© 2023 The Authors. Clinical Otolaryngology published by John Wiley & Sons Ltd.)

Background: Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process., Conclusions: We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.

Statement of Problem: Evaluating the effectiveness of the management of Olfactory Dysfunction (OD) has been limited by a paucity of high-quality randomised and/or controlled trials. A major barrier is heterogeneity of outcomes in such studies. Core outcome sets (COS) - standardized sets of outcomes that should be measured/reported as determined by consensus-would help overcome this problem and facilitate future meta-analyses and/or systematic reviews (SRs). We set out to develop a COS for interventions for patients with OD., Methods: A long-list of potential outcomes was identified by a steering group utilising a literature review, thematic analysis of a wide range of stakeholders' views and systematic analysis of currently available Patient Reported Outcome Measures (PROMs). A subsequent e-Delphi process allowed patients and healthcare practitioners to individually rate the outcomes in terms of importance on a 9-point Likert scale., Results: After 2 rounds of the iterative eDelphi process, the initial outcomes were distilled down to a final COS including subjective questions (visual analogue scores, quantitative and qualitative), quality of life measures, psychophysical testing of smell, baseline psychophysical testing of taste, and presence of side effects along with the investigational medicine/device and patient's symptom log., Conclusions: Inclusion of these core outcomes in future trials will increase the value of research on clinical interventions for OD. We include recommendations regarding the outcomes that should be measured, although future work will be required to further develop and revalidate existing outcome measures.

Voice problems, also called hoarseness or dysphonia, can cause significant morbidity with communication difficulties and social isolation. This review summarises the causes and treatment of voice problems. Common causes of voice problems are related to inflammation, non-physiological usage of the voice, benign lesions of the vocal cords and damage to the nerves innervating the larynx. Nonetheless, it is important to keep malignancy in mind as a differential diagnosis. Referral to an otorhinolaryngologist is recommended for voice problems in adults with a duration of more than two weeks.

Introduction: Olfactory dysfunction (OD) is an extremely frequent symptom of SARS-CoV-2 infection in adults. However, the symptomatology in the paediatric population remains understudied and heavily reliant on questionnaires. The aims of this study were to evaluate the prevalence of OD in children with SARS-CoV-2 infection and to assess the use of olfactory testing in predicting COVID-19 in children. Furthermore, we aimed to investigate the correlation between subjective and objective sense of smell in children., Methods: Children aged 6-12 years presenting at Test Centre Aarhus for a reverse transcription PCR for SARS-CoV-2 were invited to participate during the study period (from 8 January to 22 February 2022). They underwent olfactory testing with Sniffin' Sticks 16 Identification Kit and they were asked about their subjective assessment of smell and any confounding factors., Results: A total of 78 children completed inclusion of whom 51 had a positive SARS-CoV-2 PCR test. We found no correlation between either current SARS-CoV-2 status and Sniffin' Sticks Identification score (p = 0.500) or previous self-reported infection. We also found no correlation between subjective and objective sense of smell (p = 0. 109)., Conclusion: The lack of correlation between SARS-CoV-2 infection and OD may indicate that OD is not a dominant symptom in children. Therefore, olfactory testing is not recommended as a screening method for SARS-CoV-2 as was suggested in adults. Likewise, subjective questioning is not a reliable tool in assessing olfactory function in children., Funding: Laura Danielsen received funding for salary from Forskningsfond Hospitalsenheden Vest (now Forskningsfond Regionshospitalet Gødstrup). Alexander Wieck Fjældstad wishes to acknowledge research salary funding for other projects from Velux Fonden. The sponsors had no say, roles or responsibilities in relation to the study, including (but not limited to) the study design, data collection, management, analysis or decision to publish., Trial Registration: Not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Introduction: Two-thirds of patients with COVID-19 developed smell and taste dysfunction, of whom half experienced improvement within the first month. After six months, 5-15% still suffered from significant olfactory dysfunction (OD). Before COVID-19, olfactory training (OT) was proved to be effective in patients with post-infectious OD. Therefore, the present study aimed to investigate the progress of olfactory recovery with and without OT in patients with long COVID-19., Methods: Consecutive patients with long COVID-19 referred to the Flavour Clinic at Gødstrup Regional Hospital, Denmark, were enrolled. The diagnostic set-up at the first visit and follow-up included smell and taste tests, questionnaires, ENT examination and instructions in OT., Results: From January 2021 to April 2022, 52 patients were included due to long COVID-19-related OD. The majority of patients complained of distorted sensory quality, in particular, parosmia. Two-thirds of the patients reported a subjective improvement of their sense of smell and taste along with a significant decline in the negative impact on quality of life (p = 0.0001). Retesting at follow-up demonstrated a significant increase in smell scores (p = 0.023) where a minimal clinically important difference (MCID) in smell scores was found in 23% of patients. Full training compliance was significantly associated with the probability of MCID improvement (OR = 8.13; p = 0.04)., Conclusions: The average effect of OT is modest; however, full training compliance was significantly associated with an increased probability of a clinically relevant olfactory improvement., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Change in olfactory and/or gustatory dysfunction have gained attention in recent years because of COVID-19. However, these symptoms are common and have numerous different aetiologies, which should not be forgotten. Adequate diagnostic work up and clinical examination is essential. Treatment may include olfactory training, topically applied steroids and perhaps surgery. This review summarises common reversible causes of olfactory and/or gustatory dysfunction and current treatment modalities.

Introduction: COVID-19 is causing a wide range of clinical manifestations. Severe complications and long-lasting sequelae have been identified. Thus, olfactory disorders are reported in up to 86% of cases in mild and moderate COVID-19 infections. We present the first study comparing simple and complex post-COVID-19 cases with matched non-COVID-19 post-infectious smell and taste disorders., Methods: A total of 328 patients were recruited from the University Clinic for Flavour, Balance and Sleep, Ear-nose-throat Department, Goedstrup Hospital, Denmark. A non-COVID -19 post-infectious population of 148 individuals was identified from the Redcap database, and was matched by duration of smell and taste disorders. Post-COVID-19 patients were divided into 99 patients with simple smell and taste disorders (only suffering from smell and taste disorders after COVID-19); and (81 patients with complex smell and taste disorder plus several other post-COVID-19 complaints). Besides patient-reported outcome measures (PROM) questionnaires and quality of life score (QoL), ear-nose-throat examination, Mini-Mental State Examination (MMSE), orthonasal smell test (Sniffing's sticks), retronasal quick test, and taste screening were performed., Results: Cases with post-COVID-19-related smell and taste disorders deviated from non-COVID-19 post-infectious cases; the patients were younger, had a lower occurrence of anosmia/ageusia, and had higher overall smell test scores. In contrast, patients with post-COVID-19-related smell and taste disorders more frequently complained of distorted senses. Parosmia and phantosmia were more prevalent among patients with simple post-COVID-19 complaints than among complex cases and their QoL were more negatively affected., Conclusion: Smell and taste function differ significantly between post-COVID-19 and other non-COVID-19 post-viral cases., Level of Evidence: 3 Laryngoscope, 133:169-174, 2023., (© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Background: Definitions are essential for effective communication and discourse, particularly in science. They allow the shared understanding of a thought or idea, generalization of knowledge, and comparison across scientific investigation. The current terms describing olfactory dysfunction are vague and overlapping., Summary: As a group of clinical olfactory researchers, we propose the standardization of the terms "dysosmia," "anosmia," "hyposmia," "normosmia," "hyperosmia," "olfactory intolerance," "parosmia," and "phantosmia" (or "olfactory hallucination") in olfaction-related communication, with specific definitions in this text., Key Messages: The words included in this paper were determined as those which are most frequently used in the context of olfactory function and dysfunction, in both clinical and research settings. Despite widespread use in publications, however, there still exists some disagreement in the literature regarding the definitions of terms related to olfaction. Multiple overlapping and imprecise terms that are currently in use are confusing and hinder clarity and universal understanding of these concepts. There is a pressing need to have a unified agreement on the definitions of these olfactory terms by researchers working in the field of chemosensory sciences. With the increased interest in olfaction, precise use of these terms will improve the ability to integrate and advance knowledge in this field., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with 10 household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 5,225 self-reported a respiratory illness and were grouped based on their reported COVID test results: COVID-positive (COVID+, N = 3,356), COVID-negative (COVID-, N = 602), and COVID unknown for those waiting for a test result (COVID?, N = 1,267). The participants who reported no respiratory illness were grouped by symptoms: sudden smell/taste changes (STC, N = 4,445), other symptoms excluding smell or taste changes (OthS, N = 832), and no symptoms (NoS, N = 416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% confidence interval (CI): 15-28%), 47% in smell (95% CI: 37-56%), and 17% in oral irritation (95% CI: 10-25%) intensity. There were medium to strong correlations between perceived intensities and self-reported abilities (r = 0.84 for smell, r = 0.68 for taste, and r = 0.37 for oral irritation). Our study demonstrates that COVID-19-positive individuals report taste dysfunction when self-tested with stimuli that have little to none olfactory components. Assessing the smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and may help to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Competing Interests: The authors disclose no conflicts of interest.

Importance: The human senses of taste and smell are essential in everyday life. However, as clinical testing of the senses and patient-reported sensory problems are often diverging, additional validated questionnaires are essential for the evaluation of chemosensory impairments., Objective: To develop an instrument with all relevant domains concerning chemosensory dysfunction and quality of life using modern psychometrics., Design, Setting, and Participants: The study was designed as a questionnaire study for developing a new instrument. The study started in 2019 and was completed in 2022. Patients with chemosensory dysfunction were recruited from a specialized smell and taste clinic at an ear, nose, and throat department in Denmark. Healthy participants with no history of chemosensory dysfunction were recruited through social media., Main Outcomes and Measures: Eight domains were included (distorted chemosensation, emotional, food and meals, social, hygiene, danger, work, and relationship), and 35 items were generated based on review of the existing literature and interviews with patients and experts. Participants were tested with the Major Depression Inventory, 36-Item Short Form Health Survey, Taste Sprays, and Sniffin' Sticks for chemosensory function. Descriptive statistics were calculated for all items. Reliability, internal consistency, and validity were investigated, and a Rasch model was fitted. Healthy controls (n = 39) filled out the questionnaire for comparison of known-groups validity. Confirmatory factor analysis was performed. Finally, item reduction was performed, resulting in a final version with 21 items in 8 domains., Results: The study included responses from 316 patients, 183 women (58%) and 133 men (42%), with a mean (SD) age of 57 (15.1) years. Rasch model fit was acceptable with P > .05 for all items. An 8-dimensional confirmatory factor analysis model showed a better fit than a bifactor confirmatory factor analysis model. Cronbach α ranged from 0.65 to 0.86. Criterion validity with the Sniffin' Sticks, Taste Sprays, Major Depression Inventory, and the 36-Item Short Form Health Survey was satisfactory. The test-retest reliability was good in all domains, ranging from 0.55 to 0.86. All domains were discriminative, except the social and work domains., Conclusions and Relevance: In this survey study, the instrument was validated with 8 domains related to chemosensory dysfunction and quality of life. All items had good internal consistency, test-retest reliability, interitem correlations, item-total correlations, and Rasch model fit. The questionnaire appears suitable for use in clinical and research settings.

Introduction: Malnutrition and disturbed sense of smell and taste frequently occur in patients treated with chronic haemodialysis. The common denominator between chemosensation and nutrition may be food preferences. Our aim was to investigate smell and taste function as well as food preferences among haemodialysis patients and compare the results with those of age-matched controls., Methods: An observational case-control study was conducted on 29 patients on chronic haemodialysis and 39 age-matched healthy controls. Chemosensory function was evaluated using validated gustatory and olfactory tests. Food preferences were recorded using a questionnaire of 63 items including a five-point Likert scale of familiarity, liking and frequency., Results: Chemosensory function was significantly poorer among patients than among controls. Patients had significantly lower familiarity and frequency of consumptions of all food categories than controls and they also had significantly lower liking of vegetables, fruits and starches., Conclusions: Implementation of the provided knowledge about haemodialysis patients' smell and taste function including their food preferences are suggested, such as enhancement of odorant intensity, use of taste amplification, cooking habits and exposure to more varied food items. Assessments of food preferences and chemosensory function prior to determination of individual dietary schedules are therefore recommended., Funding: The authors did not receive any financial support for the research or drafting of this article. The authors declare that they have no financial interests to report., Trial Registration: Danish Ethical Committee project number: M-2018-188-18., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Introduction: Olfactory dysfunction (OD) is a common symptom of COVID-19. In some patients, OD persists for many months, fluctuates during recovery or parosmia may occur. Knowledge about the prognosis of these patients is insufficient., Methods: Data on chemosensory function and possible prognostic factors were collected through a baseline questionnaire and six follow-up questionnaires answered at 2-3-month intervals., Results: One year after onset of OD, 42.0% of the respondents reported sustained complete recovery, 41.7% reported partial recovery and 2.4% reported no improvement of olfaction. Follow-up was unavailable for 13.9%. Parosmia, high severity of OD and female sex were associated with lower rates of recovery. Subjects who reported that OD had a high impact on their quality of life were less likely to recover within one month. Smoking, alcohol habits, BMI and physical activity were not associated with persistence of OD., Conclusions: High recovery rates were reported within the first months. Recovery of sensory function after more than six months with no prior improvement was reported. After one year, 97.1% of participants with at least one year of follow-up had reported at least some recovery. Recurring OD after initial complete recovery was reported by 24.5% of participants. Parosmia and severity of OD were associated with prolonged recovery rates., Funding: AF received research funding from Velux Fonden. The sponsors had no say nor any responsibilities in relation to the study., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Olfactory dysfunction often has severe consequences on patients' quality of life. The most common complaint in these patients is their reduced enjoyment of food in both patients with olfactory loss and parosmia. How the different types of olfactory dysfunction differ in relation to food and cooking habits, sensory awareness, and food-related quality of life has not yet received much attention. By applying questionnaires on cooking, food, olfactory function, weight changes, sensory awareness, and food-related quality of life, we investigated how various aspects of eating differ between participants with olfactory loss ( n = 271), parosmia ( n = 251), and normosmic controls ( n = 166). Cooking habits in olfactory dysfunction revealed pronounced differences as compared with normosmic controls. Cooking with olfactory dysfunction was associated with, e.g., a lack of comfort and inspiration for cooking and an inability to make new foods successfully. Significant differences in cooking were also found between olfactory loss and parosmia. Food items were less familiar in participants with olfactory loss and parosmia, while the ratings of liking food items differed between olfactory loss and parosmia, indicating the importance of adapting ingredients in meals separately for olfactory loss and parosmia. Parosmia was associated with a higher incidence of weight loss, but we found no difference in food-related quality of life between participants with olfactory loss and parosmia. While olfactory loss and parosmia have wide-ranging consequences on patients' cooking and food habits, adapting meals to include 'safer food items' and integrating multisensory stimulation may be a possible avenue for improving the enjoyment of food.

Ecological chemosensory stimuli almost always evoke responses in more than one sensory system. Moreover, any sensory processing takes place along a hierarchy of brain regions. So far, the field of chemosensory neuroimaging is dominated by studies that examine the role of brain regions in isolation. However, to completely understand neural processing of chemosensation, we must also examine interactions between regions. In general, the use of connectivity methods has increased in the neuroimaging field, providing important insights to physical sensory processing, such as vision, audition, and touch. A similar trend has been observed in chemosensory neuroimaging, however, these established techniques have largely not been rigorously applied to imaging studies on the chemical senses, leaving network insights overlooked. In this article, we first highlight some recent work in chemosensory connectomics and we summarize different connectomics techniques. Then, we outline specific challenges for chemosensory connectome neuroimaging studies. Finally, we review best practices from the general connectomics and neuroimaging fields. We recommend future studies to develop or use the following methods we perceive as key to improve chemosensory connectomics: (1) optimized study designs, (2) reporting guidelines, (3) consensus on brain parcellations, (4) consortium research, and (5) data sharing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Veldhuizen, Cecchetto, Fjaeldstad, Farruggia, Hartig, Nakamura, Pellegrino, Yeung and Fischmeister.)

Aims: To investigate the self-reported audiological symptoms in a cohort of coronavirus disease 2019 (COVID-19) patients and monitor improvement or recovery., Material and Methods: Following the STROBE guidelines for observational studies, a retrospective questionnaire concerning audio-vestibular symptoms was conducted in a cohort of Danish COVID-19 patients with self reported chemosensory loss. Data regarding demographics, symptoms onset, duration and remission was registered in a REDCap database., Results: Of the 225 respondents with chemosensory loss, 59 (26.2%) reported concomitant hearing loss (10.7%) or tinnitus (16.4%). In a follow-up questionnaire focused on ear-symptoms, severity, and duration (n=31), 17 reported hearing loss and 21 reported tinnitus. Debut of hearing loss and tinnitus were on average 10 and 30 days respectively, after onset of initial symptoms. Among the hearing loss patients, only two patients experienced full recovery, whereas 15 had partial or no recovery after on average 266 days from COVID-19 symptom onset. Among the tinnitus patients, 7/21 had full recovery, while 14 had partial or no recovery after on average 259 days from COVID-19 symptom onset., Conclusion: In a large Danish cohort of COVID-19 patients, a significant proportion experienced concomitant audiological symptoms which seem long lasting and with negative impact on quality of life. This study warrants further investigation of the association between COVID-19 and audio-vestibular symptoms, and the need for rehabilitation among convalescents., (Copyright © 2021 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Introduction  Quality of life is closely linked to retronasal olfactory function. Familiarity with odors vary, so tests need validation. Testing can be time-consuming, so a quick test and a thorough test are needed for clinical and research settings. Objectives  The objectives of this study were to validate the original retronasal powder olfactory test in a Danish population and to develop a novel quick retronasal test for easy application. Methods  Ninety-seven participants were included in the study, 59 healthy controls and 38 patients with olfactory impairment. The retronasal test was modified by substituting unfamiliar odors and descriptors and validated with a criterion of correct identification rate of 50% in the original test and 90% in the quick test. Items with over 90% correct identification rate in the modified original test were included in the quick test, resulting in a 10-item test. Results  The modified retronasal olfactory test achieved good test characteristics, with a 10th percentile cut-off value of 13: sensitivity was 88.9%, specificity 83.0%, positive predictive value 78%, negative predictive value 91.7%, and the receiver operating characteristics area under the curve (ROC-AUC) was 0.86. The quick test achieved acceptable test characteristics, with a 10th percentile cut-off value of 8.2: sensitivity was 72.2%, specificity 90.6%, positive predictive value 83.9%, negative predictive value was 82.8%, and ROC-AUC 0.81. Conclusion  Validation of both tests demonstrated satisfactory accuracy. We recommend the quick test for screening purposes, and the modified original version for a thorough evaluation. The tests are easily implemented as they are easy to understand and very affordable., Competing Interests: Conflict of Interests Dr. Therese Ovesen reports royalties from Danish textbooks., (Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background: Use of suction drain after superficial parotidectomy (SP) is based on national consensus considered best practice, but there is no evidence on the effect of the treatment. The aim of the present study is to evaluate the effectiveness of drainage after SP by evaluating the rate of complications after SP in relation to the (ie, duration) of drainage and tumor size., Methods: Retrospective analysis was performed involving data from all consecutive patients undergoing SP at the Ear, Nose, and Throat department, Regional Hospital West Jutland, Denmark, between January 1, 2011, and December 31, 2017. Demographics including comorbidity, medication, tumor size, postoperative secretion through the drainage, as well as complications (hematoma, seroma, infection, fistulas, Frey syndrome, facial nerve palsy) were registered. Patients with secretion below 25 mL were compared to patients with secretion above 25 mL, that is, drainage less than 24 hours versus longer than 24 hours. Results : Two hundred five consecutive patients undergoing SP were enrolled. The overall risk of postoperative infection was 16.2%. Ten of 33 patients with infection were also diagnosed with an hematoma or seroma. The risk of infection increased with secretion above 25 mL (27.2%) compared to patients with less than 25 mL (13.1%; P = .0318). The same accounts for the risk of seromas/hematomas ( P = .0055). We found no evidence that demographics or comorbidity correlated to the secretion in the drainage, but there is a tendency toward male gender having a higher risk off secretion above 25 mL (odds ratio 1.39)., Conclusion: Overall, the risk of complications after SP increased with secretion beyond 25 mL (ie, drainage for more than 24 hours). This applied in particular to infections and seromas/hematomas demanding treatment. The use of routine drainage after SP is questionable, and a randomized trial is warranted to unravel the necessity of postoperative drainage.

Introduction: While magnetic resonance imaging (MRI) is not included in the current guidelines for diagnosing olfactory disorders in the most recent position paper on olfactory dysfunction, both 1.5T and 3T MRI are commonly used in the diagnostic workup of many patients with olfactory loss. Often, MRI is used to rule out intracranial tumours, but other useful information may be obtained from MRI scans in these patients. The potential of MRI in olfactory loss depends on sufficient knowledge of structural changes in different aetiologies of olfactory loss. We present common clinical MRI findings in olfactory loss and evaluate the usefulness of structural integrity scores in differentiating between aetiologies., Methods: In this study, we investigated if white matter hyperintensities (WMHs, measured by Fazekas score), global cortical atrophy (GCA), and medial temporal lobe atrophy (MTA) are more common in patients with idiopathic olfactory loss than in patients with acquired olfactory loss due to other aetiologies. Furthermore, we compared olfactory bulb (OB) configurations in different olfactory loss aetiologies., Results: In 88 patients with olfactory loss, WMHs, GCA, and MTA were not more significant findings on MRI in idiopathic olfactory loss (n = 51) compared with other causes of acquired olfactory loss (Fazekas score p = 0.2977; GCA score p = 0.6748; MTA score p = 0.7851). Bulb configurations differed in patients suffering from post-traumatic olfactory loss and may aid in identifying the underlying aetiology in patients where trauma is among the suspected causes of olfactory loss., Conclusion: We recommend that structural MRI with an OB sequence is included in the diagnostic evaluation of olfactory loss with suspected congenital and post-traumatic aetiology and should be considered in idiopathic olfactory loss with suspected central aetiology (e.g., tumour)., (© 2021 S. Karger AG, Basel.)

A rare cause of olfactory impairment is olfactory groove meningiomas with insidious onset of non-specific symptoms like headache, olfactory dysfunction, psychiatric symptoms such as depression, personality changes, declining cognitive function, visual disturbances or seizures. A common complication of surgery is loss of olfactory function. Still, the preservation of olfactory function should be attempted as olfactory loss often has a severe negative impact on quality of life. This report describes a woman with an olfactory groove meningioma and a 10-year history of olfactory impairment. It includes preoperatively and postoperatively extended olfactory testing, a neurosurgical approach to preserve the olfactory function and postoperative olfactory rehabilitation. After rehabilitation, the patient regained a normal olfactory function, even though the right-sided olfactory nerve could not be preserved during surgery. The case demonstrates the importance of performing neuroimaging in selected patients with olfactory loss and a method for preserving and potentially improving postoperative olfactory function., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects., (© 2021 ARS-AAOA, LLC.)

Background: Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD)., Objective: Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists., Methods: A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD., Results: The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction., Conclusions: The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options., (Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Olfactory perception is a complicated process involving multiple cortical and subcortical regions, of which the underlying brain dynamics are still not adequately mapped. Even in the definition of the olfactory primary cortex, there is a large degree of variation in parcellation templates used for investigating olfaction in neuroimaging studies. This complicates comparison between human olfactory neuroimaging studies. The present study aims to validate an olfactory parcellation template derived from both functional and anatomical data that applies structural connectivity (SC) to ensure robust connectivity to key secondary olfactory regions. Furthermore, exploratory analyses investigate if different olfactory parameters are associated with differences in the strength of connectivity of this structural olfactory fingerprint. By combining diffusion data with an anatomical atlas and advanced probabilistic tractography, we found that the olfactory parcellation had a robust SC network to key secondary olfactory regions. Furthermore, the study indicates that higher ratings of olfactory significance were associated with increased intra- and inter-hemispheric SC of the primary olfactory cortex. Taken together, these results suggest that the patterns of SC between the primary olfactory cortex and key secondary olfactory regions has potential to be used for investigating the nature of olfactory significance, hence strengthening the theory that individual differences in olfactory behaviour are encoded in the structural network fingerprint of the olfactory cortex., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Fjaeldstad, Stiller-Stut, Gleesborg, Kringelbach, Hummel and Fernandes.)

Background and Aim: Approximately five percent of the general population are suffering from taste disorders. Usually, subjective loss of taste is caused by smell disorders; thus, isolated loss of the sense of taste is relatively rare. Despite the influence on quality of life, isolated taste disorders (ITD) are sparsely represented in literature and clinical research. In particular, there is need for sufficient diagnostic and treatment algorithms. Aim of study is to add further information to the sparse literature on ITD and suggest an appropriate diagnostic algorithm for ITD., Methods: We present a retrospective study on patients with ITD diagnosed at the Flavour clinic, ENT department, Regional Hospital West Jutland, between 2017 and 2020. All patients underwent a thorough rhinolaryngological and otoneurologic examination, including olfactory and gustatory assessment, and a wide spectrum of biochemical, microbiological, and radiological examinations., Results: In total, 522 patients referred due to smell and/or taste disorders, 423 (81%) complained of a subjective taste disorder, only 19 (3.4%) patients were diagnosed with ITD. According to etiology, the patients were categorized in following groups: medicine-related (25%), mixed (21%), iatrogenic (21%), idiopathic (11%), radiotherapy-related (11%), and autoimmune/inflammatory (11%). Based on etiology, individualized treatment was recommended with very discouraging results., Interpretation: Diagnostics of taste disorders is a delicate and expertise demanding task. The mechanisms underlying isolated loss of taste are heterogeneous. ENT and otoneurologic examination, and specific olfactory and gustatory testing are required in all patients, whereas biochemical, microbiological, and radiological examinations are only necessary on an individual basis., (© 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Introduction  Subjective chemosensory function can differ from measured function. Previous studies on olfactory assessment have found a positive correlation between subjective and measured scores. However, information on gustatory correlation between measured and subjective functions is sparse in patients who have undergone an initial ear, nose and throat (ENT) evaluation. Objectives  To evaluate the correlation between subjective and measured olfactory and gustatory dysfunctions in a population complaining of taste and/or smell dysfunction after an initial ENT evaluation without chemosensory testing. Furthermore, we aimed to assess the need for chemosensory testing depending on the type of subjective chemosensory dysfunction. Methods  A case series in which subjective chemosensory function was assessed through a questionnaire and measured chemosensory function was assessed by validated clinical tests. Results  In total, 602 patients with complaints of olfactory and/or gustatory dysfunction were included. We found that 50% of the patients with normal gustatory function and an olfactory impairment classified their olfactory impairment as a subjective taste disorder. Furthermore, 98% of the patients who rated their olfactory function as absent did have a measurable olfactory impairment, but only 64% were anosmic. Conclusion  Subjective gustatory dysfunction was poorly correlated with measured gustatory dysfunction, and was often found to reflect olfactory dysfunction. Contrarily, subjective olfactory dysfunction was positively correlated with measurable olfactory dysfunction. Although subjective anosmia was a strong indicator of measured anosmia or hyposmia, the existence of remaining olfactory function was frequently found in these patients. Validated chemosensory testing should be performed in patients with perceived olfactory or gustatory deficits, as this could help ensure increased diagnostic precision and a relevant treatment., Competing Interests: Conflict of Interests The authors have no conflicts of interest to declare., (Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19-; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: -82.5 ± 27.2 points; C19-: -59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Chemosensory dysfunction (CD) has proven valuable in prediction of COVID-19, as it is a frequent and specific symptom of the disease. The aim of this study was to investigate the duration of CD in patients with sudden subjective olfactory and/or gustatory loss during the SARS-CoV-2 pandemic. The secondary aim was to identify possible prognostic factors for the duration of CD., Methods: An online baseline questionnaire was designed to assess subjective CD. Three rounds of follow-up questionnaires were sent out to any participants with persistent CD in 6-week intervals, prospectively assessing subjective chemosensory function and extending the follow-up time of this cohort significantly., Results: In total, 467 participants completed the baseline questionnaire. The most significant improvement and recovery of chemosensory function was observed within the first month after the initial loss. Rates became stagnant after about 2 months, and only little improvement and recovery was seen after 2-4 months. After a mean follow-up of 95.9 days (olfactory dysfunction) and 94.0 days (gustatory dysfunction), 86.7% of participants reported gustatory improvement and 82.6% reported olfactory improvement, while 55.0% reported full gustatory recovery and 43.8% reported full olfactory recovery. Female gender was associated with better improvement of gustatory function. High subjective severity of chemosensory loss was associated with lower rates of olfactory and gustatory recovery as well as improvement of olfactory function. Young age was not associated with a better prognosis., Discussion/conclusion: Rates of improvement and recovery of chemosensory function decreased after 2-4 months after initial chemosensory loss, possibly indicating that prolonged and perhaps permanent chemosensory loss may be a complication of SARS-CoV-2 infections. High subjective severity of CD may worsen the prognosis for improvement and recovery of chemosensory function., (© 2021 S. Karger AG, Basel.)

Objectives/hypothesis: The association between smoking and olfactory loss remains a conundrum. Prior studies have found negative and positive effects of smoking on olfactory function in the general population. However, smoking cessation seems to improve both rated and measured olfactory function. The purpose of this study was to investigate the olfactory function and smoking habits in patients with olfactory loss caused by different etiologies to unveil underlying patterns related to smoking., Study Design: Retrospective observational study., Methods: Patients were included from two specialized taste and smell centers. Patients underwent olfactory testing, clinical examination including rhinoscopy, and the underlying etiology was identified. Patterns of olfactory test scores, demographics, and etiologies were analyzed., Results: In total, 3,900 patients with olfactory loss were included. Of these, 521 were current smokers, and 316 were former smokers. Patients with a history of smoking did not have significantly lower olfactory function. Current smokers were more often affected by posttraumatic olfactory loss, but not sinonasal, postviral, or idiopathic olfactory loss., Conclusions: Current smoking, but not former smoking, was associated with posttraumatic olfactory loss. In relation to measured olfactory function, a history of smoking was not associated to lower olfactory scores. Our findings suggest that the general recommendations of smoking cessation for patients with olfactory loss are especially relevant for patients with posttraumatic olfactory loss. The nature of this association between current smoking and posttraumatic olfactory loss has yet to be elucidated., Level of Evidence: 2b Laryngoscope, 131:E8-E13, 2021., (© 2020 The American Laryngological, Rhinological and Otological Society, Inc.)

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± standard deviation), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

In the aftermath of COVID-19, the association between SARS-CoV-2 and chemosensory deficits have been well established. Taste and smell loss have been included in the official lists of symptoms worldwide, as it is a common symptom (and for some patients the only symptom) of COVID-19 as described in this review. Patients with COVID-19 often have combined taste and smell loss, have a milder clinical presentation, and are younger than previous patients with postviral olfactory loss. Patients should start olfactory training early and should be seen by an ear, nose and throat physician if they do not experience improvement of the senses within 12 weeks.

Introduction: Chemosensory loss is a common symptom of coronavirus disease 2019 (COVID-19) and has been associated with a milder clinical course in younger patients. Whereas several studies have confirmed this association, knowledge about the improvement and recovery of olfactory and gustatory loss is lacking. The aim of this study was to investigate the temporal dynamics of improvement and recovery from sudden olfactory and gustatory loss in patients with confirmed and suspected COVID-19., Methods: Subjective chemosensory function, symptoms of COVID-19, COVID-19 tests results, demographics and medical history were collected through a questionnaire., Results: Among the 109 study participants, 95 had a combined olfactory and gustatory loss, five participants had isolated olfactory loss and nine participants has isolated taste loss. The mean age of participants was 39.4 years and 25% of participants were under the age of 30 years. Young age was not associated with a higher recovery rate. After a mean time of > 30 days since the chemosensory loss, participants reported relatively low recovery and improvement rates. For participants with olfactory loss, only 44% had fully recovered, whereas 28% had not yet experienced any improvement of symptoms. After gustatory loss, 50% had fully recovered, whereas 20% had not yet experienced any improvement. Olfactory and gustatory deficits were predominantly quantitative and mainly included complete loss of both olfactory and gustatory function., Conclusions: Chemosensory loss was frequent in young individuals and persisted beyond a month after symptom onset, often without any improvement during this time., Funding: The author wishes to acknowledge research salary funding from Arla Foods (Viby, Denmark) and the Central Region Denmark. The sponsors had no say, roles or responsibilities in relation to the study, including (but not limited to) the study design, data collection, management and analysis., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

This case report describes a physician in the early 30ies with subjective anosmia and ageusia as the major presenting symptoms of COVID-19. Apart from a week of slightly runny nose when coming from cold to warm air, the only symptom was a sudden onset of persistent anosmia and ageusia. Two weeks after normalisation of the mild sino-nasal symptoms, the patient was tested positive for SARS-CoV-2, and anosmia was verified with Sniffin' Sticks tests. Hypogeusia was verified with taste screening and two validated taste tests. Olfactory and gustatory loss may be underestimated symptoms of COVID-19.

Chemosensory sensitivity has great variation between individuals. This variation complicates the chemosensory diagnostics, as well as the creation of a meal with universally high hedonic value. To ensure accurate characterization of chemosensory function, a common rule of thumb is to avoid food/beverages one hour before chemosensory testing. However, the scientific foundation of this time of fast remains unclear. Furthermore, the role of coffee on immediate chemosensitivity is not known and may have implications for optimization of gastronomy and hedonia. The aim of this study is to investigate the modularity effects of coffee consumption on immediate gustatory and olfactory sensitivity. We included 155 participants. By applying tests for olfactory and gustatory sensitivity before and after coffee intake, we found no changes in olfactory sensitivity, but significantly altered sensitivity for some basic tastants. We repeated our experimental paradigm using decaffeinated coffee and found similar results. Our results demonstrate that coffee (regular and decaffeinated) alters the subsequent perception of taste, specifically by increasing the sensitivity to sweet and decreasing the sensitivity to bitter. Our findings provide the first evidence of how coffee impacts short-term taste sensitivity and consequently the way we sense and perceive food following coffee intake-an important insight in the context of gastronomy, as well as in chemosensory testing procedures.

Sensory perception is neither static nor simple. The senses influence each other during multisensory stimulation and can be both suppressive and super-additive. As most knowledge of human olfactory perception is derived from functional neuroimaging studies, in particular fMRI, our current understanding of olfactory perception has systematically been investigated in an environment with concurrent loud sounds. To date, the confounding effects of acoustic fMRI-noise during scanning on olfactory perception have not yet been investigated. In this study we investigate how acoustic noise derived from the rapid switching of MR gradient coils, affects olfactory perception. For this, 50 subjects were tested in both a silent setting and an fMRI-noise setting, in a randomised order. We found that fMRI-related acoustic noise had a significant negative effect on the olfactory detection threshold score. No significant effects were identified on olfactory discrimination, identification, identification certainty, hedonic rating, or intensity rating., (Copyright © 2019 IBRO. All rights reserved.)

Objectives: The applicability of olfactory testing is dependent on cultural adaptation. The aim of this study was to validate the Sniffin' Sticks (Burghart Messtechnik, Wedel, Germany) threshold (T), discrimination (D), and identification (I) olfaction test. This data was subsequently used to investigate external validity of international normative values to separate hyposmia from normosmia., Methods: The study included 388 participants. The first step was a questionnaire study in which 238 adults rated their familiarity with 125 odor descriptors. In the second step, we evaluated the original Sniffin' Sticks (Burghart Messtechnik) in 75 participants. In the third step, we modified our odor descriptors and tested 75 participants with the new version., Results: In the I test, we found that 21 original odor descriptors were unfamiliar and that five odors had I rates < 75%. After modification, all odors had a successful I rate > 75%. By comparing the T, D, and I scores of previous validation studies, we found a significant variation in the scores between countries., Conclusion: The original Sniffin' Sticks (Burghart Messtechnik) was not applicable in Denmark. The modification resulted in improvement of familiarity and rate of I, making the test valid for use in Denmark. Furthermore, the study found a large variation in T and D scores between different countries, which should be considered when using these scores to separate hyposmia and anosmia from normosmia., Level of Evidence: 2b. Laryngoscope, 1759-1766, 2018., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)