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Objectives: Autoimmune activation by COVID-19 infection/vaccination has been postulated to be responsible for initiating or reactivating multiple types of oral mucosal immune disorders. These include: oral lichen planus; oral pemphigoid; either bullous pemphigoid or mucous membrane pemphigoid with oral involvement; pemphigus vulgaris with oral involvement; and Sjögren disease. In addition, chronic conditions such as oral burning, xerostomia, or changes in taste and/or smell have also been linked to COVID-19 infection/vaccination. Data sources: Part 1 (mucosal conditions): an English-language literature review of Pubmed, Web of Science, Scopus, and Embase was performed searching cases of oral lichen planus, oral bullous pemphigoid, mucous membrane pemphigoid, pemphigus vulgaris, and COVID-19 infection/vaccination, with additional cases from the authors’ clinical practice presented. Part 2 (nonmucosal conditions): Cases of initiated or flared Sjögren disease, chronic oral burning, or xerostomia after COVID-19 infection/vaccination from the authors’ clinical practice were aggregated. Results: The literature review discovered 29 cases of oral lichen planus following COVID-19 infection/vaccination. For bullous pemphigoid, 10 cases were identified after infection/vaccination. The number of pemphigus vulgaris cases following infection/vaccination was 28. The majority of mucosal cases were reported after vaccination. Most reported initial disease, but a substantial amount included recurrences of existing diseases. Nonmucosal disease: Sjögren disease, chronic oral burning, or xerostomia after COVID-19 infection/vaccination cases totaled 12 cases identified from the authors’ clinical practice, with the majority occurring after infection. Conclusions: Chronic conditions after infection with COVID-19 or vaccination remain relatively rare and self-limited, yet reinforce the importance of comprehensive history taking involving COVID-19 to differentiate potential etiologic factors for these conditions. [ABSTRACT FROM AUTHOR]

This paper is aimed at comprehensively reviewing olfactory and gustatory disorders caused by SARS-CoV-2 in children and adults. An electronic and manual search was done on three data bases: MEDLINE, Embase, and Web of Science. Inclusion criteria included publications written in English, involving humans in the age range of 0 to 99 years that were captured by a controlled vocabulary of thesaurus terms. Olfactory and gustatory disorders rates in COVID-19 ranged from 22% to 71.9% in adults and 16.6% to 25.8% in children. Olfactory and gustatory disorders might appear as the first symptom, and in adults might even be the only symptom (4.8% to 10%). Anosmia is the most common olfactory disorder and hypogeusia is the most common gustatory disorder. In 33% to 89% of cases, olfactory and gustatory disorders resolve spontaneously within a few weeks, coinciding with the resolution of other COVID-19 symptoms, both in adults and children. However, in some patients, olfactory and gustatory disorders persist beyond the resolution of other symptoms. Notably, children generally experience a swifter and more favorable recovery compared to adults. The precise pathogenesis underlying olfactory and gustatory disorders in the context of COVID-19 remains unclear and is likely multifactorial. Presently, no established treatment protocol exists for olfactory and gustatory disorders and current treatments reviewed lack robust evidence and are not readily available for clinical use. Olfactory training represents the only therapy currently recommended by international authorities. Pediatric practitioners and general dental practitioners should be aware of olfactory and gustatory disorders in both pediatric and adult populations, including their biologic mechanisms, treatment options, and recovery rates. [ABSTRACT FROM AUTHOR]

Olfactory dysfunction has emerged as a hallmark feature shared among several neurological conditions, including both neurodevelopmental and neurodegenerative disorders. While diseases of both categories have been extensively studied for decades, their association with olfaction has only recently gained attention. Olfactory deficits often manifest already during prodromal stages of these diseases, yet it remains unclear whether common pathophysiological changes along olfactory pathways cause such impairments. Here we probe into the intricate relationship between olfactory dysfunction and neurodegenerative and neurodevelopmental disorders, shedding light on their commonalities and underlying mechanisms. We begin by providing a brief overview of the olfactory circuit and its connections to higher-associated brain areas. Additionally, we discuss olfactory deficits in these disorders, focusing on potential common mechanisms that may contribute to olfactory dysfunction across both types of disorders. We further debate whether olfactory deficits contribute to the disease propagation or are simply an epiphenomenon. We conclude by emphasizing the significance of olfactory function as a potential pre-clinical diagnostic tool to identify individuals with neurological disorders that offers the opportunity for preventive intervention before other symptoms manifest. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Method Results Conclusion Implications Impact Reporting Method Patient or Public Contribution To explore trajectories of understanding and managing persistent chemosensory dysfunction after COVID‐19 in patients undergoing clinical treatment.A descriptive qualitative interview study with a realist approach.Data were collected in Sweden, from August 2022 to March 2023 through semi‐structured interviews with 30 patients undergoing treatment for long‐lasting smell and taste dysfunction resulting from COVID‐19. Thematic analysis was applied in a process that involved continuous discussions and refinement of codes into themes and subthemes.Three main themes were identified: (1) Understanding the sensory alterations, which includes subthemes of Searching for validation and Seeking remedies; (2) Practical coping strategies, encompassing Adapted eating and Managing olfactory training and (3) Navigating the emotional landscape, featuring Self‐persuasion and suppression and The ambivalence of acceptance. These themes highlight the cyclic and fluid nature of coping with the dysfunction, reflecting a dynamic process of adaptation. Despite treatment options like olfactory training, participants frequently experienced frustration due to limited perceived improvement and the psychological toll of managing their condition.The study highlights the complex and personal nature of coping with long‐term smell and taste dysfunction post‐COVID‐19. Coping strategies varied widely and evolved over time, reflecting a dynamic process of adaptation. The emotional and psychological impact was profound, underscoring the need for comprehensive treatment approaches that include both physiological and psychological support. There is a need for more effective interventions and support mechanisms to improve the quality of life for those affected by these persistent symptoms.This study contributes to the understanding of COVID‐19's long‐term effects on smell and taste, highlighting the need for ongoing support from health care, further research into effective interventions, and a comprehensive approach to care for individuals affected by these conditions.This study addresses trajectories and challenges of coping with persistent chemosensory dysfunction. Findings emphasise the complexity of managing persistent chemosensory dysfunction and the critical role of personalised care. The study contributes to knowledge for nurses in understanding patients with chemosensory dysfunction.This research adheres to the EQUATOR guidelines: Standards for reporting qualitative research (SRQR).No patient or public contribution. [ABSTRACT FROM AUTHOR]

Key points Decreased overall dietary consumption of micronutrients may be linked to an increased risk of olfactory dysfunction (OD) including subjective report of OD, subjective report of phantosmia, and objective OD. Interactions were identified between these micronutrients, suggesting that outcomes may vary depending on the mixture of micronutrients taken. [ABSTRACT FROM AUTHOR]

Objective: Childhood epilepsy with centrotemporal spikes (CECTS) is associated with cognitive, behavioral, and language difficulties. These epileptic discharges predominantly occur in the temporal lobe, which is known to be involved in olfactory functions. This study aims to assess olfactory dysfunction in patients with CECTS. Methods: This study included patients diagnosed with CECTS who were attending follow-ups at the Department of Child Neurology between January 2022 and July 2023. Olfactory function was evaluated using the Sniffin' Sticks (Burghart GmbH, Wedel, Germany) 12-point screening test, which was administered to 44 patients and 35 controls. The smell test and the final control EEGs were performed simultaneously. Results: A total of 44 patients and 35 control subjects were enrolled in this study. The smell scores were significantly lower in the patient group compared to the control group (p = 0.029). The patient group had a very high prevalence of anosmia compared to the control group. The normosmia rate in the control group was significantly higher. No significant difference was observed in the smell scores based on EEG findings or antiepileptic drug type. Conclusions: Olfactory dysfunction was identified in patients with CECTS compared to healthy controls, yielding results consistent with findings for other types of epilepsy. Olfactory dysfunction was detected in a greater frequency among the patients diagnosed with CECTS than among the healthy control group, and similar results were obtained with other types of epilepsy. It was deduced that these patients may experience problems with smell sensitivity throughout their lives. The most important result of this study is that this condition should be taken into account in regard to patients' well-being and lives. [ABSTRACT FROM AUTHOR]

Introduction: Patients with Parkinson's Disease (PD) commonly experience Olfactory Dysfunction (OD). Our exploratory study examined hippocampal volumetric and resting-state functional magnetic resonance imaging (rs-fMRI) variations in a Healthy Control (HC) group versus a cognitively normal PD group, further categorized into PD with No/Mild Hyposmia (PD-N/MH) and PD with Severe Hyposmia (PD-SH). Methods: We calculated participants' relative Total Hippocampal Volume (rTHV) and performed Spearman's partial correlations, controlled for age and gender, to examine the correlation between rTHV and olfactory performance assessed by the Odor Stick Identification Test for the Japanese (OSIT-J) score. Mann-Whitney U tests assessed rTHV differences across groups and subgroups, rejecting the null hypothesis for p < 0.05. Furthermore, a seed-based rs-fMRI analysis compared hippocampal connectivity differences using a one-way ANCOVA covariate model with controls for age and gender. Results: Spearman's partial correlations indicated a moderate positive correlation between rTHV and OSIT-J in the whole study population (ρ = 0.406; p = 0.007), PD group (ρ = 0.493; p = 0.008), and PD-N/MH subgroup (ρ = 0.617; p = 0.025). Mann-Whitney U tests demonstrated lower rTHV in PD-SH subgroup compared to both HC group (p = 0.013) and PD-N/MH subgroup (p = 0.029). Seed-to-voxel rsfMRI analysis revealed reduced hippocampal connectivity in PD-SH subjects compared to HC subjects with a single cluster of voxels. Conclusions: Although the design of the study do not allow to make firm conclusions, it is reasonable to speculate that the progressive involvement of the hippocampus in PD patients is associated with the progression of OD. [ABSTRACT FROM AUTHOR]

During its pre-motor stage, Parkinson's disease (PD) presents itself with a multitude of non-motor symptoms with different degrees of specificity and sensitivity. The most important among them are REM sleep behavior disorder (RBD) and olfactory dysfunction. RBD is a parasomnia characterized by the loss of REM sleep muscle atonia and dream-enacting behaviors. Olfactory dysfunction in individuals with prodromal PD is usually described as hyposmia (reduced sense of smell) or anosmia (complete loss of olfactory function). These symptoms can precede the full expression of motor symptoms by decades. A close comprehension of these symptoms and the underlying mechanisms may enable early screening as well as interventions to improve patients' quality of life. Therefore, these symptoms have unmatched potential for identifying PD patients in prodromal stages, not only allowing early diagnosis but potentially opening a window for early, possibly disease-modifying intervention. However, they come with certain challenges. This review addresses some of the key opportunities and pitfalls of both RBD and olfactory dysfunction as early markers of PD. [ABSTRACT FROM AUTHOR]

Background: Sociodemographic status (SDS) including race/ethnicity and socioeconomic status as approximated by education, income, and insurance status impact pulmonary disease in people with cystic fibrosis (PwCF). The relationship between SDS and chronic rhinosinusitis (CRS) remains understudied. Methods: In a prospective, multi‐institutional study, adult PwCF completed the 22‐Question SinoNasal Outcome Test (SNOT‐22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD‐NS), and Cystic Fibrosis Questionnaire‐Revised (CFQ‐R). Lund–Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression. Results: Seventy‐three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV1). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ‐R respiratory scores, and ppFEV1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT‐22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT‐22, QOD‐NS, or SIT scores. Conclusions: Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient‐reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF. Clinical Trials: NCT04469439 [ABSTRACT FROM AUTHOR]

Background: The olfactory cleft (OC) is the most important anatomical site for the maintenance of olfactory function. Obstruction of airflow in the OC by various conditions, such as inflammation, leads to poor olfactory function. Therefore, it is important to increase OC airflow while performing endoscopic sinus surgery (ESS). However, no technique to increase airflow has yet been established. Methods: We designed a superior turbinate lateralization (STL) procedure that displaces the entire ST bone laterally by eliminating the connection between the posterior ST and the anterior wall of the sphenoid sinus. The effect of the STL procedure was investigated in terms of anatomy and olfactory function. Results: ESS with the STL procedure was performed on seven patients with chronic rhinosinusitis and nasal polyps. The cross-sectional area of the OC at 3 months postoperatively was significantly larger than that before ESS. In addition, the Open Essence test and questionnaires revealed significantly improvements in sense of smell. Airflow in the OC was significantly higher in STL procedure group than in the non-STL procedure group. Conclusion: The STL procedure enlarges the bony framework of the OC, and by increasing OC airflow, facilitates the transport of odorants to the olfactory epithelium, thereby improving olfactory perception. [ABSTRACT FROM AUTHOR]

Objective: To investigate the platelet-rich plasma (PRP) effectiveness in patients with a long-lasting postviral olfactory dysfunction (LPOD). Methods: Forty-three consecutive patients with a long-lasting postviral OD were prospectively recruited. The injection of 1 mL of PRP was carried out in both olfactory clefts. The pre- to 6-month post-PRP injection change in olfaction was assessed with the olfactory disorder questionnaire (ODQ) and the threshold, discrimination, and identification (TDI) tests. Results: Forty-three patients received bilateral PRP injections (24 females). The mean age of patients was 58.9 ± 16.8 years. The mean duration of LPOD was 8.7 years. The pre to 6-month post-injection mean TDI significantly improved from 10.3 ± 10.2 to 20.12 ± 12.07 (p = 0.001). The mean ODQ significantly decreased from 29.8 ± 13.0 to 23.4 ± 11.3 (p = 0.013). The average change of the TDI and the ODQ were 9.8 and 6.4, respectively. Age was inversely associated with the 6-month threshold score. Conclusion: PRP appears to be a promising therapeutic strategy for long-lasting postviral OD. Our findings support the conduction of controlled randomized trial in this population of patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to develop a simple self-administered screening tool for odor memory, which allowed users to self-test their olfactory function repeatedly even at home. Methods: One hundred and ten participants were recruited (30 men, age = 50.1 ± 9.9 years; 80 women, age = 47.1 ± 11.5 years); half of them were heathy volunteers, the other half were patients with olfactory dysfunction. Fifty-one healthy participants volunteered for a retest within an interval of a maximum of 14 days. Olfactory function was assessed using the extended Sniffin' Sticks test (SST) comprising tests for odor threshold, identification, and discrimination. All participants received the Novel Olfactory Sorting Task (NOST) which is based on the sorting of 12 matching pairs of odors involving olfactory and cognitive functions. After that, all participants rated questions related to their test performance and the practicability of the test. Results: Consistent with the previous literature, significant effects of age were found. Results showed an acceptable test-retest reliability and a satisfactory validity of the NOST. The NOST score not only had positive correlations with SST, but also was capable of differentiating severe hyposmia/anosmia from normosmia by the score of 5.5 (sensitivity of 76.2%, specificity of 77.6%). Conclusion: The present study showed the good reliability, validity, and possible clinical usefulness of the NOST. As a self-performed screening test, it can be comprehended and conducted easily, which may provide a quick and simple approach to obtaining a global estimation of olfactory and cognitive functions. [ABSTRACT FROM AUTHOR]

Purpose: Olfactory dysfunction is increasingly common among COVID-19 patients, impacting their well-being. Reports have demonstrated decreased levels of cyclic adenosine monophosphate and cyclic guanosine monophosphate among patients with chronic olfactory dysfunction. A prospective randomized clinical trial was developed to demonstrate the efficacy of an oral forskolin regimen treatment, an adenylyl cyclase activator that raises intracellular levels of cyclic adenosine monophosphate, for the treatment of olfactory dysfunction following COVID-19, compared to placebo regimen. Methods: The study enrolled 285 participants with persistent olfactory dysfunction post COVID-19 infection, randomly assigning them to receive either placebo capsules (n = 120) or oral forskolin capsules (n = 165). Follow-up was conducted to track progress, with 18 participants from the placebo group and 12 from the forskolin group lost during this period. Olfactory function was assessed using the "Sniffin' Sticks" test, measuring threshold, discrimination and identification scores before and after treatment. Results: Subjects administered forskolin capsules demonstrated a significant enhancement in their composite TDI (threshold, discrimination and identification) score, suggesting a notable amelioration in olfactory functionality. Moreover, the discrimination and identification scores notably improved within the forskolin group. Conversely, no significant alterations were observed in the threshold scores. Conclusion: This study suggests that forskolin can contribute potentially to improve chronic olfactory dysfunction post COVID-19. Trial registration: DFM-IRB00012367-23-10-001. [ABSTRACT FROM AUTHOR]

Background: Intranasal trigeminal function is important in detecting environmental stimuli. The impact of age-associated chemosensory dysfunction upon taste and olfaction is well described, but an understanding of trigeminal loss (chemesthesis) is lacking. Objective: The goal of this study was to characterize trigeminal function in a cohort of older adults and explore potential impacts. Methods: Twenty-eight participants over 50 years of age were recruited from the community as part of an aging cohort study. This nested cohort completed chemosensory questionnaires, patient-reported outcome measures (PROMs), and psychophysical testing for taste (taste strips), olfaction (Sniffin' Sticks), and trigeminal function (eucalyptol lateralization). Data were analyzed for associations between trigeminal function, olfactory, and taste psychophysical performance, patient-reported metrics, and demographic risk factors. Results: Patient-reported trigeminal impairment is less severe than other chemosensory loss, with mean visual analog scores (VAS, rated 0-100 from least to most severe) for smell (32.9 ± 34.2), taste (20.6 ± 28.4), and trigeminal sensation (9.5 ± 12.8). Despite low VAS scores, psychophysical trigeminal dysfunction was present in 10 (35.7%) subjects. Psychophysical olfactory and taste dysfunction were present in 16 (57.1%) and eight (28.6%) participants respectively. Hypercholesterolemia was associated with psychophysical trigeminal dysfunction (mean lateralization performance in hypercholesterolemia 57.7% ± 17.1 vs. 74.1% ± 10.4, p =.008). Conclusion: Intranasal trigeminal impairment is present in nearly one-third of aging adults when assessed by psychophysical methods but is under-recognized. Hyperlipidemia may be associated with trigeminal impairment. Future inquiries should better characterize these findings in larger and prospective cohorts. [ABSTRACT FROM AUTHOR]

Neurodegenerative diseases such as Alzheimer’s disease and polyglutamine diseases are characterized by abnormal accumulation of misfolded proteins, leading to neuronal dysfunction and subsequent neuron death. However, there is a lack of studies that integrate molecular, morphological, and functional analyses in neurodegenerative models to fully characterize these time-dependent processes. In this study, we used C. elegans models expressing Aβ1-42 and polyglutamine to investigate early neuronal pathogenic features in olfactory neurons. Both models demonstrated significant reductions in odor sensitivity in AWB and AWC chemosensory neurons as early as day 1 of adulthood, while AWA chemosensory neurons showed no such decline, suggesting cell-type-specific early neuronal dysfunction. At the molecular level, Aβ1-42 or Q40 expression caused age-dependent protein aggregation and morphological changes in neurons. By day 6, both models displayed prominent protein aggregates in neuronal cell bodies and neurites. Notably, AWB neurons in both models showed significantly shortened cilia and increased instances of enlarged cilia as early as day 1 of adulthood. Furthermore, AWC neurons expressing Aβ1- 42 displayed calcium signaling defects, with significantly reduced responses to odor stimuli on day 1, further supporting early behavioral dysfunction. In contrast, AWA neuron did not exhibit reduced calcium responses, consistent with the absence of detectable decreases in olfactory sensitivity in these neurons. These findings suggest that decreased calcium signaling and dysfunction in specific sensory neuron subtypes are early indicators of neurodegeneration in C. elegans, occurring prior to the formation of visible protein aggregates. We found that the ER unfolded protein response (UPR) is significantly activated in worms expressing Aβ1-42. Activation of the AMPK pathway alleviates olfactory defects and reduces fibrillar Aβ in these worms. This study underscores the use of C. elegans olfactory neurons as a model to elucidate mechanisms of proteostasis in neurodegenerative diseases and highlights the importance of integrated approaches. [ABSTRACT FROM AUTHOR]

Background: Olfactory dysfunction stands as one of the most prevalent nonmotor symptoms in the initial stage of Parkinson’s disease (PD). Nevertheless, the intricate mechanisms underlying olfactory deficits in Parkinson’s disease still remain elusive. Methods: This study collected rs-fMRI data from 30 PD patients [15 with severe hyposmia (PD-SH) and 15 with no/mild hyposmia (PD-N/MH)] and 15 healthy controls (HC). To investigate functional segregation, the amplitude of lowfrequency fluctuation (ALFF) and regional homogeneity (ReHo) were utilized. Functional connectivity (FC) analysis was performed to explore the functional integration across diverse brain regions. Additionally, the graph theory-based network analysis was employed to assess functional networks in PD patients. Furthermore, Pearson correlation analysis was conducted to delve deeper into the relationship between the severity of olfactory dysfunction and various functional metrics. Results: We discovered pronounced variations in ALFF, ReHo, FC, and topological brain network attributes across the three groups, with several of these disparities exhibiting a correlation with olfactory scores. Conclusion: Using fMRI, our study analyzed brain function in PD-SH, PDN/MH, and HC groups, revealing impaired segregation and integration in PD-SH and PD-N/MH. We hypothesize that changes in temporal, frontal, occipital, and cerebellar activities, along with aberrant cerebellum-insula connectivity and node degree and betweenness disparities, may be linked to olfactory dysfunction in PD patients. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Olfactory dysfunction (OD) in the elderly is common and associated with numerous comorbidities, yet often underrecognized. This study sought to develop an instrument for widespread screening of this condition.Demographic factors, comorbidities, and olfactory‐related questions were examined in a focus group (N = 20) and development cohort (N = 190). The 4‐item Concise Aging adults Smell Test (4‐CAST) screening instrument was then developed to predict OD on Sniffin Sticks testing. An independent validation cohort (N = 147) was then examined to confirm ability of the 4‐CAST to predict OD on Smell Identification Test 40 (SIT40).The most important variables for predicting olfactory loss in older subjects were age, type II diabetes status, Visual Analog Scale (VAS) of overall rating of smell, and VAS of impact of smell upon safety. In the development cohort, the 4‐CAST model yielded predictive probability (area under the curve) of 0.805 (p < 0.001) for predicting the bottom 25th percentile on Sniffin Sticks. Results were similar in the validation cohort, as the 4‐CAST accurately classified 83.8% subjects (area under the curve [AUC] 0.789, p < 0.001) in the bottom 25th percentile of SIT40 testing. The 4‐CAST was able to accurately classify 89.4% of subjects with anosmia.The 4‐CAST is a quick screening instrument for predicting OD in older adults and has similar performance characteristics in independent populations using the two most common validated olfactory tests. Given the high prevalence of unrecognized olfactory loss in this population, this can be a useful tool for practitioners to determine which subjects may benefit from more extensive olfactory testing. [ABSTRACT FROM AUTHOR]

Olfactory loss accompanies at least 139 neurological, somatic, and congenital/hereditary conditions. This observation leads to the question of whether these associations are correlations or whether they are ever causal. Temporal precedence and prospective predictive power suggest that olfactory loss is causally implicated in many medical conditions. The causal relationship between olfaction with memory dysfunction deserves particular attention because this sensory system has the only direct projection to memory centers. Mechanisms that may underlie the connections between medical conditions and olfactory loss include inflammation as well as neuroanatomical and environmental factors, and all 139 of the medical conditions listed here are also associated with inflammation. Olfactory enrichment shows efficacy for both prevention and treatment, potentially mediated by decreasing inflammation. [ABSTRACT FROM AUTHOR]

Early detection and prevention of internalizing problems demand a thorough exploration of latent vulnerabilities before clinical symptoms emerge. Limited research attention has been paid to the influence of olfactory perception, a flexible factor intricately linked to emotional processing and external environmental factors. This study sought to examine the mediating role of olfactory function in the relationship between childhood trauma, encompassing both dimensions of child abuse and neglect, and internalizing problems. A total of 1661 individuals (801 males, Meanage = 21.67 years) participated in wave 1, with 327 participants (152 males, Meanage = 21.8 1 years) included in the follow-up wave 2 three months later. Online questionnaires, including the Childhood Trauma Questionnaire, Self-reported Olfactory Disorder Questionnaire, Beck Depression Inventory, and General Anxiety Disorder-7, were administered. Mediation tests were conducted using Mplus 8. Our findings revealed a significant mediating effect of olfactory dysfunction between childhood trauma and adult internalizing problems in wave 1 (B = 0.224, 95% CI [0.167, 0.294]). Childhood trauma heightened vulnerability to olfactory dysfunction (B = 0.721, 95% CI [0.671, 0.724]), subsequently exacerbating internalizing problems (B = 0.311, 95% CI [0.226, 0.408]). This effect persisted in longitudinal data (abuse: B = 0.686, p < 0.001; neglect: B = 0.200, p < 0.001). Regarding internalizing problems influenced by olfactory function, childhood abuse had a greater impact compared to childhood neglect (wave 1: χ2 = 56.012, p < 0.001; wave 2: χ2 = 5.156, p = 0.023). This study found that olfactory dysfunction mediated the relationship between childhood trauma and internalizing problems, contributing valuable insights into psychopathology and the early identification of symptoms related to internalizing problems. [ABSTRACT FROM AUTHOR]

To identify the differences between COVID-19-associated and non-COVID-19-associated olfactory dysfunction (OD), we analyzed demographic and clinical characteristics based on the causative virus (COVID versus non-COVID groups) in patients with post-infectious olfactory dysfunction (PIOD) who underwent the olfactory questionnaire and olfactory function test. Out of 169 patients with PIOD, 99 were diagnosed with COVID-19 (COVID group), while 70 were not (non-COVID group). The COVID group was younger and had a higher percentage of male patients as well as patients with parosmia than the non-COVID group. In the initial olfactory function tests, the TDI, discrimination and identification scores were significantly higher in the COVID group than in the non-COVID group. TDI scores were significantly increased in patients with PIOD after treatment, regardless of the group. The threshold score was significantly increased by 1.38 in the COVID group while the identification score was significantly increased by 2.67 in the non-COVID group. Patients with COVID-19-associated OD were younger in age, tended to be male, had a higher incidence of parosmia, and had better initial olfactory function test results compared to those with non-COVID-19-associated OD. Following treatment, odor detection threshold improved in the COVID group, whereas odor identification improved in the non-COVID group. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Olfactory dysfunction (OD) is a key symptom of chronic rhinosinusitis (CRS). Although extensively studied in CRS with nasal polyps (CRSwNP), OD in CRS without nasal polyps (CRSsNP) remains under‐researched. This study aims to assess the prevalence of OD and its evolution in surgically naïve patients with CRSsNP undergoing endoscopic sinus surgery (ESS).This prospective study included 97 participants with CRSsNP (mean age, 46.5 years; 70.1% men) and 97 healthy controls (mean age, 46.5 years; 70.1% men). Participants underwent psychophysical evaluations of orthonasal (using the Sniffin’ Sticks test) and retronasal olfaction (using powdered aromas) at enrolment and 6 months post‐ESS.Out of 97 patients, 81 (83.5%) completed all assessments. At enrolment, 23 (28.4%) CRSsNP patients had OD based on composite threshold, discrimination, identification scores, compared with 7 (8.6%) controls (absolute % difference, 19.8% [95% CI, 8.2–31.4]). Retronasal olfactory function was also significantly worse in CRSsNP patients. Six months post‐ESS, 30 patients (37.0%) experienced a clinically significant improvement in olfactory, whereas nonsignificant changes were observed in retronasal olfactory score, and 3.7% of patients experienced a deterioration of the olfactory function.In conclusion, although 37% of patients experienced a clinically significant improvement in their sense of smell following ESS, the overall prevalence of OD in this surgically naive population appears relatively low, especially when compared to that observed in patients with CRSwNP. Therefore, ESS may offer some benefits for enhancing orthonasal olfactory function, but the extent of these improvements appears to be limited. [ABSTRACT FROM AUTHOR]

Objective: The present study objectived to investigate the influence of Ramadan fasting (RF) on olfactory function. Methods: Sixty‐two participants were included in the current prospective study. The odor threshold and identification performances were determined by using the Connecticut Chemosensory Clinical Research Center (CCCRC) test initially (day 0) and on the first and last day (30th) of RF. Body weight (BW)s were measured initially and at the end of the study. The results were analyzed statistically. Results: The average of baseline and last‐day BWs were 78.38 ± 12.96 and 78.36 ± 12.39 kg, respectively. No significant difference was determined in terms of BWs (p =.932, p >.05). In the evaluation of CCCRC test outcomes, significant differences were observed in the scores of butanol thresholds (p =.0001), odor identification (p =.0001), food‐related odors identification (p =.0001), and the number of normosmic individuals (p =.0001) at different times (p <.05). The thresholds scores (p =.0001, p =.0001), the identification scores (p =.0001, p =.0001), food‐related odors identification scores (p =.0001, p =.0002), and the number of normomic individuals (p =.001, p =.001) detected on 30th day were significantly higher than on 0th and 1st days; respectively (p <.05). Additionally, the threshold scores (p =.0001), the identification scores (p =.003), food‐related odors identification scores (p =.007), and the number of normosmic individuals (p =.018) detected on day 1 were significantly higher than on day 0 (p <.05). Conclusion: The current study demonstrated that Ramadan fasting enhances the olfactory detection threshold and odor identification scores, significantly improving the identification of food‐related odors. The results may indicate that Ramadan fasting improves olfactory performance. Level of evidence: Level II. [ABSTRACT FROM AUTHOR]

Objectives: A self-administered Computerized Brief Smell Identification Test (cB-SIT) was developed recently to perform the olfactory identification test under computer control. The aim of this study was to evaluate the clinical applicability of the cB-SIT as compared with the traditional Brief Smell Identification Test (B-SIT). Methods: Sixty healthy volunteers with self-reported normal olfactory function, 30 hyposmic patients, and 30 anosmic patients were enrolled from June 2023 to May 2024. All enrolled participants received both B-SIT and cB-SIT in a random order to measure their odor identification ability. Thirty healthy volunteers took the second B-SIT and cB-SIT at least one week later. Results: The score was significantly different in both B-SIT and cB-SIT among healthy volunteers, hyposmic, and anosmic patients. The correct answer rate was significantly different in 10 items of the B-SIT and in 7 items of the cB-SIT among the three groups, but the post hoc test showed significant differences in correct answer rates between healthy volunteers and hyposmic patients in 7 items of both the B-SIT and cB-SIT. Test–retest results showed the score of the second B-SIT test was significantly higher than that of the first test, but the scores of the two tests of the cB-SIT were not significantly different. In the B-SIT, the lemon odorant had a higher correct answer rate in the second test than in the first test, but in the cB-SIT, the correct answer rate was not significantly different between the first and second tests in all 12 items. Conclusions: Our findings demonstrate that the cB-SIT was similar to the B-SIT and can be administered in the diagnosis of patients with olfactory dysfunction. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors (ICIs) are a rapidly expanding class of oncologic therapies whose mechanism of action can result in unique immune-related adverse events (irAEs) not seen in other cancer therapeutics. The objective of this study was to determine the presence of sinonasal irAEs with these medications. Methods: A case report of chronic rhinosinusitis with nasal polyps (CRSwNP) caused by an ICI is presented and was the impetus for this review. Review of the literature using Pubmed and Cochrane Database of Systematic Reviews was performed. Additionally, we searched the FDA adverse event reporting system (FAERS) database for sinonasal AEs in the 7 FDA-approved ICIs. Results: We demonstrate an emerging scientific literature describing cases of CRS associated with multiple ICIs with a particular predilection toward TH2 driven phenotypes. Review of the FAERS also demonstrates a small percentage of patients who report sinonasal complaints after initiating ICI therapy. Conclusion: Sinonasal symptoms and the development of CRS, in particular, are not currently well recognized as potential irAEs for ICIs. Increased awareness and further study may help to elucidate if these are more common than currently reported and if irAE-related CRS is a unique phenotype. [ABSTRACT FROM AUTHOR]

Purpose: This pilot study aimed to determine whether the Henkin olfactory test discriminates between the olfactory function of patients with olfactory loss and healthy individuals, and whether the Henkin test is correlated with a validated psychophysical olfactory test. Methods: Participants underwent olfactory testing using the modified Henkin test (including detection [DT] and recognition [RT] thresholds, magnitude estimation [ME], and hedonic ratings [H], for four different odors) and the extended "Sniffin' Sticks" test battery (odor detection, discrimination, identification). Results: Forty-four individuals (28 women, aged 19–81 years, mean: 39 years) were included. Twenty-three were healthy (mean age: 38 years) and 21 had olfactory dysfunction (OD) (mean age: 40 years). OD patients had worse mean DT, lower composite RT, and lower ME ratings. Mean and individual odor H ratings were not significantly different between the groups. Most individuals were classified as hyposmic when using the prescribed classification by Henkin, with only very few satisfying the stringent criteria of anosmia and normosmia. Modified Henkin subtests were all positively correlated with each other and with the "Sniffin' Sticks", except for Unpleasant Mean H which was only correlated with Pleasant Mean H; and Pleasant mean H which was not correlated with mean DT scores. Conclusion: The Henkin test is able to separate between OD patients and controls. However, modifications to the conduct of this test may be required. Studies that used this test should be carefully interpreted. Level of evidence: 3. [ABSTRACT FROM AUTHOR]

Purpose: Evaluating the impact of radioiodine therapy (RIT) on olfactory function in thyroid cancer patients through quantitative and qualitative olfactory tests. Method: In this cohort study, patients with thyroid cancer were included. Demographic, clinical, and laboratory data were collected. To subjectively evaluate the olfactory changes aftter RIT, the Visual Analog Scale (VAS), Self-Reported Mini-Olfactory Questionnaire (self-MOQ), and the University of Washington Quality of Life Questionnaire (UW-QOL) were assessed. Out of UW-QOL questions those related to saliva, taste, and overall health condition were analysed. For objective assessment, patients underwent both the Butanol Threshold Test (BTT) and the a version of Smell Identification Test (SIT). Patients were assessed before, one month, and six months after RIT. Results: Ninety eight patients were included (Male = 17). A statistically significant decrement was observed in olfaction based on the VAS, between the baseline and one (pvalue = 0.015) and six months (pvalue = 0.031) of follow-up. Additionally, saliva (pvalue = 0.001), taste (pvalue = 0.000), and overall health condition (pvalue = 0.010) significantly decreased one-month after RIT. The measures were not different between the baseline and 6-month follow up and the improvement of index of taste was significant from 1-month to 6-months follow ups (pvalue = 0.000). However, none of the objective tests (the BTT and the SIT) indicated a significant decline in olfaction during the follow up. Conclusion: A subjective RIT related decrease in smell function, taste, and saliva production was documented without any objective olfactory dysfunction. [ABSTRACT FROM AUTHOR]

Purpose: Study the efficacy of olfactory training in smell recovery. Methods: An extensive search was performed through different databases in order to find articles analyzing the efficacy of olfactory training as a treatment for olfactory dysfunction. Methodological quality of primary studies within the final sample was assessed following PRISMA guidelines. Standardized mean differences in pre–post olfactory training groups, and also in experimental-control and pre-follow up if possible, were computed by Hedges' g effect size statistic. Each effect size was weighted by its inverse variance. Results: Final sample was composed of 36 articles (45 pre–post effect sizes). Contrasts were performed separately for odor identification, odor discrimination, odor threshold and general olfactory function. Moderate to large and heterogeneous effect was obtained for olfactory function (g = 0.755, k = 45, SE = 0.093, CI 95% = [0.572, 0.937]), different moderators had a significant effects, such as, training duration, age and anosmia diagnosis. Conclusion: Olfactory training was found to have a positive and significant effect on rehabilitating the olfactory function. [ABSTRACT FROM AUTHOR]

Background: Intranasal corticosteroids (INCS) are used for several conditions, including allergic rhinitis and sinusitis. Consequently, their safety profile needs continuous monitoring. This study aimed to analyse the adverse drug reactions (ADRs) of the INCS with market authorisation in Europe. Methods: A retrospective analysis of the ADR data from EudraVigilance in the period between the 1 January 2011 and 12 June 2023 was performed, with 2641 reports selected for analysis. ADRs were categorised by seriousness and evolution, with a focus on the most prevalent ADRs and their alignment with the Summary of Product Characteristics (SmPC). Results: The 18–64 age group, particularly females, was most affected. Mometasone was the most reported INCS, with predominantly non-serious ADRs, evolving towards resolution, which often were not listed in the SmPC. From the reported ADRs that were not described in the SmPC of the INCS studied, "Anosmia" and "Ageusia" were highlighted. Regarding the ADRs described in the SmPC, the most frequently reported were "Epistaxis" and "Headache". The ADRs belonging to the Designated Medical Event list were also analysed, with "Angioedema" as the most reported ADR, which was mainly associated with budesonide. Conclusions: These findings underscore the importance of continuous INCS monitoring to mitigate ADRs and safeguard public health. Further research is warranted to explore potential novel signs for safety arising from previously unreported ADRs. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is typically a sporadic late-onset disorder, which has made it difficult to model in mice. Several transgenic mouse models bearing mutations in SNCA, which encodes alpha-Synuclein (a-Syn), have been made, but these lines do not express SNCA in a physiologically accurate spatiotemporal pattern, which limits the ability of the mice to recapitulate the features of human PD. Here, we generated knock-in mice bearing the G51D SNCA mutation. After establishing that their motor symptoms begin at 9 mo of age, we then sought earlier pathologies. We assessed the phosphorylation at Serine 129 of a-Syn in different tissues and detected phospho-a-Syn in the olfactory bulb and enteric nervous system at 3 mo of age. Olfactory deficit and impaired gut transit followed at 6 mo, preceding motor symptoms. The SncaG51D mice thus parallel the progression of human PD and will enable us to study PD pathogenesis and test future therapies. [ABSTRACT FROM AUTHOR]

Olfactory dysfunction is associated with aging and the earliest stages of neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases; it is thought to be an early biomarker of cognitive decline. In marmosets, a small non-human primate model used in brain research, olfactory pathway activity during olfactory stimulation has not been well studied because of the difficulty in clearly switching olfactory stimuli inside a narrow MRI. Here, we developed an olfactory-stimulated fMRI system using a small-aperture MRI machine. The olfactory presentation system consisted of two tubes, one for supply and one for suction of olfactory stimulants and a balloon valve. A balloon valve installed in the air supply tube controlled the presentation of the olfactory stimulant, which enabled sharp olfactory stimulation within MRI, such as 30 s of stimulation repeated five times at five-minute intervals. The olfactory stimulation system was validated in vivo and in a simulated system. fMRI analysis showed a rapid increase in signal values within 30 s of olfactory stimulation in eight regions related to the sense of smell. As these regions include those associated with Alzheimer's and Parkinson's diseases, olfactory stimulation fMRI may be useful in clarifying the relationship between olfactory dysfunction and dementia in non-human primates. [ABSTRACT FROM AUTHOR]

Although the few studies available on Olfactory Reference Disorder (ORD) indicate that the disorder is associated with fear of rejection, avoidance and impairment of social relationships, there are no investigations that have examined loneliness and social pain in individuals with ORD. Additionally, despite studies showing elevated comorbidity of ORD and Major Depressive Disorder (MDD), the relationship between ORD according to the ICD-11 and depressiveness has not been investigated. This exploratory pilot study examined the association of symptoms of ORD according to the ICD-11 with emotional/social loneliness, social pain and depressiveness. A total of 225 German university/college students participated in an anonymous internet-based survey. Severity of ORD symptoms were significantly associated with more severe depressiveness, greater emotional and social loneliness as well as greater social pain. In our sample, participants with self-reported ORD reported on average elevated levels of social pain and loneliness. A total of 93.3% of the participants with self-reported ORD had elevated scores of depressiveness. Emotional and social loneliness remained significantly correlated with ORD symptoms in partial correlations that adjusted for depressive symptoms. In a multiple regression analysis, olfactory concerns were associated with the total loneliness score independent of the effects of depressiveness and social pain. These preliminary results highlight the importance of considering depressive symptoms and social pain in the assessment and treatment of ORD. In addition, results suggest that individuals suffering from ORD might be at increased risk for loneliness. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methodology Results Conclusions Fortunately, the majority of COVID‐19 patients recover from olfactory dysfunction (OD) within the first couple of weeks. However, from approximately 5% up to 20% continue to suffer from OD even more than 1 year after the onset. Nonetheless, factors associated with long‐lasting OD are hardly known. The aim of this study was to identify favourable and disadvantageous markers of persisting OD in COVID‐19 patients.Sixty‐six patients (46 female; mean age: 39.9 years) that suffer from OD longer than 6 months due to laboratory‐confirmed SARS‐CoV‐2 infection have participated in this longitudinal study. Participants completed comprehensive psychophysical chemosensory tests (i.e., Sniffin' Sticks = TDI) and questionnaires twice at our department—on average 219 ± 80 (T‐1) and 489 ± 89 (T‐2) days after the onset of symptoms, respectively. Olfactory recovery rates were associated with demographic factors and questionnaires using linear regression analysis.Patients below 40 years of age improved better (TDI: 4.1 ± 4.3 vs. 0.7 ± 5.8; p = 0.008) and achieved statistically significant higher scores (TDI: 31.5 ± 4.0 vs. 27.3 ± 6.7; p = 0.033) regarding psychophysical chemosensory tests. Furthermore, linear regression analysis revealed that parosmia was associated with worse orthonasal smell function (T‐1: β = −0.346, p = 0.004; T‐2: β = −0.384, p = 0.001), especially concerning identification subtest (T‐1: β = −0.395, p = 0.001; T‐2: β = −0.398, p < 0.001). Moreover, increasing parosmia between T‐1and T‐2 led to worse orthonasal olfactory function (β = −0.294, p = 0.016).Older age and parosmia seem to be unfavourable factors of persisting OD in COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion While olfactory function decreases with age, it is unknown how age affects olfactory training (OT) efficacy. This study compared OT in two cohorts of subjects: aged ≤50 (younger cohort) and aged 51+ (older cohort) with olfactory dysfunction (OD) primarily from COVID‐19 infection.Subjects with OD primarily secondary to COVID‐19 infection were prospectively recruited and enrolled into an OT registry. Baseline data were collected and they were provided with a training kit and asked to complete OT at home twice daily for 6 months. Participants were asked to follow‐up at 3 and 6 months during training for olfactory testing and quality‐of‐life surveys (Sino‐Nasal Outcomes Test‐22 [SNOT‐22] and Questionnaire of Olfactory Disorders Negative Statements [QoD‐NS]).Fifty‐six participants completed OT (younger cohort: n = 26, older cohort: n = 30). There were no significant differences between cohorts’ Affordable Rapid Olfactory Measurement Array (AROMA), QoD‐NS, or SNOT‐22 scores at any time point. Both cohorts showed significant AROMA score improvement of more than 16 points from baseline to 3 months (younger cohort: p = 0.001; older cohort: p = 0.008). The younger cohort had significant improvements in QoD‐NS (p = 0.008) and SNOT‐22 (p = 0.042) between baseline and 3 months while the older cohort improved from 3 to 6 months (QoD‐NS: p = 0.027, SNOT‐22: p = 0.049).Both cohorts demonstrated similar significant improvement in olfactory function after 3 months of OT. The timeline of subjective improvement was different between cohorts, with younger patients experiencing earlier improvement. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess COVID‐19‐related gray matter (GM) structural alterations in two distinct groups of patients presenting with the prevailing and distinctive COVID‐19‐related neurological symptoms – isolated olfactory disorders as sole neurological manifestation (COVID‐OD) and cognitive disorders (COVID‐CD) – as compared to a control group of unaffected individuals. Methods: The study included 61 COVID‐CD patients (57 [60–63] years, 62% females), 84 COVID‐OD patients (49 [35–57] years, 60% females), and 17 controls (51 [41–52] years, 41% females). Region‐based morphometry (RBM) and voxel‐based morphometry (VBM) were performed on T1‐weighted MRI scans to assess GM regional volume and voxel‐wise density differences between COVID‐19 patients and controls. Surface‐based morphometry (SBM) was applied to investigate cortical thickness alterations. The statistical models built to assess GM structural differences among groups included total intracranial volume and age as nuisance variables. Results: The multi‐morphometric analysis revealed statistically significant (p < 0.05 corrected for multiple comparisons) reduction in GM regional volumes, in voxel‐wise GM density and in cortical thickness in both COVID‐CD and COVID‐OD patient groups as compared to controls. Across all three analyses, COVID‐CD patients showed more distributed and severe GM loss than COVID‐OD patients. The most prominently affected GM regions in the COVID‐CD group included the hippocampus, putamen, cingulate gyrus, precuneus, precentral and postcentral gyri, amygdala, lingual gyrus, and caudate nucleus. Interpretation: Our MRI findings show that COVID‐19‐related olfactory and cognitive disorders both induce GM atrophy, although at different degrees of severity, likely indicative of neurodegeneration and neuroinflammation. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking has a negative impact on the chemosensory function. The aim of the study was to evaluate the effects of smoking experience and type of tobacco products on gustatory and olfactory function. METHODS This study included 30 conventional cigarette smokers, 30 heated tobacco products (HTPs) users, and 30 non-smokers. Olfactory function was assessed with a 'Sniffin' Sticks Screening 12 Test' while the taste function was assessed with 'taste strips' for the basic tastes of sweet, sour, salty, and bitter. The lifetime exposure to smoking was calculated using the Brinkman index (BI). RESULTS Conventional cigarette smokers demonstrated decreased olfactory function in comparison to non-smokers (median: 10 vs 11; p=0.001) but HTPs users did not differ between those two groups. Overall gustatory function was lower in conventional cigarette smokers (median: 9.5) and HTPs users (median: 10) than in non-smokers (median: 14; p<0.001). A difference was detected in the sour, salty and bitter taste but without significant difference between HTPs users and conventional cigarette smokers. Negative linear correlations were found between the BI and olfactory function, overall gustatory function, sour, salty, and bitter taste (r= -0.317 - -0.585; p≤0.002). In multiple linear regression, BI was the only predictor of olfactory dysfunction when controlling for the effect of tobacco products, age, and gender accounting for 11% of variance (p=0.024, R²=0.123). For gustatory dysfunction, BI was the strongest predictor followed by gender and tobacco products accounting for 11%, 5%, and 4% (p<0.001, R²=0.259). CONCLUSIONS Olfactory and gustatory function are adversely associated with smoking, more depending on BI than tobacco product. [ABSTRACT FROM AUTHOR]

Trimethylaminuria (TMAU), colloquially known as fish odour syndrome, is a rare metabolic disorder characterised by the body's inability to properly metabolise Trimethylamine (TMA), resulting in a distinctive and unpleasant fishy odour in bodily secretions. This comprehensive review explores the pathophysiology, clinical manifestations, genetic basis, diagnostic challenges, and psychological impact of TMAU, along with management strategies. Genetic mutations affecting the flavin-containing monooxygenase 3 (FMO3) enzyme, which is responsible for TMA metabolism, contribute to the condition's hereditary nature. Diagnosis can be challenging due to intermittent symptoms and overlaps with other conditions, such as Olfactory Reference Syndrome (ORS). The psychosocial impact of TMAU can be profound, leading to embarrassment, social isolation, and mental health issues. Management strategies include dietary modifications, supplements, antibiotics, and hygiene measures to alleviate symptoms. Despite advances in understanding TMAU, further research is needed to enhance diagnostic accuracy and therapeutic approaches, ultimately improving the quality of life for affected individuals. [ABSTRACT FROM AUTHOR]

Taste and smell disorders can worsen the nutritional status of patients receiving chemotherapy and potentially affect drug treatment. However, there is limited knowledge on antineoplastic agents that induce taste and smell disorders. Therefore, we used the U.S. Food and Drug Administration Adverse Event Reporting System database to analyze the characteristics of patients and antineoplastic agents in relation to taste and smell disorders. No gender differences related to the onset of taste and smell disorders were found, whereas older age was identified as a possible risk factor. Among the antineoplastic agent classes, protein kinase inhibitors appeared to be particularly likely to induce taste and smell disorders. According to the cluster and principal component analyses, antineoplastic agents were deemed to induce taste or smell disorders. In addition, antineoplastic agents that decreased or changed these sensations could be classified. These findings might be useful in selecting drugs for patients experiencing similar side effects. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate recovery patterns of olfactory dysfunction among recovered COVID-19 patients, both subjective and objective, and correlate this recovery to the severity of the disease. Methods: The study recruited 200 patients and assigned them to two equal groups, one of them was a control group. The olfactory function of the study group was assessed via subjective and objective methods at baseline and then monthly for three months, with changes in smell function reported at each visit. These patients underwent chemosensory testing using the Sniffin' Sticks test and completed the validated Arabic version of the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS). Results: Olfactory dysfunction occurred on the first day of COVID-19 symptoms in 37% of participants. Subjective reports suggested smell recovery in 55% after 3 months, but Sniffin' Sticks showed only 1% with normal function, indicating persistent deficits in others. This study revealed smell recovery for 93% of participants (median 14 days), with most (58%) recovering within 2 weeks. No significant links were found between demographics, COVID-smell loss timing, and recovery speed. Conclusion: Three months after COVID-19, many patients perceive smell recovery, but objective tests reveal shockingly high rates of persistent dysfunction. Further follow-up with objective tests is vital to assess the true burden and potential long-term effects of smell loss. [ABSTRACT FROM AUTHOR]

Objective: Most patients with olfactory dysfunction experience stress and anxiety because of the inconvenience and changes caused by the loss of olfaction. However, psychological assessment is not performed routinely in patients with olfactory dysfunction, and the characteristics of these patients with psychological depression are unclear. Methods: In this study, we used the Self-rating Depression Scale to evaluate the degree of depression in patients who visited our clinic with olfactory dysfunction and examine the characteristics of these patients with strong depressive tendencies. Patients who visited our clinic between April 2019 and March 2020 with complaints of olfactory dysfunction were included in the study. Results: A total of 180 patients (79 male and 101 female) underwent olfactory examination and completed the Self-rating Depression Scale. Eighty-six and 94 patients were included in the low depression and high depression groups, respectively. Binomial logistic regression analysis showed significant positive associations of Self-rating Depression Scale scores with female sex and the presence of parosmia/phantosmia (p < 0.05). Conclusion: In our study, approximately half of the patients with olfactory dysfunction had depressive tendencies especially in female and parosmia/phantosmia patients. We believe that psychological assessments, such as that with the SDS, can help identify patients with olfactory dysfunction who may be at a greater risk of developing depression. [ABSTRACT FROM AUTHOR]

Background: Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults. Methods: We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self‐rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function. Results: We analyzed data from 3940 respondents over 10 years of follow‐up. A greater number of sensory disabilities was associated with greater hazard of low self‐rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self‐rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self‐rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01). Conclusions: Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults. [ABSTRACT FROM AUTHOR]

The genome of the Nipah virus (NiV) encodes a variety of structural proteins linked to a diverse array of symptoms, including fevers, headaches, somnolence, and respiratory impairment. In instances of heightened severity, it can also invade the central nervous system (CNS), resulting in more pronounced problems. This work investigates the effects of NiV on the blood-brain barrier (BBB), the vital physiological layer responsible for safeguarding the CNS by regulating the passage of chemicals into the brain selectively. To achieve this, the researchers (MMJAO, AM and MNMD) searched a variety of databases for relevant articles on NiV and BBB disruption, looking for evidence of work on inflammation, immune response (cytokines and chemokines), tight junctions (TJs), and basement membranes related to NiV and BBB. Based on these works, it appears that the affinity of NiV for various receptors, including Ephrin-B2 and Ephrin-B3, has seen many NiV infections begin in the respiratory epithelium, resulting in the development of acute respiratory distress syndrome. The virus then gains entry into the circulatory system, offering it the potential to invade brain endothelial cells (ECs). NiV also has the ability to infect the leukocytes and the olfactory pathway, offering it a "Trojan horse" strategy. When NiV causes encephalitis, the CNS generates a strong inflammatory response, which makes the blood vessels more permeable. Chemokines and cytokines all have a substantial influence on BBB disruption, and NiV also has the ability to affect TJs, leading to disturbances in the structural integrity of the BBB. The pathogen's versatility is also shown by its capacity to impact multiple organ systems, despite particular emphasis on the CNS. It is of the utmost importance to comprehend the mechanisms by which NiV impacts the integrity of the BBB, as such comprehension has the potential to inform treatment approaches for NiV and other developing viral diseases. Nevertheless, the complicated pathophysiology and molecular pathways implicated in this phenomenon have offered several difficult challenges to researchers to date, underscoring the need for sustained scientific investigation and collaboration in the ongoing battle against this powerful virus. [ABSTRACT FROM AUTHOR]

Background: Olfactory dysfunction (OD) affects many survivors of COVID‐19. Prior studies have investigated the use of platelet‐rich plasma (PRP) injections for OD. We describe the first randomized controlled trial investigating topical PRP for OD treatment and contribute to existing literature illustrating PRP as an emerging therapeutic. Methods: This is a single‐blinded, randomized controlled trial conducted from July 2022 to December 2023. Adult patients with OD ≥6 months secondary to COVID‐19 with Brief Smell Identification Test (BSIT) scores of ≤8/12 or SCENTinel odor intensity of ≤40/100 were included. Patients were randomized to three, monthly PRP or placebo‐impregnated Surgifoam treatments into bilateral olfactory clefts. The BSIT, SCENTinel, and Questionnaire of Olfactory Disorders—Negative Statements (QOD‐NS) were completed monthly through month 12. Results: Of 104 patients screened, 83 participated. No significant differences in age, OD duration, BSIT, SCENTinel, or QOD‐NS scores were found between PRP (n = 42) and placebo (n = 41) patients at baseline. PRP patients experienced a statistically significant increase in BSIT scores from baseline at months 5‒9, 11, and 12, while placebo patients did not (p < 0.05). However, total BSIT scores were similar between the two groups throughout the study. Neither the SCENTinel odor intensity scores nor the change from baseline were significantly different between the treatment groups. At month 12, PRP patients experienced minor improvement in OD‐related quality‐of‐life compared with placebo. Conclusions: This study is the first to describe topical PRP as a safe, experimental treatment for OD in humans. PRP may impact odor identification in post‐COVID‐19 OD patients, although the lack of difference in total BSIT scores highlights the need for further study. [ABSTRACT FROM AUTHOR]

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Background and Hypothesis Persistent auditory verbal hallucinations (pAVHs) and olfactory identification impairment are common in schizophrenia (SCZ), but the neuroimaging mechanisms underlying both pAVHs and olfactory identification impairment are unclear. This study aimed to investigate whether pAVHs and olfactory identification impairment in SCZ patients are associated with changes in cortical thickness. Study Design In this study, cortical thickness was investigated in 78 SCZ patients with pAVHs (pAVH group), 58 SCZ patients without AVHs (non-AVH group), and 83 healthy controls (HC group) using 3T magnetic resonance imaging. The severity of pAVHs was assessed by the Auditory Hallucination Rating Scale. Olfactory identification deficits were assessed using the Odor Stick Identification Test for Japanese (OSIT-J). In addition, the relationship between the severity of pAVHs and olfactory identification disorder and cortical thickness abnormalities was determined. Study Results Significant reductions in cortical thickness were observed in the right medial orbital sulcus (olfactory sulcus) and right orbital sulcus (H-shaped sulcus) in the pAVH group compared to both the non-AVH and HC groups (P  < .003, Bonferroni correction). Furthermore, the severity of pAVHs was found to be negatively correlated with the reduction in cortical thickness in the olfactory sulcus and H-shaped sulcus. Additionally, a decrease in cortical thickness in the olfactory sulcus showed a positive correlation with the OSIT-J scores (P  < .05, false discovery rate correction). Conclusions Cortical thickness abnormalities in the olfactory sulcus may be a common neuroimaging mechanism for pAVHs and olfactory identification deficits in SCZ patients. [ABSTRACT FROM AUTHOR]

Sinonasal teratocarcinosarcoma (SNTCS) is a rare malignancy characterized by a highly aggressive nature. It mainly arises in the ethmoidal or maxillary sinus. SNTCS has a poor prognosis, with a mean survival rate of 55% at 2 years. Herein, we presented a case of advanced SNTCS successfully treated with surgery followed by chemoradiotherapy plus targeted therapy and reviewed the published literature on this rare entity. [ABSTRACT FROM AUTHOR]

Background: COVID-19 developed a sudden onset of smelling disorders. Researchers used self-reported or special tests to study this issue. We aimed to investigate whether quantitative-test smell disorders have a considerable difference from self-reported or not. Methods: We searched 554 studies published between December 2019 to September 2020 by the PICO model. Our search strategies were based on MeSH terms in the electronic databases Web of Science (136 articles), Scopus (84 articles), and PubMed (334 articles). The duplicated articles were excluded, then the preferred reporting items for systematic reviews and meta-analysis guidance were utilized. Finally, we divided the studies into two (self-report (33 articles) and specific-test (9 articles)) groups. Results: 33 (80%) articles expressed olfactory dysfunction by self-report of patients and 9(20%) studies were conducted by a specific test. Only three studies, one in self-report; ((internal reliability, Cronbach α = 0.84) and validity (r = -0.60, p < 0.001)) and two in specific-test groups; ((test-retest r=0.94) and another study (test-retest r >0.7)) conducted validity and reliability. Self-reported studies published a various range of prevalence (20% _97%) in patients with COVID-19. COVID-19 patients with a specific-test group were found to have a primary incidence of anosmia of over 65%, even reaching 98% depending on the types of tests. Conclusion: Self-reporting of COVID-19 detection can be affected by sociodemographic factors. Although self-reported questionnaires are economical and easy to use, standardized tests provide more reliable comparisons and professional assessments. Therefore, standardized tests are recommended for more accurate screening over self-reporting. [ABSTRACT FROM AUTHOR]

Objective The assessment of baseline olfactory function before endoscopic skull base surgery (ESBS) has been relatively limited compared with analysis before functional endoscopic sinus surgery (FESS). Our study addresses this knowledge gap, assessing preoperative olfactory function in ESBS and FESS and elucidating any differences. Study Design We conducted a retrospective review of patients undergoing anterior ESBS or FESS at a single institution between 2021 and 2022. We included 171 patients and compared their reported and measured preoperative olfactory function using the Sino-Nasal Outcome Test questionnaire and the 40-item University of Pennsylvania Smell Identification Test. Results Of the 171 patients included in this study, 30% of patients underwent ESBS and 70% underwent FESS. Of all patients, only 57% correctly reported their objective preoperative olfactory function. Of the 36 ESBS patients with measured preoperative hyposmia, only 31% correctly reported hyposmia, while 69% incorrectly reported normosmia. This distribution significantly differs (p < 0.0001) from the FESS subset (89 patients), with 64% correctly reporting hyposmia and 36% incorrectly reporting normosmia. Conclusion Our analysis demonstrates higher than anticipated underreporting of preoperative hyposmia in patients undergoing ESBS as well as discrepancies between subjective and objective olfactory functions in the FESS population. The results highlight several gaps in knowledge regarding perioperative olfactory function that would be best examined with more thorough pre- and postoperative objective olfactory testing. This analysis demonstrates significant prognostic uncertainty for patients and providers and creates significant medicolegal uncertainty regarding the appropriate attribution of postoperative olfactory loss in cases without objective preoperative testing. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to determine the clinical characteristics and cephalometric risk factors associated with decreased postoperative olfaction in patients in whom the transplanum and transtuberculum expanded endonasal approach (EEA) was performed. Methods A retrospective cohort of 41 patients treated with the transplanum and transtuberculum EEA was divided into two groups based on the maximum change in the postoperative 22-item Sino-Nasal Outcome Test (SNOT22) olfaction score: prolonged olfactory loss group (n = 5) with a ΔSNOT22 olfaction score of ≥ 4 without a return to baseline and a preserved olfaction group (n = 36) with a ΔSNOT22 olfaction score ≤ 3 with return to baseline on follow-up of at least 3 months. Demographics, operative details, and cephalometric measurements were compared between the two groups. Results There were no differences in terms of the type of surgical approach (transplanum and transtuberculum), resection of turbinates (middle and superior), use of reconstructive flap (nasoseptal flap and reverse flap), or tumor pathology between the two groups. In the prolonged olfactory loss group, there was a smaller angle between the planum and the face of the sella (89.75 ± 9.18 vs. 107.17 ± 16.57 degrees, p = 0.05) and a smaller angle between the anterior nasal spine and the sphenoid sinus face (21.20 ± 2.49 vs. 25.89 ± 4.90 degrees, p = 0.047) compared with the preserved olfaction group. Conclusion Patients with a narrow angle between the planum and the face of the sella or that between the anterior nasal spine and the sphenoid sinus face are at a higher risk of prolonged olfactory dysfunction with the transplanum and transtuberculum approaches. Level of Evidence IV. [ABSTRACT FROM AUTHOR]

Purpose: To examine the long‐term effects of COVID‐19 on surgical nurses. Background: Individuals contaminated with COVID‐19 may face several metabolic or psychological issues, primarily in the respiratory, cardiovascular, nervous, musculoskeletal and renal systems during the late period. However, the long‐term epidemiology is still not clear. Design: Descriptive cross‐sectional study. Methods: The study included nurses (n = 509) who had been diagnosed with COVID‐19 at least 12 weeks before and worked in surgical departments. We collected the study data via an online survey using the snowball sampling method between December 2021 and May 2022. This study followed the Reporting of Observational Studies in Epidemiology Guideline. Results: The mean age of the nurses was 31.66 ± 8.74 years. Nurses stated that they were diagnosed with COVID‐19 approximately 36 weeks before participating in this study. We found that the nurses mostly experienced palpitation (83.5%), headache (73.5%), dyspnea (64.1%), anosmia (57.6%), arthralgia (55.7%) and burnout (58.4%) during the late period after COVID‐19. Conclusion: The long‐term effects of COVID‐19 were related to multiple organ dysfunctions. No Patient or Public Contribution: Since the study was conducted with healthy individuals who had previously experienced COVID‐19, there is no patient contribution. Relevance to Clinical Practice: This study focuses on the long‐term effects of COVID‐19 on nurses. The results support the long‐term effects of COVID‐19 and are thought to contribute to the literature. [ABSTRACT FROM AUTHOR]