Search

Introduction Smell disorders are common in the general population and occur e.g., after infections, trauma or idiopathically Treatment strategies for smell loss range from surgery, medication to olfactory training, depending on the pathology, but they are limited This study examined the effect of acupuncture on olfactory function. Methods Sixty patients with smell loss following infections of the upper respiratory tract were included in this investigation Half of the study group were randomly assigned to verum acupuncture and the other half to sham acupuncture Olfaction was measured by means of the “Sniffin’ Sticks” test battery (odour threshold, discrimination and identification). Results Compared to sham acupuncture, verum was associated with an improvement of smell function as measured by the TDI score (p = 0.039) The improvement was largely determined by improvement in odour discrimination, and was significantly better in patients with a shorter duration of the disorder. Conclusion The present results suggest that acupuncture is an effective supplementary treatment option for patients with olfactory loss.

The works purpose was to study connection between smell malfunction that reduces level of smell recognition (anosmia) and current emotional condition of patients who suffer from schizophrenia spectrum disorders and patients with depressive disorders. Methods of research. Patients who suffer from schizophrenia spectrum disorders (F20, F21, F23, F25), depressive disorders (F32, F33), and healthy individuals were examined. Methods of evaluation of current emotional condition were Beck Depression Inventory and SnaithHamilton Pleasure Scale. To determine malfunction of smell function Professional olfactometric set of odorous substances RAMORA was used. Results. In patients with schizophrenia spectrum disorders, the level of smell recognition is significantly lower than in the group of patients suffering from depressive disorders and the group of healthy people. When comparing patients with depressive disorders with a group of healthy individuals, there is a slight decrease in the identification of odors, close to normal values. In patients with depressive disorders and patients with schizophrenia, an increase in the level of anhedonia and depression is detected in comparison with healthy subjects. The overall level of smell recognition is not related to the indicators of the current emotional state (depression and anhedonia) in both clinical groups. However, the relationships between the identification of individual odorants and the actual emotional state in the group of patients with schizophrenia spectrum disorders were revealed. Conclusions. A decrease in the level of odor identification (anosmia) is observed in patients with schizophrenia spectrum. These disorders are not typical for patients with depressive disorders and people who do not suffer from mental illness. The obtained results require additional research. It can be assumed that the indicators of olfactory processes can be an additional diagnostic method of the emotional and personal sphere of patients with the schizophrenia spectrum disorders.

Olfactory dysfunction (OD) has been described in patients with antineutrophil cytoplasmic antibody-associated vasculitides (AAV), but the underlying mechanisms are not completely understood. The causes of altered smell function can generally be divided into conductive, sensorineural or others. To date no specific treatment is available for AAV-related OD and the efficacy of currently available options has not been explored. The aim of this review is to provide an overview of the causes that may lead to OD in patients with AAV. Current available treatments for OD and possible options in patients with AAV presenting with smell impairment are also mentioned.

Background: Age-related declines in taste and smell function are widely assumed to contribute to the decrease in appetite and the development of undernutrition in older adults.Objectives: Here we aim to assess the associations of both taste and smell function with several nutrition-related outcomes in a single study, with poor appetite and undernutrition as primary outcomes.Methods: This is a cross-sectional cohort study of 359 community-dwelling Dutch older adults, aged 65-93 y. Taste function was measured for all 5 basic tastes. Smell function was assessed with 3 tests: for odor identification, discrimination, and threshold. Self-reported taste and smell, appetite, energy (kcal/d) and macronutrient (% energy) intake, and covariates were assessed with extensive questionnaires. Dietary quality was calculated using the Dutch Healthy Diet index 2015, Alternative Healthy Eating Index 2010, and Mediterranean Diet Score. Body measurements included body weight (current and 2 y prior), height, and body impedance analysis. Data were analyzed via multiple logistic and linear regression.Results: Of our sample, 9.2% had poor taste and 17.0% poor smell, 6.1% had poor appetite, and 21.4% were undernourished. Self-reported poor taste (OR: 8.44; 95% CI: 1.56, 45.56; P = 0.013) was associated with poor appetite, but no other taste or smell score was associated with either poor appetite or undernutrition. Some associations were found of individual taste and smell scores with macronutrient intake and dietary quality. Self-reported poor taste and smell were both consistently associated with poorer dietary quality.Conclusions: In community-dwelling older adults, specific taste and smell impairments may have diverse consequences for appetite, food intake, or dietary quality. However, this does not necessarily result in undernutrition. The consistent associations of self-reported poor taste and smell with poor dietary quality do underline the usefulness of this information when screening for nutritional risk.

Purpose Chemotherapy can affect smell and taste function. This has never been investigated in childhood cancer patients during chemotherapy. The objective of this study was to determine whether psychophysical smell and taste tests are suitable for children with cancer. Taste and smell function, fungiform papillae density, and eating behavior were measured before (T1) and after (T2) a cycle of chemotherapy and compared with healthy controls. Methods Thirty-one childhood cancer patients treated for a hematological, solid, or brain malignancy (median age 12 years, 16 girls), and 24 healthy controls (median age: 11 years, 10 girls) participated. Smell function was measured using Sniffin’ Sticks, including a threshold, discrimination, and identification test. Taste Strips were used to determine recognition thresholds for sweet, sour, salty, and bitter taste. Papillae density was investigated by counting the fungiform papillae of the anterior tongue. Eating behavior was assessed using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Results Smell and taste function could be investigated in more than 90% of the patients, while fungiform papillae density could be determined in 61% of the patients. A significant difference in smell threshold was found between patients and controls (p = 0.001), showing lower thresholds in patients. In patients, sweet taste (p p = 0.028), and total taste function (p = 0.004) were significantly different after a cycle of chemotherapy, with higher scores at T2. Conclusion The assessment of smell, taste, and fungiform papillae density is feasible in children with cancer. Results of the current study suggest that smell and taste sensitivity increased in children with cancer.

Poor taste and smell function are widely thought to contribute to the development of poor appetite and undernutrition in older adults. It has been hypothesized that the oral microbiota play a role as well, but evidence is scarce. In a cross-sectional cohort of 356 older adults, we performed taste and smell tests, collected anthropometric measurements and tongue swabs for analysis of microbial composition (16S rRNA sequencing) and Candida albicans abundance (qPCR). Older age, edentation, poor smell and poor appetite were associated with lower alpha diversity and explained a significant amount of beta diversity. Moreover, a lower Streptococcus salivarius abundance was associated with poor smell identification score, whereas high C. albicans abundance seemed to be associated with poor smell discrimination score. In our population, neither the tongue microbiota, nor C. albicans were associated with poor taste or directly with undernutrition. Our findings do suggest a host-microbe interaction with regard to smell perception and appetite.

ImportanceSudden smell loss is a specific early symptom of COVID-19, with an estimated prevalence of ~40% to 75%. Smell impairment affects physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery.ObjectiveTo characterize smell function and recovery up to 11 months post COVID-19 infection.Settings, ParticipantsThis longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial respiratory symptoms, chemosensory function and COVID-19 diagnosis survey (S1) between April and September 2020 and completed a follow-up survey (S2) between September 2020 and February 2021; 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness.Main Outcomes & MeasuresPrimary outcomes are ratings of smell and taste function on a visual analog scale, and self-report of parosmia (smell distortions) and phantosmia (unexplained smells). Secondary outcomes include a checklist of other COVID-19 symptoms.ResultsOn follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID. During COVID-19 illness, the ability to smell was slightly lower among those who did not recover their pre-illness ability to smell at S2.Conclusions and RelevanceWhile smell loss improves for many individuals who lost it due to COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is also associated with wider COVID-19 symptoms and may persist for many months after COVID-19 onset. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long term sequelae; more research into treatment options is strongly warranted given that conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health.Trial registrationThis project was pre-registered at OSF: https://osf.io/3e6zc.Graphical abstractKey PointsQuestionWhat are the characteristics of smell and taste recovery of COVID-19 patients?FindingsIn this preregistered observational study of 1,468 participants, smell loss is associated with a higher number of COVID-19 symptoms, and may persist for at least 11 months following disease onset. While a majority of participants report quantitative improvement in their ability to smell, the prevalence of parosmia and phantosmia increases substantially at follow-up. Taste recovers faster than smell, suggesting taste and smell recover separately and can be distinguished by the respondents.MeaningOlfactory dysfunction appears to be a component of long-COVID, with parosmia as a prominent symptom in almost half of those with smell loss. More research into treatment is needed, especially given that olfactory dysfunction is associated with depression and loss of appetite. Health professionals should be aware of these common and long lasting effects.

Diabetes mellitus is one of the most common chronic systemic diseases seen in children. The increasing prevalence of Type 1 diabetes mellitus (T1DM) among children is alarming. Although olfaction has been found to be altered in some adult T1DM subjects, it is unknown whether this is the case in children and, if so, whether the dysfunction adversely influences their quality of life (QOL).Using the Pediatric Smell WheelThe PSW scores were lower in the T1DM patients than in the controls (9.17 vs 10.37; p 0.0001), although, in both cases, the scores fell within the normal range for individuals of their age (i.e., at or above 80%). Interestingly, such scores were lower in left-handed than in right-handed patients (8.00 vs 9.46; p = 0.001). Lower QOL indices were also found for the T1DM than for the controls for the domains of Emotional Function (p = 0.02), Social Function (p = 0.014), School Function (p = 0.011), and Psychosocial Status (p = 0.002). No significant associations were evident between PSW scores and disease duration and QOL scales.Our study demonstrates, for the first time, that modest decrements in smell function are evident in children with TIDM.

Item does not contain fulltext BACKGROUND & AIMS: Cancer patients undergoing palliative chemotherapy can experience a variety of chemosensory and food preference changes which may impact their nutritional status and quality of life. However, evidence of these changes in oesophagogastric cancer (OGC) patients is currently mostly qualitative and not supported by quantitative data. The aim of this study was to assess how self-reported and objective taste and smell function and food preferences change over time during chemotherapy in OGC patients. METHODS: This observational study included 15 advanced OGC patients planned for first line treatment with capecitabine and oxaliplatin. Participants completed two test sessions scheduled before start of cytotoxic treatment and after two cycles. Self-reported and objective taste and smell function and the macronutrient and taste preference ranking task were conducted at each test session. RESULTS: Self-reported taste and smell did not change upon chemotherapy. Objective taste function decreased during chemotherapy, although this was not statistically significant (p = 0.06), objective smell function did not change. Before and during chemotherapy, high protein foods were preferred over high carbohydrate and over low energy products, but food preferences did not change over time. A lower self-reported taste function correlated with a lower preference for high-protein products (rho = 0.526, p = 0.003). CONCLUSION: This study suggests that objective taste function decreases during chemotherapy in OGC patients, but not smell function. A low reported taste function was related to a lower preference for high-protein products.

Survivors of head and neck squamous cell cancers (HNSCC) frequently complain of taste dysfunction long after radiation therapy is completed, which contradicts findings from most sensory evaluation studies that predict dysfunction should resolve few months after treatment. Therefore, it remains unclear whether taste and smell function fully recovers in HNSCC survivors. We evaluated HNSCC survivors (n = 40; age 63 ± 12 years, mean ± standard deviation) who received radiation therapy between 6 months and 10 years before recruitment and compared their responses to those of a healthy control group (n = 20) equivalent in age, sex, race, smoking history, and body mass index. We assessed regional (tongue tip) and whole-mouth taste intensity perception using the general Labeled Magnitude Scale and smell function using the University of Pennsylvania Smell Identification Test (UPSIT). To determine possible differences between groups in retronasal smell perception, we used solutions of sucrose with strawberry extract, citric acid with lemon extract, sodium chloride in vegetable broth, and caffeine in coffee and asked participants to rate perceived smell and taste intensities with and without nose clips. We found groups had similar UPSIT and taste intensity scores when solutions were experienced in the whole mouth. However, HNSCC survivors were less likely to identify low concentrations of bitter, sweet, or salty stimuli in the tongue tip relative to healthy controls. Our findings suggest persistent and subtle localized damage to the chorda tympani or to the taste buds in the fungiform papillae of HNSCC survivors, which could explain their sensory complaints long after completion of radiotherapy.

Introduction: To evaluate the recovery rate of loss of smell (LOS) with objective olfactory testing in COVID-19 patients. Methods: Adults with confirmed COVID-19 and self-reported sudden LOS were prospectively recruited through a public call from the University of Mons (Belgium). Epidemiological and clinical data were collected using online patient-reported outcome questionnaires. Patients benefited from objective olfactory evaluation (Sniffin-Sticks-test) and were invited to attend for repeated evaluation until scores returned to normal levels. Results: From March 22 to May 22, 2020, 88 patients with sudden-onset LOS completed the evaluations. LOS developed after general symptoms in 44.6% of cases. Regarding objective evaluation, 22 patients (25.0%) recovered olfaction within 14 days following the onset of LOS. The smell function recovered between the 16th and the 70th day post-LOS in 48 patients (54.5%). At the time of final assessment at 2 months, 20.5% of patients (N = 18) had not achieved normal levels of olfactory function. Higher baseline severity of olfactory loss measured using Sniffin-Sticks was strongly predictive of persistent loss (p < 0.001). Conclusion: In the first 2 months, 79.5% of patients may expect to have complete recovery of their olfactory function. The severity of olfactory loss, as detected at the first Sniffin-Sticks-test, may predict the lack of mid-term recovery., SCOPUS: ar.j, info:eu-repo/semantics/published

Introduction: The World Health Organization declared COVID-19 a pandemic on March 11, 2020. The virus that causes COVID-19 was designated as severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). Several studies have reported chemosensory dysfunction, such as anosmia and ageusia, as common findings in COVID-19 positive patients. To date, qualitative olfactory testing has been performed only in a very few cohort studies on COVID-19 patients. However, objective testing is necessary to verify or determine the true magnitude of their deficits. Moreover, the proportion of COVID-19 patients exhibiting true olfactory disturbances is unknown. Aim of the Study: To determine the true prevalence of olfactory dysfunction in COVID-19 patients by objective assessment in mild to moderate symptomatic patients. Materials & Methodology: This was a prospective cross-sectional analytical study. All patients who were COVID-19 positive and having mild to moderate symptoms and not admitted in ICU formed part of the study group. Objective evaluation of smell function was done. Results: Self-reported smell dysfunction was present in 26.9% patients (n=62) and taste dysfunction was seen in 10.9% (n=25) of patients. On quantitative assessment of smell dysfunction, it was noted that 41.3% (n=95) of patients had some form of smell dysfunction out of which 70.5% patients (n=67) had hyposmia and 29.5% patients (n=28) had anosmia. Conclusion: Incidence was found to be more by objective assessment when compared to self-reported symptoms.

Loss of smell function (Anosmia) is reported to be associated with novel coronavirus disease 2019 (COVID-19) infection. The present study was designed to evaluate the effectiveness of an indigenously developed prototype smell test to identify/diagnose asymptomatic COVID-19 positive individuals. A panel of five different odorants belonging to Indian household with unique and mutually exclusive odor were used to develop prototype kit to test the hypothesis. The developed prototype kit was tested at 2 centers (N = 49 and 34) with slight modifications. Simultaneously, the kit was also tested on 55 (N = 35 and 20) healthy controls. Our results indicate that otherwise asymptomatic COVID-19 positive individuals were having quantifiable deficit in smell sensation. Interestingly, the variable sensitivity of different odorants was observed in different patients. None of the healthy controls reported difficulty in sensing any of the odorant, whereas, some of healthy controls did misidentify the odorants. Overall, the present study provides a preliminary data that loss in smell sensation for various odorants can be exploited as a quick and affordable screening test to identify infected cases among at risk individuals.

BACKGROUND: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), is responsible for the largest pandemic since the 1918 influenza A virus subtype H1N1 influenza outbreak. The symptoms presently recognized by the World Health Organization are cough, fever, tiredness, and difficulty breathing. Patient-reported smell and taste loss has been associated with COVID-19 infection, yet no empirical olfactory testing on a cohort of COVID-19 patients has been performed. METHODS: The University of Pennsylvania Smell Identification Test (UPSIT), a well-validated 40-odorant test, was administered to 60 confirmed COVID-19 inpatients and 60 age- and sex-matched controls to assess the magnitude and frequency of their olfactory dysfunction. A mixed effects analysis of variance determined whether meaningful differences in test scores existed between the 2 groups and if the test scores were differentially influenced by sex. RESULTS: Fifty-nine (98%) of the 60 patients exhibited some smell dysfunction (mean [95% CI] UPSIT score: 20.98 [19.47, 22.48]; controls: 34.10 [33.31, 34.88]; p < 0.0001). Thirty-five of the 60 patients (58%) were either anosmic (15/60; 25%) or severely microsmic (20/60; 33%); 16 exhibited moderate microsmia (16/60; 27%), 8 mild microsmia (8/60; 13%), and 1 normosmia (1/60; 2%). Deficits were evident for all 40 UPSIT odorants. No meaningful relationships between the test scores and sex, disease severity, or comorbidities were found. CONCLUSION: Quantitative smell testing demonstrates that decreased smell function, but not always anosmia, is a major marker for SARS-CoV-2 infection and suggests the possibility that smell testing may help, in some cases, to identify COVID-19 patients in need of early treatment or quarantine.

Background Smell dysfunction is highly prevalent worldwide and has adverse effects on quality of life. Smell loss in rhinitis subjects is mainly caused by mechanical obstruction of odorant transmission due to mucosal type 2 inflammation. We determined the association of 25-hydroxyvitamin D (25[OH]D) levels with the severity of smell dysfunction in children. Methods We measured the olfactory threshold score in a total of 518 children (10-12 years old, 264 boys) using the Sniffin' Sticks kit, and the children were divided into tertiles according to olfactory threshold score. We also assessed serum 25[OH]D level, common aeroallergen-specific immunoglobulin E, rhinitis severity with visual analog scale, and the Total Four Symptom Score, and pre- and post-decongestant nasal patency with acoustic rhinometry. Results The children with 25(OH)D deficiency had significantly reduced mean olfactory threshold scores when compared to those with 25(OH)D levels of ≥20.0 ng/mL (6.56 ± 3.54 and 7.28 ± 3.87, respectively, P = .036). The proportion of loss of smell function and pre-decongestant nasal patency significantly associated with low 25(OH)D levels (chi-square trend test, P for trend = .007). Likewise, after adjustment for confounders, children with smell loss (third tertile) were significantly associated with low 25(OH)D level (aβ=-0.062, 95% CI=-0.064 to -0.060, P = .009) independent of aeroallergen sensitization, and a low pre-decongestant nasal patency. Conclusions 25-Hydroxyvitamin D is significantly associated with smell dysfunction independent of aeroallergen sensitization, nasal obstruction, and the presence of allergic rhinitis. This finding may provide insight into the mechanisms involved in the development of olfactory dysfunction.

Background Wolfram syndrome is a rare genetic disease characterized by insulin-dependent diabetes, optic nerve atrophy, sensorineural hearing loss and neurodegeneration. Although olfactory dysfunction, a classical clinical marker of neurodegenerative processes, has been reported in Wolfram syndrome, its use as a clinical marker in Wolfram is limited due to data scarcity. In addition, it is unknown whether Wolfram syndrome affects the sense of taste. Methods Smell and taste perception were assessed in participants with Wolfram syndrome (n = 40) who were 15.1 ± 6.0 years of age (range: 5.1–28.7 years) and two sex- and age-matched control groups: one group with type 1 diabetes mellitus (T1D; n = 25) and a healthy control group (HC; n = 29). Smell sensitivity was assessed by measuring n-butanol detection thresholds and smell identification by using the University of Pennsylvania Smell Identification Test (UPSIT). Taste function was assessed using NIH Toolbox, which includes the assessment of sucrose (sweet) taste preference, and perceived intensity of sucrose, sodium chloride (salty), and quinine hydrochloride (bitter) both in the tip of the tongue (regional test) and the whole mouth. Results Smell sensitivity was not significantly different among groups; however, smell identification was impaired in Wolfram syndrome, as reflected by significantly lower UPSIT scores in Wolfram syndrome compared to HC and T1D (P P Conclusion Wolfram syndrome was associated with olfactory dysfunction. However, the olfactory dysfunction was qualitative (related to smell identification) and not secondary to olfactory insensitivity or diabetes, suggesting is arising from dysfunction in central olfactory brain regions. In contrast to olfaction, and despite decreased perception of taste intensity in the anterior tongue, the sense of taste was overall well-conserved in individuals with Wolfram syndrome. Future longitudinal studies of taste and smell perception in Wolfram syndrome will be important to determine the use of the chemical senses as clinical markers of disease progression.

Gustation and olfaction are two of the chemical senses. Variations in taste and smell function and perception have been associated with undesirable dietary changes. Accumulating evidence suggests that shorter sleep duration, either through curtailment or deprivation, acutely and, typically, negatively influences chemosensory function and perception. These changes are best exemplified by increased preference for sweeter stimuli after shorter sleep duration and are consistent with other work demonstrating associations with short sleep duration and increased carbohydrate consumption. Work to date has relied upon model systems with minimal complexity. Whether these stimuli accurately reflect changes that also occur when evaluating complex stimuli is uncertain. More research is needed to fully understand how sleep affects the chemical senses and how these alterations may perturb dietary intake.

Background In this study, we employed a novel children's olfactory test in order to more accurately assess the relationship between nasopharyngeal obstruction and odor identification ability. We quantified the impact of adenoidectomy on olfactory function, established whether the influences of the operation were related to the preoperative amount of nasopharyngeal obstruction, and determined whether sex influenced the olfactory measures. Methods Fifty-three boys and 23 girls were administered a standardized children's olfactory test, the Pediatric Smell Wheel™, before and 45 days after adenoidectomy. They ranged in age from 5 to 12 years and exhibited varying degrees of adenotonsillar hypertrophy and histories of recurrent adenotonsillitis. Radiographs of the nasopharynx were used to grade the degree of nasopharyngeal obstruction. Results Significant postoperative improvement in smell function occurred more frequently in children with >50% preoperative obstruction of the nasopharynx. In this group, average function improved 50.8% after surgery (95% confidence interval [CI], 39.1% to 64%). Improvement on 9 of the 11 odors was present, with significant differences occurring for the odors of bubble gum, baby powder, mint, and cinnamon. No sex differences were evident. Conclusion Olfactory dysfunction occurs primarily in children whose nasopharyngeal obstruction is >50%. Removal of the hypertrophied adenoids returned smell function back to normal in these cases. This study suggests that smell loss may be of value in decisions regarding whether or not to perform adenoidectomy in children with nasopharyngeal obstruction.

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

In this study, we introduce an extension of previous work by Soler et al. (Int Forum Allergy Rhinol 6(3):293–298, 2016) on a modified endoscopic scoring system of the Lund–Kennedy Score (focusing on the olfactory cleft) to evaluate its correlation with the olfactory function in patients with various smell disorders. A prospective cohort study. Two-hundred and eighty-eight participants were included and categorized in five groups according to the cause of their olfactory disorder: (0) control, (1) idiopathic, (2) sino-nasal, (3) postinfectious and (4) post traumatic olfactory loss. Olfaction was evaluated using the “Sniffin’ Sticks” test. The classical Lund–Kennedy scoring and a new olfactory cleft specific Lund–Kennedy scoring (OC–LK) were performed to evaluate mucosal changes. Significantly higher OC–LK scores on both sides were found in smell-impaired patients as compared to normosmic controls. When comparing the 4 groups, a significant difference of the OC–LK score were present between the sino-nasal and all other groups. Most importantly, significant negative correlations with strong effects were shown in the sino-nasal group between the OC–LK score and odor discrimination and odor identification. However, no such correlation emerged between the classical LK score and smell function. Olfactory cleft evaluation using the OC–LK score correlates with the olfactory function in patients with sino-nasal smell disorder. This diagnostic tool may reflect the underlying pathophysiological mechanism of sino-nasal smell loss, and therefore, should complement olfactory diagnostics in patients with sino-nasal smell disorder.

Objective Over 24% of older American adults (approximately 14 million) are estimated to have reduced olfactory sensitivity. Previous studies have provided evidence that patients with diabetes mellitus (DM) or its complications are at increased risk of olfactory dysfunction. We therefore investigated whether smell dysfunction was associated with DM-related biomarkers, including fasting blood glucose, glycohemoglobin, serum insulin, and homeostasis model assessment of insulin sensitivity (HOMA-IR), in older US adults. Methods Data from 9,678 older adults who had participated in the 2013 to 2014 National Health and Nutrition Examination Survey were available for this study. We used the eight-item, self-administered scratch-and-sniff smell test (Sensonics, Inc., Haddon Heights, NJ) for assessing smell. Smell dysfunction was defined as the condition with an odor identification score of ≤ 5. Results Of the 978 participants, 20% of older adults (n = 193) were defined as having smell dysfunction. After adjustment for potential confounding variables, participants in the highest HOMA-IR quintile had approximately two-fold increased odds (odds ratio = 2.25; 95% confidence interval: 1.25-4.05) of smell dysfunction compared with those in the lowest HOMA-IR quintile. In contrast, the odds of smell dysfunction were not associated with the quintiles for fasting blood glucose, glycohemoglobin (HbA1c), or serum insulin levels. Conclusion We found a significant association between smell dysfunction and severe insulin resistance in older US adults. Our data suggests that insulin resistance may be mechanistically linked to loss of smell function. Level of evidence 4. Laryngoscope, 128:1992-1996, 2018.

Changes in food preferences and chemosensory function are frequently reported during chemotherapy, but the nature of these changes are largely unknown. We followed and characterized food preferences, taste and smell function over chemotherapy treatment in breast cancer patients and compared to women without cancer. Furthermore, we assessed associations between taste and smell function and food preferences in breast cancer patients. Women with newly diagnosed breast cancer (n = 28) completed test sessions before, halfway, shortly after, and six months after chemotherapy. Twenty-eight women without cancer were tested at similar time points as control. During test sessions, food preferences were assessed with the Macronutrient and Taste Preference Ranking Task. Self-reported taste and smell function were tested on a visual analogue scale. Objective taste and smell function were assessed with Taste Strips and Sniffin’ Sticks. Breast cancer patients liked high-protein, high-fat, sweet, and savoury products less during chemotherapy, which returned to baseline six months after chemotherapy, while the control group was stable over time. Chemotherapy led to a decreased taste and smell function which recovered six months after chemotherapy. A better self-reported taste was associated with higher liking of high-protein, low-energy, savoury and sweet products. Breast cancer patients undergoing chemotherapy have altered food preferences for certain macronutrients, but not specifically for sweet or savoury tastes. Chemotherapy has a transient influence on food preferences and chemosensory function, of which patients should be informed prior to treatment, and which should be monitored during treatment due to the consequences for nutritional intake and quality of life.

Background & aims: Taste and smell changes due to chemotherapy May contribute to the high prevalence of overweight in testicular cancer patients (TCPs). This study investigates the taste and smell function, dietary intake, food preference, and body composition in TCPs before, during, and up to 1 year after cisplatin-based chemotherapy.Methods: Twenty-one consecutive TCPs participated. At baseline TCPs were compared to healthy controls (N = 48). Taste strips and 'Sniffin' Sticks' were used to determine psychophysical taste and smell function. Subjective taste, smell, appetite, and hunger were assessed using a questionnaire. Dietary intake was analyzed using a food frequency questionnaire. Food preference was assessed using food pictures varying in taste (sweet/savoury) and fat or protein content. A Dual-Energy X-ray Absorptiometry (DEXA) scan was performed to measure whole body composition.Results: Compared to controls, TCPs had a lower smell threshold (P = 0.045) and lower preference for high fat sweet foods at baseline (P = 0.024). Over time, intra-individual psychophysical taste and smell function was highly variable. The salty taste threshold increased at completion of chemotherapy compared to baseline (P = 0.006). A transient decrease of subjective taste, appetite, and hunger feelings was observed per Chemotherapy cycle. The percentage of fat mass increased during chemotherapy compared to baseline, while the lean mass and bone density decreased (P Conclusions: Coping strategies regarding subjective taste impairment should especially be provided during the first week of each chemotherapy cycle. Since the body composition of TCPs already had changed at Completion of chemotherapy, intervention strategies to limit the impact of cardiovascular risk factors should probably start during treatment.

DIZDAR, DENIZHAN/0000-0002-0991-2706; DIZDAR, DENIZHAN/0000-0002-0991-2706 WOS:000417392200006 PubMed: 27658749 Introduction: The olfactory system is affected by the nutritional balance and chemical state of the body, serving as an internal sensor. All bodily functions are affected by energy loss, including olfaction; hunger can alter odour perception. Objective: In this study, we investigated the effect of fasting on olfactory perception in humans, and also assessed perceptual changes during satiation. Methods: The "Sniffin' Sticks'' olfactory test was applied after 16 h of fasting, and again at least 1 h after Ramadan supper during periods of satiation. All participants were informed about the study procedure and provided informed consent. The study protocol was approved by the local Ethics Committee of Gaziosmanpas, a Taksim Education and Research Hospital (09/07/2014 no: 60). The study was conducted in accordance with the basic principles of the Declaration of Helsinki. Results: This prospective study included 48 subjects (20 males, 28 females) with a mean age of 33.6 +/- 9.7 (range 20-72) years; their mean height was 169.1 +/- 7.6 (range 150.0-185.0) cm, mean weight was 71.2 +/- 17.6 (range 50.0-85.0) kg, and average BMI was 24.8 +/- 5.3 (range 19.5-55.9). Scores were higher on all items pertaining to olfactory identification, thresholds and discrimination during fasting vs. satiation (p < 0.05). Identification (I) results: Identification scores were significantly higher during the fasting (median = 14.0) vs. satiation period (median = 13.0). Threshold (T) results: Threshold scores were significantly higher during the fasting (median = 7.3) vs. satiation period (median = 6.2). Discrimination (D) results: Discrimination scores were significantly higher during the fasting (median = 14.0) vs. satiation period (median = 13.0). The total TDI scores were 35.2 (fasting) vs. 32.6 (satiation). When we compared fasting threshold value of > 9 and 9 (p < 0.05). Conclusion: Olfactory function improved during fasting and declined during satiation. The olfactory system is more sensitive, and more reactive to odours, under starvation conditions, and is characterised by reduced activity during satiation. This situation was more pronounced in patients with a better sense of smell. Olfaction-related neurotransmitters should be the target of further study. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.

Background: Several lipid-related hormones and peptides, such as glucagon-like peptide-1 and leptin, are involved in the regulation of taste and smell function. However, to our knowledge, it remains unknown whether these chemosensory functions are associated with lipid profiles.Objective: We examined the cross-sectional association between taste and smell dysfunction and blood cholesterol concentrations.Methods: With the use of a questionnaire, we assessed chronic smell and taste dysfunction in 12,627 Chinese participants (10,418 men and 2209 women; mean age: 54.4 y) who did not take hypolipidemic agents. Participants were categorized into 3 groups based on the number of smell and taste dysfunctions, ranging from 0 (best) to 2 (worst). A general linear model was used to test differences in serum concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides (TGs) across groups with different smell and taste status after adjusting for age, sex, education, occupation, smoking, drinking, obesity, and history of cardiovascular disease, cancer, and head injury.Results: The prevalence of smell and taste dysfunction was 2.4% and 1.2%, respectively. Worse smell and taste dysfunction was associated with higher total cholesterol concentrations (P-trend = 0.005). No significant differences were observed in LDL cholesterol, HDL cholesterol, and TG concentrations across groups with different numbers of chemosensory dysfunctions (P-trend > 0.1 for all). The associations between chemosensory dysfunction and total cholesterol concentrations were more pronounced in participants aged ≤60 y and in those who were nonsmokers relative to their counterparts (P-interaction < 0.05 for all).Conclusions: In this large cross-sectional study, chemosensory dysfunction was associated with higher serum total cholesterol concentrations among Chinese adults. Prospective studies are needed to investigate the temporal relation between these chemosensory dysfunctions and hypercholesterolemia.

Dizziness and vertigo are common symptoms associated with minor head trauma or whiplash. Although these symptoms improve within a few weeks in many patients, the symptoms can last much longer in some patients. Furthermore, patients with minor trauma often suffer from other symptoms such as hearing loss, tinnitus, olfactory dysfunction, or taste disorder. The aim of the present study was to clarify the process by which dizziness following trauma arises. We investigated 254 patients (115 males and 139 females, with an average age of 44.2 years) who suffered from chronic dizziness following trauma but who did not have any abnormal head CT or MRI findings. In each of the patients, we evaluated the vestibular function and hearing, taste and smell by performing a spontaneous or gaze nystagmus test, an ENG evaluation (eye tracking test, optokinetic nystagmus test, caloric test), a stabilometer test, standard pure tone audiometry, a speech discrimination test, taste test (electrogustometry, filter-paper disk assay using taste solutions), and a smell test (intravenous olfaction test, odor-identification card test for Japanese). Accordingly, we investigated the relation between body sway and other sensory functions. We found a larger sway area than usual in 60％ of the patients undergoing a stabilometer test with their eyes open and with their eyes closed. The results of the nystagmus and ENG evaluations suggested a vestibular disorder in 15％ to 20％ of the patients and a brainstem or cerebellum disorder in 10％ or less of the patients. A significant correlation between the body sway area and smell identification was observed. However, smaller correlations were observed between body sway and the hearing threshold, the laterality of the hearing, the taste function, and the smell threshold. According to this study, we speculated that chronic dizziness following minor trauma might arise from related to central nervous system disorders, such as disorders of the hippocampus, hypothalamus, entorhinal cortex or other olfactoryrelated cognitive areas.

Purpose We previously demonstrated the presence of sonic hedgehog (Shh) in nasal mucus in normal subjects and in patients with smell loss (hyposmia). Nasal mucus Shh levels were found significantly diminished in untreated hyposmic patients of multiple etiologies. Since treatment with oral theophylline has been previously associated with improvement in smell function we wished to study if such treatment increased nasal mucus Shh as well as improved smell function in patients with hyposmia. Methods Forty-four patients with hyposmia of several etiologies were evaluated for changes in hyposmia by subjective measurements of smell, taste and flavor perception and by olfactometry. Measurements of nasal mucus Shh were made in relationship to each set of sensory measurements. Patients were treated with oral theophylline at doses of 200–800 mg for periods of 2–10 months with sensory function, nasal mucus Shh and serum theophylline levels evaluated at these time intervals. Nasal mucus Shh measurements were made with a sensitive spectrophotometric ELISA assay and theophylline with a fluorometric assay. Results There was consistent, significant improvement in subjective responses in smell, taste and flavor perception and in olfactometry associated with increased nasal mucus Shh and serum theophylline after theophylline treatment. Conclusions Improvement in smell function and in nasal mucus Shh was positively correlated in a dose-response relationship after treatment with oral theophylline. Results are consistent with a successful role for theophylline in improvement of smell function in hyposmic patients of multiple etiologies associated with increased nasal mucus Shh which can act as a biochemical marker for smell function.

Background The sense of smell is sensitive to hundreds of thousands of odorants. Smell disorders significantly compromise the quality of life. A National Health and Nutrition Examination Survey (NHANES) 2013-2014 survey among US population aged 40 years of age and older years found smell dysfunction in ∼ 20.5 million (13.5%) of Americans (1). Prevalence increased with age. Other factors influencing the sense of smell include ethnicity, smoking, medications, head trauma, chronic sinusitis, upper respiratory tract infections, alcoholism and neurological disorders. The University of Pennsylvania Smell Identification Test (UPSIT) (2) is a well-validated test of olfactory function that correlates with odor detection and other quantitative measures of olfaction. This test has become the ‘gold standard’ for olfactory testing and is comprised of four test booklets, each containing 10 microencapsulated (scratch & sniff) odors. Patients with gout, the most common inflammatory arthritis, frequently have multiple associated comorbidities, affecting many organs and aspects of one’s health. Objectives To determine whether gout patients have an impaired sense of smell. Methods This was a cross-sectional prospective study of gout patients seen in our rheumatology clinic. The first 30 clinic patients were recruited during the period 7/15/17-5/25/18. Each patient was administered the 40-item UPSIT. UPSIT scores were compared to age- and sex-matched controls from a normative database maintained at the University of Pennsylvania Smell and Taste Center using a paired t-test. Results Gout patients ranged in age from 31 - 86 years (mean: 59 years); 26 (87%) of patients were ≥ 40 years old and included 26 men and 4 women. The duration of gout ranged from 1- 43 years (mean: 9 years), with 19 having gout for >5 years. Visible tophi were observed in 6 patients (33%). C-reactive protein was within normal range except in one gout patient. Serum urate levels ranged from 5.1-12 mg/dL (mean: 6.29 mg/dL). Two patients were current smokers; both have microsomia. No patients had head trauma, chronic sinusitis, upper respiratory tract infections, alcoholism or neurological disorders. The mean UPSIT scores of the two groups did not differ significantly [respective patient and control means (SDs) = 31.40 (5.79) and 31.80 (4.37); t29 = -0.342, p = 0.74]. Conclusion This is the first study to quantitatively assess smell function in patients with gout. Despite being a systemic inflammatory disease, with multiple assocaited comorbidities, we did not find a statistically significant effect of gout on smell function using a well validated olfactory test. References [1] Liu G, Zong G, Doty RL, Sun Q. Prevalence and risk factors of taste and smell impairment in a nationwide representative sample of the US population: a cross-sectional study. BMJ Open2016;6:e013246. [2] Doty RL, Shaman P, Dann M. Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav1984;32:489-502. Disclosure of Interests Naomi Schlesinger Grant/research support from: Pfizer, Consultant for: YesNovartis, Horizon Pharma, Proteo Thera, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, Mohamed Elsaid: None declared, Vinod Rustgi Grant/research support from: Genfit, Consultant for: yes Allergan, Zydus, Abbvie

Many patients suffer from olfactory disorders or smelling function disturbance. Based on research in America there are 2.7 million adults who have a disturbance in the sense of smell..

Marciniak Aleksandra, Mielnik-Niedzielska Grażyna. Smell dysfunction from symptoms to diagnosis – recent methods of olfactory function assessment. Journal of Education, Health and Sport. 2019;9(2):235-242. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.2564084 http://ojs.ukw.edu.pl/index.php/johs/article/view/6588 https://pbn.nauka.gov.pl/sedno-webapp/works/904209 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part b item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eissn 2391-8306 7 © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 30.01.2019. Revised: 30.01.2019. Accepted: 13.02.2019. Smell dysfunction from symptoms to diagnosis – recent methods of olfactory function assessment Aleksandra Marciniak MD1 (https://orcid.org/0000-0002-8228-8786) Grażyna Mielnik-Niedzielska PhD1 (https://orcid.org/0000-0002-0818-9771) 1Pediatric Otolaryngology Clinic ul. prof. Antoniego Gębali 6, 20-867, Lublin Corresponding Author: Aleksandra Marciniak Present Corresponding Address: Pediatric Otolaryngology Clinic ul. prof. Antoniego Gębali 6, 20-867, Lublin Telephone number: + 48510081082 E-mail address: marciniak.alex@gmail.com Key words: olfactory system, smell function, odorant perception, odour detection, olfaction Abstract Sense of smell poses an incredibly significant aspect of our life, it has been present from the beginning of our existence and its role in maintaining the well-being of our organism is non-sustainable. Olfactory system dysfunctions have a negative influence on general health status, psychological condition and quality of life. Smell detection disturbances can not only lead to loss of pleasant feelings or basic defence mechanism deficiency, but also may be symptoms of serious ongoing or commencing diseases. The authors aimed to present in this article the most important information on physiology of olfaction system, most recent methods of examination and possible causes of smell dysfunction. A systematic review of the literature concerning smell examination was conducted including both previous review articles and original papers. Smell assessment remains an enigmatic branch of medicine, qualified personnel and special equipment which would enable to fully and reliably evaluate the condition of olfactory function is still not widely available. It seems that serious consideration of patients' complaints on odour perception, directed and complete investigation of reported dysfunctions, and adequately adjusted multidisciplinar treatment would be effective according to both, quality and length of patients' life. &nbsp

Head injury, particularly that resulting in brain injury, is a significant public health concern. For example, annual incidence rates of traumatic brain injury, a common consequence of head injury, range from 54 to 60 million people worldwide, including 2.2-3.6 million people whose trauma is moderate to severe. Trauma to the face and brain, including blast injuries common in modern warfare, can result in alterations in the ability to both smell and taste. In the case of smell, these include total loss of function (anosmia), decreased sensitivity (hyposmia), alterations in odor quality (dysosmia), and hallucination (phantosmia). Although taste dysfunction, i.e., altered perception of such basic taste-bud-mediated sensations as sweet, sour, bitter, salty, and savory (umami), can be similarly influenced by head trauma, the effects are typically more subtle and less studied. The present review provides an up-to-date assessment of what is known about the impact of head injury on quantitative measures of taste and smell function, including the influences of severity, type of injury, location of insults, prognosis, and approaches to therapy.

A number of neurodegenerative diseases are accompanied by disordered smell function. The degree of dysfunction can vary among different diseases, such that olfactory testing can aid in differentiating, for example, Alzheimer's disease (AD) from major affective disorder and Parkinson's disease (PD) from progressive supranuclear palsy. Unfortunately, altered smell function often goes unrecognized by patients and physicians alike until formal testing is undertaken. Such testing uniquely probes brain regions not commonly examined in physical examinations and can identify, in some cases, patients who are already in the "preclinical" stage of disease. Awareness of this fact is one reason why the Quality Standards Committee of the American Academy of Neurology has designated smell dysfunction as one of the key diagnostic criteria for PD. The same recommendation has been made by the Movement Disorder Society for both the diagnosis of PD and identification of prodromal PD. Similar suggestions are proposed to include olfactory dysfunction as an additional research criterion for the diagnosis of AD. Although taste impairment, i.e., altered sweet, sour, bitter, salty, and umami perception, has also been demonstrated in some disorders, taste has received much less scientific attention than smell. In this review, we assess what is known about the smell and taste disorders of a wide range of neurodegenerative diseases and describe studies seeking to understand their pathologic underpinnings.

SIMSEK, GOKCE/0000-0001-5281-0986; INAL, MIKAIL/0000-0003-0642-7913 WOS: 000480739000096 PubMed: 31166267 Objectives: Nasal septum deviations are deformities that occur in the cartilage and bones of the septum. The aim of the present study is to evaluate the patients with septum deviation according to the acoustic rhinometry measurements in terms of changes in smell function and the effects on quality of life. Methods: Twenty patients with septum deviation between the ages18 to 75 years old and 20 subjects without septum deviation were included in the study. Control group consisted of the 20 subjects with no septal deviation. After ENT examinations, acoustic rhinometry measurements, the SF-36 quality of life scale, and the Brief Smell Identification Tests were applied to all patients. Type of septum deviation is classified according to Mladina classification by anterior rhinoscopy examination, nasal endoscopy, and paranasal computed tomography. Results: The study indicated that the most common deviation type was Mladina Type 3 (65%). Bilateral total smell score of the women in the septum straight group is significantly lower than the men in terms of total smell scores by gender (P< 0.05). The total smell score values in septum group were significantly lower than those of the control group (P< 0.05). According to the individual smell values, cinnamon, banana, and soap odors of the septum deviation group were seen to be significantly lower than the septum straight group (P< 0.05). Conclusion: The results of the study indicated that olfactory dysfunction occurs in patients with septum deviation. Therefore, treatment of septum deviation is necessary for the improvement of nasal obstruction besides the treatment of the smell dysfunction. Kirikkale University Scientific Research Projects Coordination UnitKirikkale University [2014/065] The authors' work has been supported by Kirikkale University Scientific Research Projects Coordination Unit (Project number: 2014/065).

5 p., Objective: Functional movement disorders (FMDs) mimic a range of movements, neuropsychiatric and neurodegenerative disorders known to have smell dysfunction, which has been neglected in terms of its application to FMD. We aim to determine the smell status in FMD patients tested by a non-invasive, reliable and validated olfactory test. Patients and methods: We quantitatively assessed in thirty-five FMD patients their smell status and compared it to that of healthy age- and sex-matched controls, and of patients with Parkinson’s disease (PD). All participants were administered the Brief Smell Identification Test (B-SIT), a standardized short version of the University of Pennsylvania Smell Identification Test (UPSIT). The Picture Identification Test (PIT), a visual test analogous in content and form to the UPSIT designed to control for non-olfactory cognitive confounds, was also administered. Results: The B-SIT scores of the FMD patients were higher than those from PD patients [respective means (standard deviations: SDs) = FMD, 9.54 (1.57); PD, 4.64 (1.05), p < 0.01)] but similar to the smell scores from healthy controls [9.97 (1.77), p=0.35]. Gender, age, time of disease onset, smoking status, and phenotypic expression did not influence the test scores. Fourteen FMD patients who mentioned having olfactory dysfunction before smell testing have their test results within normal range. PIT scores from patients and healthy controls were within normal range. Conclusions: These findings indicate that FMD patients have normal olfactory function. Olfactory testing may be helpful in identifying and differentiating FMD from other movement, neurodegenerative and neuropsychiatric diseases for which smell function is altered.

Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV-2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.

Taste and smell are considered to be functions that contribute to the maintenance of good nutritional status. The present study evaluates taste and smell function in patients with burning mouth syndrome (BMS) versus a control group. A cross-sectional study was made of 36 consecutive patients with BMS and 56 healthy patients. Smell was assessed using the Sniffin’ Sticks test, while taste was evaluated with Taste Strips. Oral quality of life was assessed with the Oral Health Impact Profile-14 (OHIP-14), and the severity of dry mouth with the Thompson Xerostomia Inventory. The patients with BMS had a mean age of 60.4 ± 10.5 years, while the controls had a mean age of 61.3 ± 19 years. No significant differences in smell were recorded between the two groups. In contrast, significant differences in taste function were observed between the patients with BMS and the controls. In the patients with BMS, 44.4% suffered taste alterations compared with the 3.4% healthy controls. Further studies in such patients are needed to allow improved management of the chemosensory problems, mouth dryness, and oral health-related quality of life in BMS.

Purpose Oral nutritional supplements (ONS) are commonly prescribed to malnourished patients to improve their nutritional status. Taste and smell changes in patients with cancer can affect the palatability of ONS. The present study investigated: (1) the palatability of six ONS in testicular cancer patients before, during the first two cycles, and after chemotherapy; (2) the relation between the palatability and taste and smell function; (3) the metallic taste of these ONS. Methods Twenty-one testicular cancer patients undergoing first-line cisplatin-based chemotherapy participated. Two milk-based (vanilla; strawberry), two juice-based (apple; orange), and two yoghurt-based (vanilla-lemon; peach-orange) ONS were tested. A questionnaire was used to assess the palatability of ONS and to which extent the attribute ‘metallic’ was applicable. Taste and smell function were measured using taste strips and ‘Sniffin’ Sticks’, respectively. Results The palatability of ONS was highly variable among patients. The milk-based strawberry ONS was preferred most before, during, and after chemotherapy. The liking of the milk-based vanilla ONS tended to decrease over time (p = 0.053), whereas the liking of the other ONS remained stable. A higher smell threshold and a lower sour taste threshold were correlated to a decreased liking of the milk-based vanilla ONS. The two juice-based ONS tended to taste more metallic during than before chemotherapy. Conclusion Health care professionals and patients should be aware that the palatability of ONS can change over time. Regular structured contact between health care professionals and patients regarding the choice of ONS seems warranted. Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3263-6) contains supplementary material, which is available to authorized users.

Background Smell function has been initiated with theophylline treatment in 63% of patients with Type II congenital smell loss. Based upon a systematic evaluation of the protein components of nasal mucus we have demonstrated that interactions among four chemical moieties in nasal mucus may play significant roles in this initiation. Prior to treatment three of these moieties, cAMP, cGMP and sonic hedgehog (Shh), were significantly decreased in concentration whereas one of these moieties, TNFalpha, was increased in concentration. The mechanism(s) responsible for initiation of smell function in these patients, not immediately apparent, may depend upon understanding interactions among these moieties. Methods Measurements of cAMP, cGMP, Shh and TNFalpha in nasal mucus by specific spectrophotometric immunoassays before and after treatment with theophylline. Results Before theophylline treatment cAMP, cGMP and Shh in nasal mucus, which act as growth factors to support olfactory receptor function, were significantly decreased below normal levels whereas TNFalpha which acts as a “death factor” to inhibit olfactory receptor function was significantly increased above normal. After theophylline treatment cAMP, cGMP and Shh increased significantly whereas TNFalpha decreased significantly. Conclusions These results indicate that there are specific biochemical changes associated with smell loss in patients with Type II congenital smell loss and that correction of these biochemical changes are associated with initiation of smell function in these patients. Understanding these relationships play an important role in understanding receptor action in smell function.

Background The gold standard of treatment for esthesioneuroblastoma consists of en bloc craniofacial resection with postoperative therapy dictated by histology and tumor extent. Numerous studies have shown fully endoscopic approaches to provide comparable survival and recurrence rates with decreased patient morbidity. Here we report the first multi-institutional series assessing smell outcomes of patients who underwent unilateral endoscopic resection of esthesioneuroblastoma with preservation of the contralateral olfactory bulb. Methods A multi-institutional retrospective review was performed identifying patients who underwent endoscopic unilateral resection of esthesioneuroblastoma with preservation of 1 olfactory bulb between 2003 and 2015. After completion of postoperative radiation, patients were administered the University of Pennsylvania Smell Identification Test (UPSIT) to assess olfactory function. Results Fourteen patients (7 males, 7 females) were identified and tested for posttreatment olfactory function. All 14 patients received postoperative radiotherapy and 4 patients received additional chemotherapy. Mean follow-up time was 51.7 months. There was no disease recurrence. Six patients (43%) were found to have residual smell function with 2 patients (14%) having normal or mildly reduced smell function. Conclusion Here we report the first multi-institutional series demonstrating smell preservation after unilateral endoscopic resection of esthesioneuroblastoma. In carefully selected patients, this approach can yield comparable survival with decreased patient morbidity.

Background Differences in smell function between men and women have been studied by several investigators with variable results We were interested in determining if differences in olfactory function might occur between men and women with loss of smell hyposmia To do this we evaluated their olfactory function before and after oral theophylline treatment Methods Three hundred twelve patients with hyposmia women and men with chronic smell dysfunction of several etiologies were studied in an open label controlled clinical trial before and after daily treatment with oral theophylline with doses of mg for periods of months Smell function was measured both subjectively and by olfactometry before and at termination of each treatment period as was serum theophylline Results Before oral theophylline treatment there were no significant gender differences in olfactory function between hyposmic men and women However after theophylline treatment which improved smell function in both men and women subjectively improvement was greater in women than in men but clinically apparent by olfactometry only after a theophylline dose of mg at which time differences were statistically significant Conclusion These results indicate relative increased olfactory sensitivity in hyposmic women compared to hyposmic men after treatment with oral theophylline which improved smell function in both groups Although mechanism s are not well defined these results could relate to a differential effect of theophylline on smell function relative to decreased metabolic clearance of theophylline in women than in men

Introduction: The olfactory system is affected by the nutritional balance and chemical state of the body, serving as an internal sensor. All bodily functions are affected by energy loss, including olfaction; hunger can alter odour perception. Objective: In this study, we investigated the effect of fasting on olfactory perception in humans, and also assessed perceptual changes during satiation. Methods: The "Sniffin' Sticks" olfactory test was applied after 16 h of fasting, and again at least 1 h after Ramadan supper during periods of satiation. All participants were informed about the study procedure and provided informed consent. The study protocol was approved by the local Ethics Committee of Gaziosmanpaşa Taksim Education and Research Hospital (09/07/2014 no: 60). The study was conducted in accordance with the basic principles of the Declaration of Helsinki. Results: This prospective study included 48 subjects (20 males, 28 females) with a mean age of 33.6 ± 9.7 (range 20-72) years; their mean height was 169.1 ± 7.6 (range 150.0-185.0) cm, mean weight was 71.2 ± 17.6 (range 50.0-85.0) kg, and average BMI was 24.8 ± 5.3 (range 19.5-55.9). Scores were higher on all items pertaining to olfactory identification, thresholds and discrimination during fasting vs. satiation (p < 0.05). Identification (I) results: Identification scores were significantly higher during the fasting (median = 14.0) vs. satiation period (median = 13.0). Threshold (T) results: Threshold scores were significantly higher during the fasting (median = 7.3) vs. satiation period (median = 6.2). Discrimination (D) results: Discrimination scores were significantly higher during the fasting (median = 14.0) vs. satiation period (median = 13.0). The total TDI scores were 35.2 (fasting) vs. 32.6 (satiation). When we compared fasting threshold value of >9 and ≤9, the gap between the fasting and satiety thresholds was significantly greater in >9 (p < 0.05). Conclusion: Olfactory function improved during fasting and declined during satiation. The olfactory system is more sensitive, and more reactive to odours, under starvation conditions, and is characterised by reduced activity during satiation. This situation was more pronounced in patients with a better sense of smell. Olfaction-related neurotransmitters should be the target of further study. Resumo Introdução: O sistema olfatório é afetado pelo equilíbrio nutricional e estado químico do corpo, que serve como um sensor interno. Todas as funções corporais são afetadas pela perda de energia, inclusive o olfato; a fome pode alterar a percepção do odor. Objetivo: Neste estudo, investigamos o efeito do jejum sobre a percepção olfativa em seres humanos, e também avaliamos as mudanças de percepção durante a saciedade. Método: O teste olfatório Sniffin Sticks foi aplicado após 16 horas de jejum e novamente pelo menos 1 hora após a ceia do Ramadã durante os períodos de saciedade. Todos os participantes foram informados sobre os procedimentos do estudo e forneceram o consentimento informado. O protocolo do estudo foi aprovado pelo Comitê de Ética do Gaziosmanpaşa Taksim Education e Research Hospital (2014/09/07 n° 60). O estudo foi conduzido de acordo com os princípios básicos da Declaração de Helsinki. Resultados: Foram incluídos 48 pacientes (20 homens, 28 mulheres) com média de 33,6 ± 9,7 aos (variação 20-72); a altura média deles era de 169,1 ± 7,6 cm (variação 150-185), o peso médio era de 71,2 ± 17,6 kg (variação de 50-85) e o IMC médio era de 24,8 ± 5,3 (variação de 19,5-55,9). Os escores foram maiores em todos os itens correspondentes à identificação olfativa, limiares e discriminação durante jejum vs. saciedade (p < 0,05). Resultados da identificação (I): os escores de identificação foram significativamente maiores durante o jejum (mediana = 14) vs. período de saciedade (mediana = 13). Resultados limiares (T): os escores limiares foram significativamente maiores durante o jejum (mediana = 7,3) vs. período de saciedade (mediana = 6,2). Resultados de discriminação (D): os escores de discriminação foram significativamente maiores durante o jejum (mediana = 14) vs. período de saciedade (mediana = 13). Os escores totais de TDI foram de 35,2 (jejum) vs. 32,6 (saciedade). Quando comparamos o valor do limiar de jejum de > 9 e ≤ 9, a diferença entre os limiares de jejum e de saciedade foi significativamente maior em > 9 (p < 0,05). Conclusão: A função olfatória melhorou durante o jejum e diminuiu durante a saciedade. O sistema olfatório é mais sensível e mais reativo aos odores em condições de fome e é caracterizado por atividade reduzida durante a saciedade. Essa situação foi mais pronunciada em pacientes com um melhor sentido olfativo. Os neurotransmissores relacionados com o olfato devem ser alvo de um estudo mais aprofundado.