scholarly journals Sense of smell disorders in family physician practice

Alergoprofil ◽  
2021 ◽  
Vol 17 (2) ◽  
pp. 47-53
Author(s):  
Piotr Rapiejko
Keyword(s):  
Nasal Polyps ◽  
Sensory Input ◽  
Respiratory Infections ◽  
Physician Practice ◽  
Olfactory Neuron ◽  
Nasal Patency ◽  
Sense Of Smell ◽  
Acute Rhinosinusitis ◽  
Olfactory Impairment ◽  
Smell Disorders

A properly functioning sense of smell recognizes both food and danger and provides sensory input. Sense of smell is lost and/or impaired in diseases accompanied by impaired nasal patency such as chronic rhinosinusitis with or without nasal polyps, allergic rhinitis, respiratory infections including acute rhinosinusitis. In the case of rhinosinusitis in adults, olfactory impairment is one of the four main symptoms of the disease. They can also be caused by damage to the olfactory neuron, e.g. in the course of a viral infection. Loss of smell and/or taste reported by patients with COVID-19 may be a diagnostic hint. Modern intranasal glucocorticosteroids are used to treat olfactory disturbances and loss of smell caused by nasal patency impairment (or accompanying diseases with nasal patency impairment).

Efficacy of an Aqueous and a Powder Formulation of Nasal Budesonide Compared in Patients with Nasal Polyps

1998 ◽  
Vol 12 (3) ◽  
pp. 183-190 ◽  
Author(s):  
Mirko Tos ◽  
Frank Svendstrup ◽  
Helge Arndal ◽  
Steffen Ørntoft ◽  
John Jakobsen ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Treated Group ◽  
Nasal Symptom ◽  
Primary Efficacy Variable ◽  
Treatment Alternative ◽  
Polyp Size ◽  
Sense Of Smell ◽  
Nasal Symptoms ◽  
Symptom Scores ◽  
Overall Evaluation

Nasal polyps are commonly treated surgically. Intranasal administration of topical corticosteroids has gained increased acceptance as a treatment alternative. The aim of our study was to compare the efficacy of treatment of two formulations of budesonide with placebo on nasal polyps. At four Danish clinics 138 patients suffering from moderate or severe nasal polyps were randomized to a twice daily treatment with Rhinocort® Aqua 128 μg, Rhinocort Turbuhaler® 140 μg or placebo (Astra Draco, Sweden) for 6 weeks. Polyp size (primary efficacy variable), nasal symptoms, sense of smell, and patients’ overall evaluation of treatment of efficacy were assessed by scores. Polyp size was reduced significantly in both budesonide treated groups compared with placebo, but there was no statistical difference between the two actively treated groups. Patients’ nasal symptom scores was significantly more reduced in the Aqua compared to the Turbuhaler treated group, and both reduced symptom scores were significantly better compared to placebo. Sense of smell was significantly improved in the actively treated groups compared to placebo. The proportion of patients rating substantial or total control over symptoms after 6 weeks treatment was 60.9% and 48.2% in the Aqua and Turbuhaler-treated groups, respectively, which was significantly better compared with 29.8% in the placebo-treated group. Rhinocort Aqua and Rhinocort Turbuhaler were equally well tolerated.

scholarly journals EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

2012 ◽  
Vol 50 (1) ◽  
pp. 1-12
Author(s):  
W.J. Fokkens ◽  
V.J. Lund ◽  
J. Mullol ◽  
C. Bachert ◽  
I. Alobid ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Position Paper ◽  
Executive Summary ◽  
Acute Rhinosinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Adults And Children ◽  
Management Schemes ◽  
The Relationship

The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

Abstract 29: Olfactory Function and Neurocognitive Outcomes in Old Age: the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Priya Palta ◽  
Honglei Chen ◽  
Jennifer A Deal ◽  
David Knopman ◽  
Michael Griswold ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Processing Speed ◽  
Mean Difference ◽  
Z Score ◽  
Sense Of Smell ◽  
Z Scores ◽  
Olfactory Impairment ◽  
Global Cognition ◽  
Domain Scores

Introduction: Impairment in the sense of smell is associated with plaques and tangles in the olfactory region of the brain, which connects to the hippocampus where neuropathologic changes related to mild cognitive impairment (MCI) and dementia due to Alzheimer’s disease are first sited. Olfactory impairments may thus be a marker for poor cognitive function and MCI. We assessed olfaction and cognitive function in 6055 White and Black men and women aged 60-99 years. Methods: Sense of smell was measured in ARIC-NCS participants (2011-2013) by the 12-item Sniffin’ Sticks screening test (score range: 0-12, median: 10). A clinically validated threshold (smell score <6) defined olfactory impairment (OI). A multidimensional neuropsychological assessment (10 tests) ascertained performance in domains of memory, language, executive function/processing speed, and global cognition. For relative comparisons across the tests, raw cognitive test scores were standardized to z scores and averaged to yield domain scores. Following review of neuropsychological assessments, medical history, cerebral magnetic resonance imaging, and physical examinations, MCI was classified by a neurologist and neuropsychologist, and adjudicated by a third reviewer. Multivariable linear regression estimated the mean difference in domain-specific z scores among participants with and without OI. Logistic regression was used to quantify the prevalence odds of MCI in participants with vs. those without OI. Models were adjusted for age, sex, race, education, ARIC study center, hypertension, diabetes, smoking, and ApoE4. Race and sex were explored as effect modifiers. Results: The participants’ mean age was 76 years; 41% were male and 23% Black. The prevalence of olfactory impairment was 14%. Compared to participants with no OI, those with OI had a statistically significantly lower mean z score across all cognitive domains [memory: Beta= -0.37 (95% confidence interval [CI]: -0.45, -0.30); language: Beta= -0.39 (95% CI: -0.46, -0.33); executive function/processing speed: Beta= -0.24 (95% CI: -0.32, -0.17); global cognition: Beta= -0.34 (95% CI: -0.41, -0.26). Effect modification by race was observed in the domain of language. Blacks with OI had a greater mean difference in language z score compared to Blacks without OI (Beta= -0.57 (95% CI: -0.70, -0.44)). OI was associated with MCI in Whites, but not Blacks: white participants with OI had greater odds of MCI (Odds Ratio [OR] =1.76, 95% CI: 1.40, 2.21). Sex did not modify these associations. Conclusions: Compared to average cognitive aging (annual rate of decline of 0.04-0.05 standard deviation units/year) relatively large differences in standardized cognitive domain scores are observed between those with and without olfactory impairment among older adults. An impaired sense of smell may serve as a readily accessible early marker of neurodegeneration.

Intranasal steroid therapy – EPOS 2020

2020 ◽  
Vol 74 (3) ◽  
pp. 41-49
Author(s):  
Piotr Rot ◽  
Piotr Rapiejko ◽  
Dariusz Jurkiewicz
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Over The Counter ◽  
Acute Rhinosinusitis ◽  
Counter Medication ◽  
Anti Inflammatory ◽  
New Generation ◽  
Country Specific

Introduction: Due to their strong, multidirectional anti-inflammatory activity, intranasal glucocorticoids are the mainstay of treatment in rhinosinusitis, including acute rhinosinusitis, chronic rhinosinusitis, and chronic rhinosinusitis with nasal polyps, as well as allergic rhinitis. Owing to its high systemic safety and high anti-inflammatory efficacy, mometasone furoate – a new-generation intranasal glucocorticoid – was approved in 2019 as an over-the-counter medication for Polish patients diagnosed with allergic rhinitis. Scientific societies and expert groups recommend the use of intranasal glucocorticoids in a much broader range of indications. In February 2020, an updated version of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) was published. Aim: This article discusses the role of nasal glucocorticoids in regimens used in the treatment of nasal sinusitis as published in EPOS 2020 with Polish country-specific realities being taken into account.

scholarly journals Chemosensory Function and Dysfunction

1998 ◽  
Vol 9 (3) ◽  
pp. 267-291 ◽  
Author(s):  
A.I. Spielman
Keyword(s):  
Respiratory Infections ◽  
Food Selection ◽  
Diagnostic Procedures ◽  
Future Research ◽  
Molecular Events ◽  
Transduction Mechanisms ◽  
Olfactory Systems ◽  
Smell Disorders ◽  
Chemosensory Function ◽  
Taste And Smell

Taste and smell are fundamental sensory systems essential in nutrition and food selection, for the hedonic and sensory experience of food, for efficient metabolism, and, in general, for the maintenance of a good quality of life. The gustatory and olfactory systems demonstrate a diversity of transduction mechanisms, and during the last decade, considerable progress has been made toward our understanding of the basic mechanisms of taste and smell. Understanding normal chemosensory function helps clarify the molecular events that underlie taste and smell disorders. At least 2,000,000 Americans suffer from chemosensory disorders-a number that is likely to grow as the aging segment of the population increases. Smell disorders are more frequent than taste disturbances, due to the vulnerability and anatomical distinctiveness of the olfactory system, and because a decline in olfactory function is part of the normal aging process. Common gustatory and olfactory complaints are due to a number of medications, to upper respiratory infections, to nasal and paranasal sinus diseases, and to damage to peripheral nerves supplying taste and smell. Most chemosensory complaints have an identifiable cause. Although diagnosis of taste and smell disorders has improved considerably over the last two decades, treatment of these disorders is still limited to conditions with discernible and reversible causes. Future research is needed for a better understanding of chemosensory mechanisms, establishing improved diagnostic procedures, and disseminating knowledge on chemosensory disorders among practitioners and the general public.

scholarly journals Will Septal Correction Surgery for Deviated Nasal Septum Improve the Sense of Smell? A Prospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Neelima Gupta ◽  
P. P. Singh ◽  
Rahul Kumar Bagla
Keyword(s):  
Nasal Septum ◽  
Small Sample Size ◽  
Small Sample ◽  
Septal Deviation ◽  
Olfactory Function ◽  
Deviated Nasal Septum ◽  
Sense Of Smell ◽  
Correction Surgery ◽  
Olfactory Impairment ◽  
A Prospective Study

Background and Objectives. Nasal obstruction due to deviated nasal septum is a common problem bringing a patient to an otorhinolaryngologist. Occasionally, these patients may also complain of olfactory impairment. We proposed to study the effect of septal deviation on the lateralised olfactory function and the change in olfaction after surgery of the septum (septoplasty).Methods. Forty-one patients with deviated nasal septum were evaluated for nasal airflow, olfactory score, and nasal symptomatology. Septoplasty was done under local anesthesia. Pre- and postoperative olfactory scores, airflow and olfactory scores, and nasal symptomatology and olfactory scores were compared and correlated.Results. The range of preoperative composite olfactory score (COS) on the side of septal deviation was 4–14 (mean7.90±2.234) and on the nonobstructed side was 9–18 (mean14.49±2.378). Severity of deviated nasal septum and preoperative COS of diseased side were correlated and the correlation was found to be significant (rho = −0.690,p=0.000(<0.001)). The preoperative mean COS (7.90±2.234) was compared with the postoperative mean COS (12.39±3.687) and the improvement was found to be statistically significant (p=0.000(<0.001)).Conclusion. We found improvement in olfactory function in 70.6% patients after surgery, no change in 20.1%, and reduced function in 7.6%. With the limitation of a small sample size and a potential repeat testing bias, we would conclude that correction of nasal septal deviation may lead to improvement in sense of smell.

scholarly journals An olfactogenetic approach identifies olfactory neurons and brain centers directing negative oviposition decisions inDrosophila

2017 ◽  
Author(s):  
Sonia G. Chin ◽  
Sarah E. Maguire ◽  
Paavo Huoviala ◽  
Gregory S.X.E. Jefferis ◽  
Christopher J. Potter
Keyword(s):  
Site Selection ◽  
Brain Region ◽  
Odorant Receptor ◽  
Projection Neurons ◽  
Olfactory Neuron ◽  
Neuron Type ◽  
Olfactory Neurons ◽  
Lateral Horn ◽  
Sense Of Smell ◽  
The Brain

AbstractThe sense of smell influences behaviors in animals, yet how odors are represented in the brain remains unclear. The nose contains different types of olfactory sensory neurons (OSNs), each expressing a particular odorant receptor, and OSNs expressing the same receptors converge their axons on a brain region called a glomerulus. InDrosophila, second order neurons (projection neurons) typically innervate a single glomerulus and send stereotyped axonal projections to the lateral horn. One of the greatest challenges to studying olfaction is the lack of methods allowing activation of specific types of olfactory neurons in an ethologically relevant setting. Most odorants activate many olfactory neurons, and many olfactory neurons are activated by a variety of odorants. As such, it is difficult to identify if individual types of olfactory neurons directly influence a behavior. To address this, we developed a genetic method inDrosophilacalled olfactogenetics in which a narrowly tuned odorant receptor, Or56a, is ectopically expressed in different olfactory neuron types. Stimulation with geosmin (the only known Or56a ligand), in anOr56amutant background leads to specific activation of only the target olfactory neuron type. We used this approach to identify which types of olfactory neurons can directly guide oviposition decisions. We identified 5 OSN-types (Or71a, Or47b, Or49a, Or67b, and Or7a) that, when activated alone, suppress oviposition. Projection neurons partnering with these OSNs share a region of innervation in the lateral horn, suggesting that oviposition site-selection might be encoded in this brain region.Significance StatementThe sense of smell begins by activation of olfactory neurons in the nose. These neurons express an olfactory receptor that binds odorants (volatile chemicals). How the sense of smell is encoded in the brain remains unclear. A key challenge is due to the nature of olfactory receptors themselves - most respond to a wide range of odorants - so it is often impossible to activate just a single olfactory neuron type. We describe here a novel approach inDrosophilacalled ‘olfactogenetics’ which allows the specific experimental activation of any desired olfactory neuron. We use olfactogenetics to identify olfactory neurons and brain regions that guide egg-laying site selection. Olfactogenetics could be a valuable method to link olfactory neuron activities with circuits and behaviors.

scholarly journals Olfaction and traumatic head injury - Is it possible to discriminate between malingering and patients with smell disorders based on nowadays knowledge?

2015 ◽  
Vol 5 (19) ◽  
pp. 153-160
Author(s):  
Iulia Sabaru ◽  
Codrut Sarafoleanu
Keyword(s):  
Head Injury ◽  
Head Trauma ◽  
Point Of View ◽  
Traumatic Head Injury ◽  
Olfactory Loss ◽  
Legal Implications ◽  
Traumatic Head ◽  
Olfactory Impairment ◽  
Smell Disorders

Abstract BACKGROUND. Olfaction is one the most important senses; however, even nowadays it is incompletely known in humans from an anatomical and physiological point of view, but also as concerns the assessment methods and treatment. The main causes for acquired olfactory dysfunctions involve inflammatory pathology (local or general) and head trauma. Olfactory impairment after traumatic head injury (THI) is more frequent than believed. Today there are a number of tests for assessing the loss of smell, but more studies are needed in order to establish standardized protocols for patients with such pathology after THI. This uncertainty is more and more exploited by malingerers. OBJECTIVE. The aim of the paper was to find in literature the necessary information in order to permit a correct management of a patient with olfactory impairment after head trauma and to establish new protocols that may help identify malingerers when medico-legal implications exists. MATERIAL AND METHODS. We studied an amount of works and studies in order to highlight the diagnosis options specialist have, if such a case is encountered (olfactory loss after THI). RESULTS. Recent studies show that great progress has been made, but more scientific research is needed. Specialists still search correlation between all diagnosis methods. CONCLUSION. Olfactory disorders are an important topic given their importance in patient quality of life, but also for the medico-legal implications.

scholarly journals Consequences of undetected olfactory loss for human chemosensory communication and well-being

2020 ◽  
Vol 375 (1800) ◽  
pp. 20190265 ◽  
Author(s):  
A. Oleszkiewicz ◽  
F. Kunkel ◽  
M. Larsson ◽  
T. Hummel
Keyword(s):  
Social Cognitive ◽  
Daily Life ◽  
Well Being ◽  
Major Effect ◽  
Olfactory Communication ◽  
Olfactory Perception ◽  
Sense Of Smell ◽  
Olfactory Loss ◽  
Health Functioning ◽  
Olfactory Impairment

Olfactory perception has implications for human chemosensory communication and in a broader context, it affects well-being. However, most of the studies investigating the consequences of olfactory loss have recruited patients who have already been categorized as having a dysfunctional sense of smell and sought help in an ENT clinic. We revisit these findings by distinguishing subjects with olfactory impairment from a group of subjects who all declared a normal sense of smell when enrolling for this study. In the initial sample of 203 individuals, we found 59 to have impaired olfaction and four with marginal olfactory performance, not useful in daily life. Interestingly, we found a significant between-group difference in cognitive functioning, further supporting the notion of the relationship between cognition and olfactory performance. However, their chemosensory communication and well-being appeared not to be different from subjects with normosmia. Impaired olfactory function certainly has a severe impact on daily life but more so in individuals who are bothered with it and decide to seek treatment. The limited-to-no olfactory perception in the fraction of subjects who neither complain about it nor seek help in ENT clinics does not seem to have a major effect on their social, cognitive, emotional and health functioning. This article is part of the Theo Murphy meeting issue ‘Olfactory communication in humans’.

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