Sniffin’ Sticks Screening 12 test: Presentation of odours on  filter paper improves the recognition rate

To the Editor: Monitoring of olfactory function and diagnosis of olfactory disorders using the pen-based “Sniffin' Sticks test” is problematic during the SARS-CoV-2 pandemic due to hygienic concerns. The aim of this study was to find out whether the results of olfactory testing obtained by presenting odours on a single-use filter paper is identical to performing the test by presenting the odour pens according to the manufacturer’s manual.

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Postinfectious Olfactory Dysfunction: Oral Steroids and Olfactory Training versus Olfactory Training Alone: Is There any Benefit from Steroids?

ORL ◽

10.1159/000516316 ◽

2021 ◽

pp. 1-8

Author(s):

Sotiria Genetzaki ◽

Evangelia Tsakiropoulou ◽

Vasilios Nikolaidis ◽

Konstantinos Markou ◽

Iordanis Konstantinidis

Keyword(s):

Olfactory Dysfunction ◽

Olfactory Function ◽

Line Treatment ◽

First Line ◽

Olfactory Testing ◽

Significant Difference ◽

Oral Steroids ◽

Group A ◽

Olfactory Training ◽

First Line Treatment

Introduction: There are limited treatment options for postinfectious olfactory dysfunction (PIOD). Olfactory training has recently been used in clinical practice, but no medical treatment is widely accepted. Although there is weak evidence for their value, some physicians use oral corticosteroids as first-line treatment. The aim of this study was to compare combined oral methylprednisolone and olfactory training with olfactory training alone in the management of PIOD. Methods: This prospective cohort study included 131 patients with PIOD over a 2-year period before the COVID-19 pandemic. Seventy-eight patients who were treated with oral methylprednisolone and olfactory training (group A) were compared with 53 patients who were treated with olfactory training only (group B). Olfactory function was evaluated with “Sniffin’ Sticks” at baseline and 2, 8, and 16 weeks after initial assessment. Patients who improved after steroid treatment underwent magnetic resonance imaging of the paranasal sinuses, skin prick tests, lung spirometry, and sputum eosinophil assessment. Results: Oral steroids improved 19.23% of patients (n = 15) of group A. History, clinical evaluation, imaging, and laboratory tests identified an inflammatory background in half of them (n = 8). The remaining 7 had no findings of nasal inflammation, and all had a short history of olfactory dysfunction. Both groups significantly improved in olfactory testing results at the end of the olfactory training scheme without significant difference between them. Conclusions: The percentage of improved patients after oral methylprednisolone was relatively low to suggest it as first-line treatment. Half of the improved patients had an underlying upper airway inflammatory condition not related to the infection that caused the acute loss of olfactory function.

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Exposure to odours improves olfactory function in healthy children

Rhinology Journal ◽

10.4193/rhino14.192 ◽

2015 ◽

Vol 53 (3) ◽

pp. 221-226

Author(s):

E. Mori ◽

W. Petters ◽

V.A. Schriever ◽

C. Valder ◽

T. Hummel

Keyword(s):

Training Group ◽

Olfactory Function ◽

Controlled Study ◽

Healthy Children ◽

Olfactory Sensitivity ◽

Short Term ◽

Short Term Exposure ◽

Olfactory Testing ◽

Test Kit ◽

Olfactory Training

Background: Short-term exposure to odours, also called "olfactory training" has been shown to improve olfactory function in healthy people but also in people with olfactory loss. Aim of this single center, prospective, controlled study was to investigate the change of olfactory function following twice-daily, short-term exposure to 4 odours over a period of approximately 12 weeks. Material and methods: We compared odour identification abilities and odour thresholds between an olfactory training group (TR group) and a group that did not perform such training (noTR group). Participants exposed themselves twice daily to 4 odours ("rose", "eucalyptus", "lemon", "clove"). Olfactory testing was performed before and after the training period using the "Sniffin' Sticks" test kit (odour identification plus odour thresholds). Results: At baseline the two groups were not significantly different in terms of age and measures of olfactory sensitivity. The TR group performed significantly better for odour thresholds for all 4 odours compared to the noTR group after 12 weeks of olfactory training. Also, with regard to odour identification the TR group outperformed the noTR group. No significant differences were found for diary-based intensity ratings. Conclusion: Repeated exposure to odours seems to improve general olfactory sensitivity in children.

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Intranasal sodium citrate solution improves olfaction in post-viral hyposmia

Rhinology Journal ◽

10.4193/rhino16.054 ◽

2016 ◽

Vol 54 (4) ◽

pp. 368-374

Author(s):

K.L. Whitcroft ◽

C. Merkonidis ◽

M. Cuevas ◽

A. Haehner ◽

C. Philpott ◽

...

Keyword(s):

Sodium Citrate ◽

Feedback Inhibition ◽

Olfactory Function ◽

Placebo Control ◽

Free Calcium ◽

Citrate Solution ◽

Trial Methodology ◽

Olfactory Cleft ◽

Olfactory Testing ◽

Before And After

Background: Calcium plays an integral role in olfactory signal transduction, including feedback inhibition. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. We aimed to investigate the utility of intranasal sodium citrate in improving the olfactory function of hyposmic patients, by performing this prospective placebo controlled, single-blind trial. Methodology: Monorhinal olfactory testing for odour identification and threshold was performed in hyposmic patients using Sniffin Sticks, before and after treatment. Treatment consisted of one-off sodium citrate solution application to the olfactory cleft. Sodium chloride solution was applied to the contralateral olfactory cleft, which therefore acted as placebo control. Patients were blinded to the side of sodium citrate application, and side of treatment was randomized between patients. Results: 57 patients participated, aged 22-79. Causes of hyposmia included: post-viral (7); posttraumatic (10); sinonasal disease (30) and idiopathic (10). Compared with placebo, there was significant improvement in the identification scores of participants with post-viral hyposmia, following sodium citrate treatment. No significant change in olfactory function occurred for either identification or threshold in any other aetiological subgroup. Conclusions: Intranasal sodium citrate may be of benefit to patients with post-viral hyposmia.

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Quality of Life in Patients With Olfactory Loss Is Better Predicted by Flavor Identification Than by Orthonasal Olfactory Function

Chemical Senses ◽

10.1093/chemse/bjz027 ◽

2019 ◽

Vol 44 (6) ◽

pp. 371-377 ◽

Cited By ~ 11

Author(s):

Anna Oleszkiewicz ◽

Dahae Park ◽

Katarzyna Resler ◽

Julia Draf ◽

Anja Schulze ◽

...

Keyword(s):

Quality Of Life ◽

Predictive Value ◽

Wide Spectrum ◽

Olfactory Function ◽

Self Report ◽

Hierarchical Regression ◽

Upper Respiratory Tract ◽

Olfactory Loss ◽

Olfactory Testing

Abstract To date, most studies on the relationship between chemosensory performance and quality of life have focused on orthonasal measures of olfactory function. In the current investigation, we examined the predictive value of orthonasal and flavor identification indices of olfactory function on a wide spectrum of health and sociopsychological factors, including quality of life, life satisfaction, overall health, and depressive symptoms. Participants were 178 ENT patients (Mage = 58 ± 1), representing various causes of olfactory loss: idiopathic smell loss (n = 51; Mage = 63 ± 2), sinunasal disease (n = 27; Mage = 56 ± 3), head trauma (n = 33; Mage = 51 ± 2), and infections of the upper respiratory tract (n = 67; Mage = 59 ± 2). They completed self-report questionnaires and underwent olfactory testing using Sniffin’ Sticks (orthonasal olfactory testing) and “Taste Powder” (intraorally applied flavors for retronasal olfactory testing, additionally inducing taste sensation). Data were analyzed with hierarchical regression models wherein the first step included subjects’ sex, age, and orthonasal olfaction score. In the second step, we included the “Taste Powder” score. Tested models revealed that the first step was not significantly predicting variables of interest; however, there was an improvement of the model’s predictive value when the “Taste Powder” score was added. Results of this study suggest that flavor identification significantly improves predictions of health and sociopsychological functioning of ENT patients with various etiologies.

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Olfactory Groove Meningioma: Does anosmia improve following surgery? Report of 20 surgically treated patients in Dhaka Medical College Hospital, Dhaka

Journal of Dhaka Medical College ◽

10.3329/jdmc.v24i1.29562 ◽

2016 ◽

Vol 24 (1) ◽

pp. 44-46

Author(s):

Sukriti Das ◽

Md Manirul Islam ◽

Md Mahfuzur Rahman ◽

Md Zillur Rahman ◽

Md Rafiqul Islam ◽

...

Keyword(s):

Olfactory Function ◽

College Hospital ◽

Olfactory Groove ◽

Medical College ◽

Olfactory Testing ◽

Mri Scans ◽

Function Preservation ◽

Olfactory Groove Meningioma ◽

Rare Benign Tumour ◽

Ct And Mri

Objective: Olfactory Groove Meningioma(OGM) are rare benign tumour account for 8-13% of all intracranial meningiomas and reported about 12 % of all basal meningiomas. Anosmia is thought to be among the commonest symptoms, even though patients often present with headache, visual problem and mental dysfunction.Methods: Tweenty patients (male = 12 andfemale = 8) with olfactory groove meningioma were examined. In all patients extensive pre operative and post operative olfactory testing was performed using conventional soap and cotton soaked with perfume. In 14 cases, meningioma was lateralized (8 Left, 6 Right), in 6 patients meningioma were extended in both sides. CT and MRI scans were performed in all cases.Results:In preoperative testing, 14 patients were found to be anosmic on the side of the tumor, 2 were hyposmic and 4 were normosmic. Postoperative ipsilaterally all patients became anosmic but contralaterally 14 patients were anosmic ,2 were hyposmic and 4 were normosmic.Conclusion:The likelihood of normal post operative olfactory function preservation contra lateral to the tumour was possible in too some extent in smaller size.However,preservation of olfactory function ipsilateral to the tumor seems to be extremely difficult irrespective of tumor size or surgical approach.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 44-46

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High prevalence of long-term olfactory dysfunction confirmed by olfactory testing after a community COVID-19 outbreak

HNO ◽

10.1007/s00106-021-01129-7 ◽

2021 ◽

Author(s):

Hilmar Gudziol ◽

Timo Kirschstein ◽

Mathias W. Pletz ◽

Sebastian Weis ◽

Orlando Guntinas-Lichius ◽

...

Keyword(s):

Population Based ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Taste Disturbance ◽

Gustatory Function ◽

Psychophysical Testing ◽

Olfactory Testing ◽

High Prevalence ◽

Normal Taste

Abstract Purpose The prevalence of long-term olfactory and gustatory dysfunction in participants suffering from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19) is unknown. Furthermore, evaluations of the reliability of participants’ self-reporting of olfactory function (SOF) and gustatory function (SGF) using extended objective psychophysical testing are missing. Methods In this population-based cohort study in a PCR-tested community in Thuringia, Germany, olfactory function was extensively examined 4 months after a COVID-19 outbreak using the “Sniffin Sticks” test battery to determine the TDIa score, i.e., the sum of results obtained for threshold, discrimination, and identification scores averaged for both nasal sides. Gustatory function was assessed using the three-drop test resulting in the gustatory composite score (CSg). The data were compared with SOF and SGF. Results Of 43 adult convalescents (median age: 68 years; 58% female) after SARS-CoV‑2 infection, 18 participants (42%) had olfactory complaints due to SOF, one participant (2%) complained of taste disturbance due to SGF. The TDIa was 22.0 ± 5.9. Normosmia, hyposmia, and anosmia were seen in 17, 18, and eight participants, respectively. TDIa correlated with SOF (rs = −0.434, p = 0.004); CSg was 23.5 ± 2.7. Normogeusia and hypogeusia were objectified in 39 and four participants, respectively. The prevalence of long-term olfactory dysfunction and gustatory dysfunction in the study group was 60.5 and 9.3%, respectively. Conclusion The SOF was reliable, especially for participants who felt a sudden chemosensory dysfunction during the outbreak. At 4 months after SARS-CoV‑2 infection, a high proportion of participants were dysosmic, whereas nearly all of them had normal taste function.

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Subjective and Objective Assessment of Olfactory Function in Post-Laryngectomy Patients

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v24i2.679 ◽

2009 ◽

Vol 24 (2) ◽

pp. 19-22

Author(s):

Ricardo L. Ramirez ◽

Windolyn D. Panganiban ◽

Joel A. Ramirez

Keyword(s):

Health Care Providers ◽

Total Laryngectomy ◽

Objective Assessment ◽

Olfactory Function ◽

Care Providers ◽

Management Options ◽

Olfactory Testing ◽

Significant Difference ◽

Identification Test ◽

Smell Identification

Objective: To determine the olfactory function among post-laryngectomy patients using a questionnaire adapted from that of the Smell and Taste Clinic of Hospital of University Pennsylvania (HUP) and the Santo Tomas Smell Identification Test. Methods: Design: Descriptive study Setting: Tertiary Private Hospital Outpatient Department Patients: Twenty five subjects who had undergone total laryngectomy and met inclusion and exclusion criteria underwent rigid nasal endoscopy and olfactory function assessment using an adaptation of the questionnaire of the Smell and Taste Clinic of Hospital of University Pennsylvania (HUP) and the Santo Tomas Smell Identification Test (ST-SIT). Results: Twenty one male subjects completed olfactory testing. All had subjective sense of smell before laryngectomy. Statistically significant correlation was noted between the subjective post-operative smell function and the objective olfactory function test scores. There was no statistically significant difference noted in the ST SIT scores with regards age, duration from laryngectomy to olfactory testing, number of smoking pack- years, use of olfactory technique/maneuver, loss of appetite and adjunctive chemotherapy and radiotherapy. Conclusion: All subjects post-laryngectomy had subjective complaints of varying levels of olfactory difficulties based on a structured questionnaire and were documented to be anosmic by an objective smell identification test. Olfactory problems following laryngectomy can have significant effects on the lives of laryngectomees, and health care providers should be knowledgeable of available management options for this condition. Key words: olfaction, anosmia, total laryngectomy, olfactory testing

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Self-Ratings of Olfactory Function and Their Relation to Olfactory Test Scores. A Data Science-Based Analysis in Patients with Nasal Polyposis

Applied Sciences ◽

10.3390/app11167279 ◽

2021 ◽

Vol 11 (16) ◽

pp. 7279

Author(s):

Jörn Lötsch ◽

Constantin A. Hintschich ◽

Petros Petridis ◽

Jürgen Pade ◽

Thomas Hummel

Keyword(s):

Nasal Polyposis ◽

Rating Scales ◽

Rating Scale ◽

Olfactory Function ◽

Test Battery ◽

Clinical Test ◽

Olfactory Test ◽

Olfactory Testing ◽

Numerical Rating ◽

Self Assessments

Olfactory self-assessments have been analyzed with often negative but also positive conclusions about their usefulness as a surrogate for sensory olfactory testing. Patients with nasal polyposis have been highlighted as a well-predisposed group for reliable self-assessment. In a prospective cohort of n = 156 nasal polyposis patients, olfactory threshold, odor discrimination, and odor identification were tested using the “Sniffin’ Sticks” test battery, along with self-assessments of olfactory acuity on a numerical rating scale with seven named items or on a 10-point scale with only the extremes named. Apparent highly significant correlations in the complete cohort proved to reflect the group differences in olfactory diagnoses of anosmia (n = 65), hyposmia (n = 74), and normosmia (n = 17), more than the true correlations of self-ratings with olfactory test results, which were mostly very weak. The olfactory self-ratings correlated with a quality of life score, however, only weakly. By contrast, olfactory self-ratings proved as informative in assigning the categorical olfactory diagnosis. Using an olfactory diagnostic instrument, which consists of a mapping rule of two numerical rating scales of one’s olfactory function to the olfactory functional diagnosis based on the “Sniffin’ Sticks” clinical test battery, the diagnoses of anosmia, hyposmia, or normosmia could be derived from the self-ratings at a satisfactorily balanced accuracy of about 80%. It remains to be seen whether this approach of translating self-assessments into olfactory diagnoses of anosmia, hyposmia, and normosmia can be generalized to other clinical cohorts in which olfaction plays a role.

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Severity of Anosmia as an Early Symptom of COVID-19 Infection May Predict Lasting Loss of Smell

Frontiers in Medicine ◽

10.3389/fmed.2020.582802 ◽

2020 ◽

Vol 7 ◽

Author(s):

Jerome R. Lechien ◽

Fabrice Journe ◽

Stephane Hans ◽

Carlos M. Chiesa-Estomba ◽

Vincent Mustin ◽

...

Keyword(s):

Complete Recovery ◽

Objective Evaluation ◽

Patient Reported Outcome ◽

Sudden Onset ◽

Olfactory Function ◽

Olfactory Loss ◽

Olfactory Testing ◽

Patient Reported ◽

Smell Function ◽

The University

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.

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Olfactory groove meningioma with a 10-year history of smell loss and olfactory recovery after surgery

BMJ Case Reports ◽

10.1136/bcr-2021-244145 ◽

2021 ◽

Vol 14 (8) ◽

pp. e244145

Author(s):

Andreas Steenholt Niklassen ◽

Rasmus Langelund Jørgensen ◽

Alexander Wieck Fjaeldstad

Keyword(s):

Psychiatric Symptoms ◽

Negative Impact ◽

Olfactory Nerve ◽

Olfactory Function ◽

Olfactory Groove ◽

Olfactory Loss ◽

Olfactory Testing ◽

History Of ◽

Olfactory Groove Meningioma ◽

Olfactory Impairment

A rare cause of olfactory impairment is olfactory groove meningiomas with insidious onset of non-specific symptoms like headache, olfactory dysfunction, psychiatric symptoms such as depression, personality changes, declining cognitive function, visual disturbances or seizures. A common complication of surgery is loss of olfactory function. Still, the preservation of olfactory function should be attempted as olfactory loss often has a severe negative impact on quality of life. This report describes a woman with an olfactory groove meningioma and a 10-year history of olfactory impairment. It includes preoperatively and postoperatively extended olfactory testing, a neurosurgical approach to preserve the olfactory function and postoperative olfactory rehabilitation. After rehabilitation, the patient regained a normal olfactory function, even though the right-sided olfactory nerve could not be preserved during surgery. The case demonstrates the importance of performing neuroimaging in selected patients with olfactory loss and a method for preserving and potentially improving postoperative olfactory function.

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