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PubMed1994

Disorders of taste and smell.

Chemosensory dysfunction involves deficits in taste or smell. Aberrations in these senses can be quite distressing to the patient and can negatively impact on nutritional well-being. A thorough history and physical examination are important in isolating the etiology of the sensory loss from the numerous causes of taste and smell disorders. The diagnosis can be simplified by the fact that only a few causes (nasal and sinus disease, viral-induced loss, and head trauma) are responsible for the vast majority of chemosensory dysfunctions. Therapy is limited, but one should be aware of the existing medical and surgical treatment modalities.

Humans↗
PubMedDate not supplied

[Possibilities of helium-neon lasers in olfactory disorders].

310 patients with olfactory analyzer dysfunction have been examined. Of them 40 patients received laser radiation on the olfactory zone. The course comprised 10 sessions. A response occurred in 26 patients who exhibited neither side effects nor allergy. The conclusion is made on validity of using helium-neon laser in perspective olfactory defects.

Adolescent↗
PubMed1979

Electron microscopic studies of testes in Kallman syndrome.

A patient with Kallman syndrome is presented emphasizing the urologic aspects of this unusual disorder. Testes biopsy at the time of orchiopexy demonstrated infantile testes with interstitial fibrosis and a diminished Leydig and Sertoli cell population. The electron micrograph confirmed type B Sertoli cells. The implications of these findings are discussed and details of treatment given.

Adolescent↗
PubMed1992

[Clinical application of the smell identification test].

Clinical application of the standardized "scratch and sniff" olfactory test in Japanese is described. Over 300 subjects participated in three experiments. In experiment 1, 29 odorants used in the smell identification test were rated as to their experiences. The ratios of the experiences in each combination of odorants were compared. In experiment 2, the test was applied to normal subjects. Average test scores decreased as a function of age, with the greatest decline occurring between the sixth and tenth decades of life. In experiment 3, the test was shown to differentiate between subjects with olfactory disorders and normal controls. This self-administered test now makes it possible to rapidly and accurately assess general olfactory function in the laboratory, clinic, or through the mail without complex equipment or space consuming stores of chemicals.

Adult↗
PubMedDate not supplied

A double blind study of the effects of zinc sulfate on taste and smell dysfunction.

A randomized, double blind crossover study of the effects of zinc sulfate and placebo was carried out in 106 patients with taste and smell dysfunction secondary to a variety of etiological factors. In the patient group prior to treatment, mean serum zinc concentration and leukocyte alkaline phosphatase activity were significantly lower than normal. Results indicate that zinc sulfate was effectively equivalent to placebo in the treatment of these disorders. Although these results demonstrate abnormalities of zinc metabolism in some patients with taste and smell dysfunction they fail to provide evidence for a single, therapeutic approach to the many disorders which are associated with abnormalities of taste and smell. However, the methods and procedures developed in this study demonstrate that taste and smell dysfunction can be studied in a quantitative, systematic manner.

Adult↗
PubMed2004

Nasal manifestations of systemic illnesses.

This article is focused on the nasal and sinusal manifestations of systemic diseases, such as infections, immunodeficiencies, chronic multisystemic disorders, inflammatory bowel diseases, deposition diseases, hematologic diseases, respiratory diseases, and smell and taste disorders. A concise review of some of the systemic diseases that commonly present complaints in the nose and paranasal sinuses, including their prevalence, sinonasal manifestations, diagnosis, and treatment, is provided.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Chronic sinusitis and olfactory dysfunction.

Chronic rhinosinusitis encompasses a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 weeks' duration. In addition to nasal obstruction and discharge, chronic sinusitis is a common cause of olfactory dysfunction. Smell loss can result in problems including safety concerns, hygiene matters, appetite disorders, and changes in emotional and sexual behavior. Although smell loss related to sinonasal disease is probably the most treatable form of olfactory dysfunction and treatment can improve olfactory sensation in the setting of sinusitis, most studies show that the effects are usually transient and incomplete.

Anti-Bacterial Agents↗
PubMed2001

Patterns of non-conductive olfactory disorders in eastern Austria: a study of 120 patients from the Department of Otorhinolaryngology at the University of Vienna.

BACKGROUND: About 1% of the population suffer from disorders of the chemosensory system. In the United States at least two million people have problems related to smell and taste. The sense of smell enables the individual to determine the flavour of food and beverages and is most important as a sophisticated warning system. For the present investigation, we collected data on the age pattern and causes of olfactory disorders in eastern Austria. METHODS: 120 patients with non-conductive olfactory disorders were examined over a 9-month period starting from July 1998 at the outpatient clinic of the Ear Nose and Throat Department of the University of Vienna. Data concerning the underlying population taken from the 1998 population census in Vienna were used for comparison, in order to gain a more representative estimation of the distribution of these disorders. The diagnosis was based on thorough history taking, physical examination, CT scan, and olfactory testing for sensitivity by means of so-called "sniffin' sticks". RESULTS: The patients' ages ranged from 16 to 86 years (mean, 54.5 years; 74 females, 46 males). Those older than 50 years seem to have a higher risk of developing olfactory disorders. Only 15 of the female patients were pre-menopausal. Olfactory disorders were most frequently caused by viral infections in the upper respiratory tract (n = 51). Fifteen patients reported head trauma as a cause of olfactory loss, and 45 causes were idiopathic. Most of those in whom the olfactory disorder had been in existence for less than 3 months were anosmic (84%), very few were hyposmic (16% of a total of 19 patients). In contrast, 38% (of a total of 29 patients) in whom the disease had been in existence for 3 and 6 months were hyposmic. Parosmia was reported in 16 cases. Most parosmias appeared after viral infection (56%). Eight of the 120 patients reported dysgeusia. CONCLUSIONS: The present study is a first step towards an assessment of olfactory disorders in Austria. We found similar causes of non-conductive olfactory disorders as have been reported in the literature for other countries, namely upper respiratory infection leading to postviral olfactory disorders, and head trauma. With increasing age women seem to suffer more often from chemosensory dysfunction than men, which may be related to hormonal factors.

Adolescent↗
PubMed1999

[Anosmia caused by inhaled hazardous substances. Significance for expert assessment general practice].

BACKGROUND: Both environmental and occupational pollutants can affect the functional integrity of the olfactory epithelium or even destroy olfactory tissue. However, occupational hyposmia and anosmia have not been included into the list of occupational diseases. Therefore, compensation of occupationally induced smell disorders is difficult. OBJECTIVE: To evaluate patients with toxic hyposmia for the pollutants involved and to discuss consequences for occupational and environmental medicine. METHODS: A total of 19 patients were evaluated in our departments between 1993 and 1997 for olfactory disorders related to environmental or occupational pollutants. The charts of these patients were retrospectically analyzed and the causative pollutants compared with the literature. RESULTS: A chronical exposure to mixtures of metal dusts and steam, volatile organic substances, and anorganic gases were the most common pollutants involved in occupational dysosmia. Only one case of acute development of an anosmia due to exposure to CO and combustion gases was documented. CONCLUSIONS: Olfactory disorders are underestimated in occupational and environmental medicine. Relevance of olfactotoxic substances for occupational medicine can be postulated in metal and chemical workers, in welding and disinfection. The list of occupational diseases should be completed by olfactory hyposmia and anosmia.

Adult↗
PubMed2003

Olfactory dysfunction in cerebellar ataxia and multiple system atrophy.

BACKGROUND: Olfactory dysfunction has been reported in Parkinson's (PD) and Alzheimer's disease (AD). OBJECTIVE: We studied olfactory function in eight patients with multiple system atrophy of cerebellar type (MSA-C), eleven patients with sporadic cerebellar ataxia of unknown etiology and thirteen controls matched for age and gender. Subjects received tests for n-butanol odor thresholds, odor identification, and odor discrimination. RESULTS: Olfactory thresholds were abnormally high in 16% of the patients. Odor discrimination and odor identification were impaired in 44 % and 74% of the patients, respectively. There was no significant difference in olfactory function between patients with sporadic ataxia of unknown etiology and MSA-C patients. CONCLUSIONS: The present data suggest that olfactory dysfunction is common to various neurodegenerative disorders and not specifically restricted to PD or AD. Cerebellar dysfunction affected suprathreshold olfactory function more severely than odor thresholds. Thus cerebellar lesions may affect the processing of odor-related information to a higher degree than the transport of odorants to the receptor through sniffing.

Cerebellar Ataxia↗
PubMedDate not supplied

Ultrastructural changes and olfactory deficits during 3-methylindole-induced olfactory mucosal necrosis and repair in mice.

Olfactory mucosa from C57BL/6N mice was examined by transmission electron microscopy at 0.5, 1, 2, 4, 6, 24, 48, and 72 h after 400 mg 3-methylindole (3MI)/kg ip, and at 7, 14, and 21 days after 300 mg 3MI/kg or vehicle. Degeneration was evident in epithelial cells of Bowman's glands and olfactory sustentacular cells by 0.5 h, but not in neurons until 24 h, by which time necrosis was fully developed in sustentacular cells and epithelium of Bowman's glands. Sustentacular cells and neurons detached from the basal lamina by 48 h. Lamina proprial fibroblasts were hypertrophied by 72 h and, with collagen fibrils, formed the bulk of the mucosa at 7 days. By 21 days, fibroblasts were less conspicuous, but Bowman's glands were rarely observed and were lined by epithelial cells without secretory granules. Mucosal epithelium was reconstituted, but disorderly and lacked olfactory differentiation. Mice treated with 3MI were more likely than control mice to taste water treated with isoamyl acetate (odorant) and quinine monohydrochloride (aversive tastant). Though olfactory neurons were initially spared, their absence in the regenerated epithelium explains lingering olfactory deficits in murine 3MI toxicosis.

Animals↗
PubMed1978

Psychomotor seizures, arterio-venous malformation and the olfactory reference syndrome. A case report.

A case history is reported of a 44-year-old man with a 6-year history of psychomotor seizures. For the past year he had described persistent olfactory hallucinations of an unpleasant nature which he referred to himself. In many respects these symptoms conform to the pattern observed in the olfactory reference syndrome, a recently described but apparently quite discrete psychiatric disorder; there were, however, certain atypical features. At a later stage unilateral anosmia was noted. Radiological examination then demonstrated an arterio-venous malformation in the right frontal lobe. The relationship between the malformation and the psychomotor seizures, and the implications that each has for the development of an olfactory reference syndrome are fully discussed.

Adult↗
PubMed2003

Impairment of olfactory identification ability in individuals at ultra-high risk for psychosis who later develop schizophrenia.

OBJECTIVE: Previous investigation has revealed stable olfactory identification deficits in neuroleptic-naive patients experiencing a first episode of psychosis, but it is unknown if these deficits predate illness onset. METHOD: The olfactory identification ability of 81 patients at ultra-high risk for psychosis was examined in relation to that of 31 healthy comparison subjects. Twenty-two of the ultra-high-risk patients (27.2%) later became psychotic, and 12 of these were diagnosed with a schizophrenia spectrum disorder. RESULTS: There was a significant impairment in olfactory identification ability in the ultra-high-risk group that later developed a schizophrenia spectrum disorder but not in any other group. CONCLUSIONS: These findings suggest that impairment of olfactory identification is a premorbid marker of transition to schizophrenia, but it is not predictive of psychotic illness more generally.

Adolescent↗
PubMedDate not supplied

The initial evaluation of dysosmia.

Patients with disturbances in their sense of smell often represent a bewildering array of alternative diagnoses. The existing knowledge of olfactory disorders has been schematized into a systematic history approach toward the development of a differential diagnosis for dysosmic patients. Its components should elicit essential elements of the history which, according to the literature, have been associated with dysosmia. The ability to update the details of specific components permits it to be adapted to the needs of the individual practitioner.

Humans↗
PubMed1999

[Smell and taste disorders].

Disorders of the chemical senses are frequent. They can severely affect our lives. Appropriate testing is needed to determine the nature of the patient's complaints. Because many chemosensory disorders are secondary to a wide variety of diseases, olfactory or gustatory complaints may help in establishing certain differential diagnoses, e.g. in Alzheimer's disease. In turn, treatment of the underlying diseases may restore chemosensory function in these patients. Future developments appear possible in light of the availability of standardised tools for the assessment of chemosensory dysfunction.

Alzheimer Disease↗
PubMed1998

Effect of zinc sulfate on sensorineural olfactory disorder.

We administered zinc sulfate to patients with sensorineural (post-viral, post-traumatic, or unknown aetiology) olfactory disorder and examined its effects. The patients were divided into three groups by method of treatment: zinc sulfate only, combination of zinc sulfate and the usual therapy, or the usual therapy. For disorders of post-viral and unknown aetiologies, there were no significant differences in improvement among the three groups. However, for post-traumatic olfactory disorder, the zinc sulfate groups had significantly higher improvement rates than did the group that received the usual therapy. The difference between post-traumatic and post-viral olfactory disorders in the effect of zinc sulfate therapy appeared to depend on the pathology of the associated lesions. In cases of post-traumatic olfactory disorder, regenerative capacity is retained in the olfactory epithelium because the blast cells of olfactory receptor cells remain intact. However, for post-viral olfactory disorder, the lack of olfactory receptor cells and blast cells due to viral infection results in loss of regenerative capacity. We also determined pre-treatment serum zinc concentrations in those patients who planned to be treated with zinc sulfate. Pre-treatment serum zinc concentration was not significantly related to improvement rates.

Craniocerebral Trauma↗
PubMedDate not supplied

[Bilateral isolated trigeminal neuropathy (author's transl)].

Spillane and Wells (1959) were the first to describe the syndrome known as isolated trigeminal neuropathy in which deficit in the trigeminal nerve occurs either unilaterally or bilaterally without evidence of any local lesion. It may be a truly isolated disorder but can also be the predominant element of a more diffuse neuropathy provoking, more particularly, ageusia and anosmia. The bilateral forms are fairly frequently related to connective tissue diseases but many are of unknown aetiology. A case is reported of the bilateral form with ageusia and anosmia, cubital deficit, and slowing of the conduction rate in the limbs. No aetiology was found.

Aged↗
PubMedDate not supplied

[Reflex therapy in the treatment of cochleo-vestibular and olfactory disorders].

The authors have performed combined therapy of 300 patients with acute and subacute neurosensory hypoacusis varying in etiology, 45 patients with acute and subacute disorders of the olfactory analyzer caused by previous infections, emotional stress, inhalation of irritants. The treatment included a 10-day course of reflex therapy, antihypoxic and vasoactive drugs. As a result, a positive trend was observed in acoustic, vestibular and olfactory functions in the majority of cases. The scheme is proposed for routine otorhinolaryngological practice.

Hearing Loss, Sensorineural↗