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PubMed1975

Defects of taste and smell in patients with hypothyroidism.

Taste and smell functions were measured in 18 unselected patients with untreated primary hypothyroidism, and in 15 of the 18 patients after treatment with thyroid hormones. Before treatment, 9 of the 18 patients (50 per cent) were aware of some alteration in their sense of taste, and 7 of the 18 patients (39 per cent) were aware of some alteration in their sense of smell. Distoritions of tase (dysgeusia) and smell (dysosmia) were frequent complaints among the untreated patients; dysgeusia was observed by 7 patients (39 per cent) and dysosmia by 3 patients (17 per cent). Median detection and recognition thresholds for four taste stimuli salt (sodium chloride), sweet (sucrose), sour (hydrochloric acid) and bitter (urea), and for two smell stimuli (pyridine and nitrobenzene), were determined in each patient before and after treatment with thyroid hormones. Before treatment, decreased taste acuity (hypogeusia) for at least one stimulus was observed in 14 of the patients (83 per cent); the most common abnormalities were in the detection and recognition of bitter stimuli. Median detection thresholds for both smell stimuli were also markedly elevated (hyposmia) before therapy. Treatment with throid hormones largely reversed both the taste and smell defects. In one patient, taste and smell abnormalities were completely corrected after 16 days of treatment with thyroxine. This study indicates that taste and smell defects are common clinical abnormalities in primary hypothyroidism, and suggests that these defects may contribute to the anorexia and lack of interest in eating which are frequently observed.

Adult↗
PubMed1986

Role of thought, sight, smell, and taste of food in the cephalic phase of gastric acid secretion in humans.

The relative importance of thought, sight, smell, and taste of food in the cephalic phase of gastric acid secretion has not been studied systematically. We found that discussing appetizing food for 30 min (without sight, smell, or taste) increased acid secretion from 4 to 13 mmol/h in healthy human subjects (p less than 0.001) and also increased serum gastrin concentrations significantly (p less than 0.02). Discussing food resulted in an acid secretory response that averaged 66% +/- 10% of the response to modified sham feeding, which activates thought, sight, smell, and taste. Discussing topics other than food (e.g., current events, sports) did not increase acid secretion significantly. The sight of appetizing food (without smell or taste), the smell of appetizing food (without sight or taste), or the combination of sight and smell (without taste) also increased acid secretion and serum gastrin concentrations significantly. However, sight and smell were significantly less potent stimulants of acid secretion than sham feeding, with responses averaging only 23%-46% of the response to sham feeding. These studies indicate that thinking about food is a potent stimulant of gastric secretion in healthy humans. Moreover, the sight and smell of food increase gastric acid secretion and serum gastrin concentrations, probably by provoking thoughts related to food.

Adult↗
PubMed1986

[Role of smell in the food-seeking activity of newborn puppies].

In 36 newborn puppies, positive responses to the mother hair smell appear immediately after birth which indicates emanation of a corresponding pheromone. Within 6 hrs after isolation from the mother, the preference for her smell is reduced and substituted with a response to hair smell of other females. Learning of the motor to the mother smell seems to occur yet in prenatal period. The inherent negative response to cat's smell does not depend on the duration of the puppy isolation from the mother. During first 3 days of life (the 1st period), learning of the food-seeking response to an artificial smell is possible (imprinting). Starting from the 4th-5th day of life, the ability to form a food-seeking response to smell disappears. In 11-12 day old puppies, a conditioning can be achieved by means of combining smell with feeding 5-6 times. The role of olfaction in the puppy food-seeking behaviour during ontogenesis, is discussed.

Animals↗
PubMed1989

Characteristics of rat lateral hypothalamic neuron responses to smell and taste in emotional behavior.

Single unit activity in the lateral hypothalamus (LHA) of the rat was recorded while the animal learned to discriminate cue signals. Normally preferred potables (glucose, orange, or grape solution) or intracranial self-stimulation (ICSS) were used as rewards. Electric shock or tail pinch were used as aversive stimuli. The same behavior, licking, was the response required to either obtain the rewarding stimuli or avoid the aversive ones. For positive reinforcement a rat was rewarded with fluid or ICSS upon licking a spout presented in front of its mouth. In negative reinforcement experiments, an aversive stimulus, electric shock or tail pinch, was applied if the rat did not lick the spout. Solutions having smell only, taste only, or smell-plus-taste, were prepared from oranges or grape extract. Of 392 neurons analyzed, 256 responded differentially to rewarding and aversive stimuli, and 138 of these were tested with the 3 different solutions. Similar LHA neural responses occurred during actual drinking of the 3 kinds of solutions, as well as on recognition of the cue signal. Responses to smell only had shorter latency than responses to taste only. Neural activity in response to solutions that could be both smelled and tasted was the sum of activity in response to taste-only solutions plus that in response to smell-only solutions. Cue signal responses were rapidly acquired, usually within 2-5 trials, for both taste-only and smell-only solutions. The results indicate the integration of both taste and olfactory information by the same LHA neurons, and these neurons are involved in cue signal learning. Present results of LHA neuronal responses to taste and smell suggest that the intensity of gustation and olfaction may add together to enhance instinctive hedonic sensations. These neurons are involved in the formation of stimulus-reinforcement association in learning, and in elicitation of conditioned emotional responses.

Action Potentials↗
PubMed1998

Relation between CT scan findings and human sense of smell.

Symptom questionnaires were obtained from 106 patients immediately before nasal and sinus computed tomography scans at the Johns Hopkins Outpatient Center. Their scans were analyzed by two otolaryngologists and three neuroradiologists by using a semiobjective rating system of the size and opacity of 36 anatomic areas. Patients estimated their own left and right sense of smell as excellent, diminished, or absent. Results of the data are as follows: (1) There is no correlation between smell ability and size of the nasal and sinus structures. This indicates that there is no gross effect of the bulging of sinuses into the nasal airway; (2) As a rule, opacity of only left-sided anatomic structures was correlated with both left and right sense of smell (p < 0.01). This suggests that our subjects were using their left smell receptors preferentially, to the exclusion of and in place of the right smell receptors; and (3) Total, not partial, opacity of the left olfactory cleft, frontal recess, or ethmoidal infundibulum was correlated with decreased sense of smell. This suggests that these anterior structures in the region of the olfactory cleft do affect airflow, but complete obstruction of these spaces is needed. Possible explanations for the effect of opacified sinuses on the sense of smell include (1) The presence of fluid or thickened mucosa in the sinuses may interfere with perceived olfactory ability by changing nasal airflow patterns or odorant access to receptors; (2) There may be olfactory receptors inside the sinuses; and (3) There may be a relation between the trigeminal receptors in the sinuses and the olfactory system.

Humans↗
PubMed2004

A longitudinal descriptive study of self-reported abnormal smell and taste perception in pregnant women.

Self-reported abnormal sensitivity, qualitative distortions and phantom sensations with respect to smell and taste was assessed with a longitudinal design, based on questions referring to gestational weeks 13-16 and 31-34 of pregnancy in comparison with 9-12 weeks post partum and with non-pregnant women with corresponding time durations and intervals. The results show that abnormal smell and/or taste perception was reported by 76% of the pregnant women, typically believed to be caused by their pregnancy. Increased smell sensitivity was found to be very common at the early stage of pregnancy (67% of all pregnant respondents) and occasionally accompanied by qualitative smell distortions (17%) and phantom smells (14%). The smell abnormalities were less common at the late pregnancy stage and almost absent post partum. Abnormal taste sensitivity was fairly commonly reported (26%), often described as increased bitter sensitivity and decreased salt sensitivity. These results, suggesting that abnormal smell and/or taste perception is experienced by a large majority of pregnant women, imply that further research is needed to understand to what extent these chemosensory changes may underlie food aversions and craving with implications for food intake during pregnancy.

Diet↗
PubMed1993

Smell dysfunction and related factors in diabetic patients.

OBJECTIVE: To analyze smell function in diabetic patients and healthy control subjects, with reference to individual characteristics and major complications of the disease. RESEARCH DESIGN AND METHODS: A cross-sectional study of smell recognition in 68 diabetic patients and 30 control subjects without known cause of smell impairment was conducted. Smell was studied using a kit of flavors that patients were asked to recognize, leading to a smell recognition score ranging from 0 (no recognition) to 20 (perfect recognition). Demographic and clinical data, and the electrogustometric threshold were recorded in both groups. Metabolic control and degenerative complications were studied in diabetic patients. RESULTS: The SRS was significantly lower in diabetic patients than in control subjects (12.4 +/- 0.5 vs. 15.1 +/- 0.5, P < 0.001). By use of univariate and multivariate analyses, this difference could not be explained by individual factors such as age, sex, body mass index, blood pressure, or tobacco or alcohol consumption but was related to diabetes. SRS correlated with EGT (r = 0.70, P < 0.001). In the diabetic group, SRS was associated with age (r = 0.29, P < 0.05), duration of diabetes (r = 0.27, P < 0.05), microalbuminuria (12.2 +/- 0.8 vs. 14.4 +/- 0.9, P < 0.05), peripheral neuropathy (10.3 +/- 1.0 vs. 14.1 +/- 0.9, P < 0.01), and EGT (r = 0.39; P < 0.001). By use of multivariate analysis, the strongest association was found with EGT (R2 = 0.15). CONCLUSIONS: These results suggest that smell recognition is impaired in patients with diabetes mellitus. Smell dysfunction is associated with age and degenerative complications of diabetes, suggesting a degenerative mechanism related to diabetes.

Adult↗
PubMed1994

Smell acuity for acetone and its relationship to taste ability to phenylthiocarbamide in a Nigerian population.

Acetone smell sensitivity and phenylthiocarbamide taste sensitivity thresholds have been measured simultaneously for 970 Nigerians (542 males and 428 females) using modified sorting techniques. The distribution was bimodal in both cases and the frequency of subjects with high smell acuity for acetone was 9.6% while that of non-tasters was 12.60% with a gene frequency, as computed by maximum likelihood methods, of 0.355 +/- 0.015. Females showed a higher frequency for smell sensitivity to acetone but a slightly lower frequency of non-tasters compared to males. Acetone smell sensitivity and PTC with high smell acuity for acetone were tasters while 30.28% of subjects least sensitive taste ability decreased with age in the overall population. All the subjects least sensitive to acetone were non-tasters, a significantly higher proportion than in the overall population. The correlation between acetone smell acuity and phenylthiocarbamide taste ability demonstrates a strong allelic association. All the 94 individuals with high smell acuity for Acetone were tasters for phenylthiocarbamide.

Acetone↗
PubMed1990

[Relationship between an offensive smell given off from human foot and Staphylococcus epidermidis].

The bacteria isolated from foot skins of 17 volunteers by the swab sampling method were mostly gram-positive cocci, which were identified as Staphylococcus epidermidis by the ID-kit SP-18 (Nissui Co., Ltd). After incubation of S. epidermidis on agar plates containing oleic acid and Tween 80 for 24 h at 35 C, the smell noticed was similar to an offensive smell of human pes. However, under the same conditions, the smell of another staphylococcal species was different from that of S. epidermidis. Except for the staphylococcal species, the colonies isolated from the skins were mostly those of yeast (unidentified) and gave off no offensive smell. From these results, it was considered that the smell of human pes might be given off by S. epidermidis, and if this species is inhibited, the smell would also be inhibited. A selective bactericide for gram-positive bacteria, which is a lotion containing deoxycholic acid, was applied to the feet of the 17 volunteers. The experiments showed that the application obviously decreased the counts of colonies of S. epidermidis and inhibited the smell as compared with controls.

Adult↗
PubMed2005

Smell identification ability in twin pairs discordant for Parkinson's disease.

Olfactory dysfunction has been proposed to be a sign that may precede the motor features of Parkinson's disease (PD). To determine whether smell identification deficits predict subsequent PD, we studied smell identification ability using the University of Pennsylvania Smell Identification Test (UPSIT) in 62 members of male twin pairs discordant for PD at baseline. Smell identification ability was reduced at baseline in the twins with PD compared to their unaffected brothers (23 vs. 31 of 40; P = 0.001). UPSIT scores were not reduced in the twins without PD when compared to age- and gender-specific normal values. After a mean interval of 7.3 years, 28 unaffected twins were still alive and 19 agreed to a second evaluation. Two had newly developed PD. Neither twin had impaired smell identification at baseline. The average decline in UPSIT percentile scores in these 2 twins was greater than in the 17 twins who did not develop PD (-68% vs. -24%; P = 0.01). In subjects who did not meet Core Assessment Program for Intracerebral Transplantations diagnostic criteria for PD at baseline, the presence of cardinal signs of parkinsonism was not associated with lower baseline UPSIT scores nor with a subsequent decline. Smell identification ability may not be a sensitive indicator of future PD 7 or more years before the development of motor signs, even in a theoretically at-risk population.

Aged↗
PubMed2002

[Do blind persons have a better sense of smell than normal sighted people?].

Functional disorders of sense organs may intensify the remaining senses. It is presumed that blind persons do not only hear better and have an intensified tactile sense but also have a stronger sense of smell. Better hearing ability was demonstrated by auditory evoked potentials. We investigated the sense of smell of blind persons by subjective tests (Sniffin' sticks: threshold, discrimination and identification) and for the first time also by objective tests (olfactory evoked potentials and trigeminal evoked potentials) and compared the results with the smelling ability of normal sighted persons by pair matching. Moreover, the investigated persons judged their performance via a questionnaire. The subjective test showed neither differences in the peripheral function nor in the central function between both groups. The amplitudes and latencies of the evoked potentials of vanillin, carbon dioxide and hydrogen sulfide were also not different. Blind persons tried unasked to identify the smell given in the discrimination test and thought themselves to be better in smelling. For the first time the smelling ability of blind people was compared with normal sighted people by objective test methods. Neither with subjective nor with objective methods differences were found.

Adult↗
PubMed1999

[Screening of olfaction with smell diskettes].

BACKGROUND: Aim of the study was the development of a new screening test of olfaction with reusable diskettes as odorant applicators. METHODS: A screening test of olfaction was designed using 8 diskettes containing different odorants. The diskettes can be opened to release the odor and are closed after testing. The test was designed as a triple forced multiple choice test using a questionnaire, resulting in a score from 0 to 8 correct answers. Ninety-one volunteers with a normal sense of smell and 13 patients with subjective hyposmia or anosmia were tested to validate the developed test. The same volunteers were also tested with the sniffin' sticks test, another screening test of olfaction that is already validated. After testing, the volunteers were asked to compare the two tests. RESULTS: Among the 91 volunteers with normal sense of smell, 10 achieved a score of 7, and 81 a score of 8 in the smell disk test. The 13 patients with hyposmia or anosmia achieved a score between 0 and 5. Based on the test design, there is a probability of 99.74% that a person who achieves a score of 7 or 8 will have normal olfaction. In the sniffin' sticks test, 85 volunteers with normal sense of smell achieved a score in the normal range for this test (6-8) whereas 6 volunteers were below with a score of 4 or 5. The 13 patients with hyposmia or anosmia scored between 0 and 6. The smell disk test was preferred by 86 persons, the sniffin' sticks test by 5, and 12 assessed both tests as equal. CONCLUSIONS: The developed screening test is reliable for identifying patients with a normal sense of smell, and it can distinguish them from patients with hyposmia and anosmia. The diskettes proved to be reliable and comfortable applicators for odorants in clinical practice.

Adolescent↗
PubMed1990

Smell and taste function in subjects with chronic obstructive pulmonary disease. Effect of long-term oxygen via nasal cannulas.

It was hypothesized that subjects with chronic obstructive pulmonary disease (COPD) receiving long-term oxygen via nasal cannulas have an impaired sense of smell and/or taste. To objectively evaluate the sense of smell and taste, this study used the University of Pennsylvania Identification Test (UPSIT), a 40-item "scratch-n-sniff" test and a 20-item taste test using the four basic taste sensations of sweet, salt, sour, and bitter. Twenty subjects (15 male, 5 female) with severe COPD receiving long-term oxygen therapy (group 1), and an equal number of age- and sex-matched subjects with COPD not receiving oxygen therapy (group 2), and a healthy control group (group 3) were studied. Twelve subjects (seven male, five female) from group 1 subsequently underwent transtracheal oxygen catheter installation. Mean +/- SD for the basic smell test was significantly greater in group 3 (35.35 +/- 3.58) as compared with group 1 (27.70 +/- 6.07) or group 2 (31.10 +/- 4.95) (p less than 0.005). The difference between group 1 and 2 was not significant (p = 0.066). However, when adjusted for pack years of smoking, there were no significant differences between the three groups. Mean +/- SD correct responses for the basic taste test were significantly greater in group 3 (15.75 +/- 1.81) as compared with group 2 (12.8 +/- 2.78) (p less than 0.005) and group 1 (14.00 +/- 2.33) (p less than 0.05). There was no significant difference between group 1 and 2. The corrected data for taste, adjusted for years since quitting smoking, did not alter the basic differences between the groups. Mean smell and taste test scores were essentially unchanged in 12 subjects after six months of transtracheal oxygen therapy. Long-term oxygen use via nasal cannulas in this group of subjects with COPD did not appear to impair their sense of smell and taste. Smoking had a significant but variable effect on the sense of smell and taste.

Female↗
PubMed2000

Smell and taste disorders: a primary care approach.

Smell and taste disorders are common in the general population, with loss of smell occurring more frequently. Although these disorders can have a substantial impact on quality of life and may represent significant underlying disease, they are often overlooked by the medical community. Patients may have difficulty recognizing smell versus taste dysfunction and frequently confuse the concepts of "flavor" and "taste." While the most common causes of smell disturbance are nasal and sinus disease, upper respiratory infection and head trauma, frequent causes of taste disturbance include oral infections, oral appliances (e.g., dentures), dental procedures and Bell's palsy. Medications can interfere with smell and taste, and should be reviewed in all patients with reported dysfunction. In addition, advancing age has been associated with a natural impairment of smell and taste ability. A focused history and a physical examination of the nose and mouth are usually sufficient to screen for underlying pathology. Computed tomographic scanning or magnetic resonance imaging of affected areas, as well as commercially available standardized tests, may be useful in selected patients. The causes of olfactory dysfunction that are most amenable to treatment include obstructing polyps or other masses (treated by excision) and inflammation (treated with steroids). Enhancement of food flavor and appearance can improve quality of life in patients with irreversible dysfunction.

Age Factors↗
PubMed2001

The effect of laser assisted uvulopalatoplasty on the sense of smell and taste.

AIM: To assess the effect, if any, of Laser Assisted Uvulo Palatoplasty (LAUP) on the sense of smell and taste. MATERIALS AND METHODS: A prospective study examined 33 patients undergoing LAUP for snoring. Significant sinonasal pathology was excluded in all patients by a complete examination including rigid nasal endoscopy. None of the cases had any systemic illness or drug history that was likely to affect the sense of smell or taste. Twenty-eight patients were male and five female. The mean age was 44 years (range, 25-67). Twelve patients (36%) were regular smokers, and eight patients (24%) were ex-smokers all of whom reported a change in smell and taste after stopping. Preoperative assessment utilised a visual analogue score of smell and taste perception, the University of Pennsylvania Smell Identification Test (UPSIT) for the assessment of olfaction (maximum score of 40), and whole mouth testing for solutions of NaCl, sucrose, quinine, citric acid and acetic acid. LAUP technique was standardised for each case and reassessment was performed 3 months postoperatively. RESULTS: Three patients failed to complete the study and were excluded. The mean values for visual analogue score pre and post surgery were 9.1 and 8.9 respectively, which was not significant using Wilcoxon Rank test (P = 0.257). The mean value of the UPSIT scores before surgery were 32.3 (+4.0), range, 24-39, and after surgery 31.2 (+4.3), range 20-37. There was no significant difference in pre and post UPSIT scores (p = 0.068). Whole mouth taste testing had a preoperative mean value of 4.1 and a postoperative value of 4.2. The difference was not statistically significant, Wilcoxon Rank test (p = 0.317). CONCLUSION: In this study there was no significant change in the patients' perception of smell and taste or in their objective measurement following a standardised Laser Assisted Uvulopalatoplasty.

Adult↗
PubMed2006

[Estimation of smell sense rehabilitation in patients after total laryngectomy].

The loss of sense of smell significantly decreases a quality of life after total laryngectomy. That is why this problem should be considered within a complex rehabilitation of laryngectomized patients. The smell exercises ought to start parallely to the speech rehabilitation. The aim of our study was to estimate the efficacy of smell rehabilitation after total laryngectomy. 59 persons after total laryngectomy attending the fourteen days long rehabilitation camp were examined. All the patients had the examination of three smells identification (lemon, mint and anise) made before the beginning of exercises. All the persons had also the efficacy of air aspiration through the nose measured. The control examination of those parameters was conducted after fourteen days of exercises of making the negative pressure in the throat and nasopharynx directing the air flow into the olfactory area of the nose. We confirmed a statistically significant differences between the smell identification and the force of aspiration before and after rehabilitation. We confirmed that patient's age and the time from laryngectomy have the influence into the efficacy of smell rehabilitation.

Adult↗
PubMedDate not supplied

Disturbances of smell and taste after high central midface fractures.

Estimation of the senses of smell and taste in patients who had suffered a high central midface fracture between 1979 and 1989 was carried out. 180 of these patients were operated on for repositioning and fixation of their fractures. A written questionnaire was sent to 165 living patients, 109 individuals responded, a response rate of 66%. Of these patients, 38% claimed to suffer impaired ability to smell and 23% not to taste well. 64% mentioned unconsciousness after the trauma. With rising seriousness of the trauma, more disturbances of smell are found: from 25% of the nasal fractures, to 80% of the fronto-nasal-Le Fort fractures. In more than half of the cases of disturbance of smell, a simultaneous impairment of taste was reported. It can be concluded that disturbance of smell most often appears after fronto-maxillary and fronto-nasal fractures. However, the higher and more extensive the fracture is, the more frequently is unconsciousness reported. Consequently, impairment of smell can be attributed to the fracture itself, but also to a cerebral lesion located more proximally.

Adolescent↗
PubMed2004

Taste and smell disturbance with the alpha-adrenoceptor agonist midodrine.

OBJECTIVE: To report a case of a disturbance of taste and smell associated with the alpha-adrenoceptor agonist midodrine. CASE SUMMARY: A 64-year-old white man with autonomic failure was started on midodrine 5 mg/day as treatment for orthostatic hypotension. After 3 months, the dose was increased to 12.5 mg/day, whereupon he noted a new onset of taste and smell disturbance. These symptoms made eating so unpleasant that the man greatly reduced his food intake, leading to significant weight loss. In addition, he experienced well-recognized adverse effects of midodrine, such as scalp pruritus, after the dose increase. All symptoms resolved with a dose reduction of midodrine (to 5 mg/day), and the patient increased his food intake, resulting in a return to his initial body weight. DISCUSSION: Midodrine is commonly associated with dose-dependent adverse effects, such as scalp pruritus and cutis anserina. Disorders of taste and smell have not been previously reported with midodrine, although it has been suggested that other sympathomimetic drugs may have effects on the olfactory threshold. Severe disorders of taste and smell may impact not only on a patient's quality of life, but also on their physical well-being, with significant weight loss being reported in this case. According to the Naranjo probability scale, this patient's taste and smell disturbance was probably associated with midodrine. CONCLUSIONS: The use of midodrine may be associated with taste and smell disturbance. This case suggests that such an association is likely to be dose dependent.

Adrenergic alpha-Antagonists↗