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Risk of decline and chance of improvement in olfaction among patients with post-traumatic olfactory loss

Published online by Cambridge University Press:  22 October 2015

C-L Kuo
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, Republic of China Department of Otolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Department of Otolaryngology, Taoyuan Armed Forces General Hospital, Taiwan, Republic of China Department of Otolaryngology, Hsinchu Armed Force Hospital, Taiwan, Republic of China
C-H Shu*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China Department of Otolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China
*
Address for correspondence: Dr Chih-Hung Shu, Department of Otorhinolaryngology – Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, Republic of China Fax: +886 2 2875 5715 E-mail: chihhung003@gmail.com

Abstract

Objective:

To evaluate the chance of improvement and risk of decline in olfaction among patients with post-traumatic olfactory loss.

Methods:

This study comprised 80 patients. Changes in olfaction were determined using a visual analogue scale and the ‘Sniffin’ Sticks' test. Logistic regression was used to identify predictors for olfactory changes.

Results:

Olfactory changes were observed in 9–35 per cent of patients. The rates of improvement and decline according to visual analogue scale scores were 35 per cent and 10 per cent respectively, whereas those in the Sniffin’ Sticks test were 9 per cent and 11 per cent respectively. There was a predictive link between non-anosmia and decline in Sniffin’ Sticks test scores (odds ratio = 16.61, p = 0.003). A positive correlation was observed between the scores in the first and last examinations (rho = 0.532, p < 0.001).

Conclusion:

Patients should be informed that they may experience an improvement or decline in olfaction following post-traumatic olfactory dysfunction. This study provides evidence to support comprehensive counselling regarding prognosis as an integral part of management strategies.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented orally at the 118th American Academy of Otolaryngology – Head and Neck Surgery Annual Meeting and OTO EXPOSM, 21–24 September 2014, Orlando, Florida, USA.

References

1Landis, BN, Konnerth, CG, Hummel, T. A study on the frequency of olfactory dysfunction. Laryngoscope 2004;114:1764–9CrossRefGoogle Scholar
2Collet, S, Grulois, V, Bertrand, B, Rombaux, P. Post-traumatic olfactory dysfunction: a cohort study and update. B-ENT 2009;5(suppl 13):97107Google ScholarPubMed
3Schofield, PW, Moore, TM, Gardner, A. Traumatic brain injury and olfaction: a systematic review. Front Neurol 2014;5:5CrossRefGoogle ScholarPubMed
4Costanzo, RM, Miwa, T. Posttraumatic olfactory loss. Adv Otorhinolaryngol 2006;63:99107Google ScholarPubMed
5Rombaux, P, Huart, C, Deggouj, N, Duprez, T, Hummel, T. Prognostic value of olfactory bulb volume measurement for recovery in postinfectious and posttraumatic olfactory loss. Otolaryngol Head Neck Surg 2012;147:1136–41CrossRefGoogle ScholarPubMed
6Jiang, RS, Wu, SH, Liang, KL, Shiao, JY, Hsin, CH, Su, MC. Steroid treatment of posttraumatic anosmia. Eur Arch Otorhinolaryngol 2010;267:1563–7CrossRefGoogle ScholarPubMed
7Ikeda, K, Sakurada, T, Takasaka, T, Okitsu, T, Yoshida, S. Anosmia following head trauma: preliminary study of steroid treatment. Tohoku J Exp Med 1995;177:343–51CrossRefGoogle ScholarPubMed
8Fujii, M, Fukazawa, K, Takayasu, S, Sakagami, M. Olfactory dysfunction in patients with head trauma. Auris Nasus Larynx 2002;29:3540CrossRefGoogle ScholarPubMed
9Fukazawa, K, Fujii, M, Tomofuji, S, Ogasawara, H, Seo, W, Sakagami, M. Local injection of dexamethasone acetate suspension into the nasal mucosa in cases of olfactory disturbance [in Japanese]. Nihon Jibiinkoka Gakkai Kaiho 1999;102:1175–83CrossRefGoogle ScholarPubMed
10Seo, BS, Lee, HJ, Mo, JH, Lee, CH, Rhee, CS, Kim, JW. Treatment of postviral olfactory loss with glucocorticoids, Ginkgo biloba, and mometasone nasal spray. Arch Otolaryngol Head Neck Surg 2009;135:1000–4CrossRefGoogle ScholarPubMed
11Lee, CH, Mo, JH, Shim, SH, Ahn, JM, Kim, JW. Effect of ginkgo biloba and dexamethasone in the treatment of 3-methylindole-induced anosmia mouse model. Am J Rhinol 2008;22:292–6CrossRefGoogle ScholarPubMed
12Elovic, EP, Zafonte, RD. Ginkgo biloba: applications in traumatic brain injury. J Head Trauma Rehabil 2001;16:603–7CrossRefGoogle ScholarPubMed
13Hummel, T, Sekinger, B, Wolf, SR, Pauli, E, Kobal, G. ‘Sniffin' sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 1997;22:3952CrossRefGoogle ScholarPubMed
14Hummel, T, Kobal, G, Gudziol, H, Mackay-Sim, A. Normative data for the “Sniffin' Sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 2007;264:237–43CrossRefGoogle Scholar
15Reden, J, Mueller, A, Mueller, C, Konstantinidis, I, Frasnelli, J, Landis, BN et al. Recovery of olfactory function following closed head injury or infections of the upper respiratory tract. Arch Otolaryngol Head Neck Surg 2006;132:265–9CrossRefGoogle ScholarPubMed
16London, B, Nabet, B, Fisher, AR, White, B, Sammel, MD, Doty, RL. Predictors of prognosis in patients with olfactory disturbance. Ann Neurol 2008;63:159–66CrossRefGoogle ScholarPubMed
17Callahan, CD, Hinkebein, JH. Assessment of anosmia after traumatic brain injury: performance characteristics of the University of Pennsylvania Smell Identification Test. J Head Trauma Rehabil 2002;17:251–6CrossRefGoogle ScholarPubMed
18Landis, BN, Hummel, T, Hugentobler, M, Giger, R, Lacroix, JS. Ratings of overall olfactory function. Chem Senses 2003;28:691–4CrossRefGoogle ScholarPubMed
19Shu, CH, Hummel, T, Lee, PL, Chiu, CH, Lin, SH, Yuan, BC. The proportion of self-rated olfactory dysfunction does not change across the life span. Am J Rhinol Allergy 2009;23:413–16CrossRefGoogle Scholar
20Doty, RL, Yousem, DM, Pham, LT, Kreshak, AA, Geckle, R, Lee, WW. Olfactory dysfunction in patients with head trauma. Arch Neurol 1997;54:1131–40CrossRefGoogle ScholarPubMed
21Zusho, H. Posttraumatic anosmia. Arch Otolaryngol 1982;108:90–2CrossRefGoogle ScholarPubMed
22Welge-Lüssen, A, Hilgenfeld, A, Meusel, T, Hummel, T. Long-term follow-up of posttraumatic olfactory disorders. Rhinology 2012;50:6772CrossRefGoogle ScholarPubMed
23Haxel, BR, Grant, L, Mackay-Sim, A. Olfactory dysfunction after head injury. J Head Trauma Rehabil 2008;23:407–13CrossRefGoogle ScholarPubMed
24Green, P, Iverson, GL. Effects of injury severity and cognitive exaggeration on olfactory deficits in head injury compensation claims. NeuroRehabilitation 2001;16:237–43CrossRefGoogle ScholarPubMed