The Sniffin’ Sticks Odor Discrimination Memory Test: A Rapid, Easy-to-Use, Reusable Procedure for Testing Olfactory Memory

Objectives: Neurodegenerative diseases can alter odor memory in addition to inducing quantitative impairment, and olfactory memory can be tested using the validated olfactory memory test with encapsulated odors (Odor Discrimination Memory Test [ODMT]). The aim of this study was to investigate the new Sniffin’ Sticks ODMT (SSODMT), which is comparable with the ODMT. Methods: The SSODMT was administered to 48 subjects (30 women, 18 men; mean age, 34.6 ± 16.3 years). Olfactory function was assessed using the 16-item Sniffin’ Sticks Identification Test. The ODMT was administered to a subgroup of 10 subjects to assess the comparability of the SSODMT and the ODMT. Test-retest reliability was studied in another 20 subjects (10 women, 10 men; mean age, 32.9 ± 16.4 years). Results: The mean SSODMT score was 10.7 ± 1.8 (range, 5-12). SSODMT test scores were significantly correlated with Sniffin’ Sticks Identification Test scores (r67 = 0.66, P < .001) and were significantly negatively correlated with subject age (r48 = −0.70, P < .001). SSODMT and ODMT scores were highly and significantly correlated, indicating that the test results were comparable (r10 = 0.75, P < .05). Test-retest analysis revealed a significant correlation (r20 = 0.68, P < .001). Conclusions: These results demonstrate the usefulness of the new SSODMT and its comparability with the ODMT. The SSODMT is an easy, rapid, and low-cost tool that is suitable for routine use in evaluating odor memory

Bitter Taste Perception of the Human Tongue Mediated by Quinine and Caffeine Impregnated Taste Strips

Objectives: Tests for gustatory function have become increasingly important in diagnosis and treatment of patients with taste disorders. While caffeine and quinine hydrochloride solutions have been used for global testing of bitter perception, only quinine has been used to test regional bitter perception by means of taste strips. The aim of the present study was to validate caffeine impregnated taste strips as an alternative to quinine taste strips for assessment of regional bitter perception. Methods: A total of 46 healthy volunteers (mean age/range, 23/19-27 years) were included in this study. Quinine and caffeine impregnated taste strips were pairwise presented at different parts of the tongue. Perceived intensity and hedonic dislike were evaluated using labeled magnitude scales. Additionally, gustatory function was assessed using the taste strips test and overall sense of taste was rated using visual analog scales. Results: Assessment of gustatory function demonstrated scores within the normogeusic range in most included subjects (mean/SD, 13.1/2.5). Notably, equally concentrated quinine and caffeine impregnated taste strips placed on different regions of the tongue did not lead to significant differences in perceived intensity or hedonic dislike, whereas quinine and caffeine impregnated taste strips of different concentrations placed on the same region on the tongue led to significant differences of perceived intensity and hedonic dislike. Furthermore, no correlation was found between self-assessment of gustatory function and taste strips scores. Conclusion: Caffeine seems to be a valid bitter compound for regional testing using taste strips and may be used alternatively to quinine

Radiological Markers of the Olfactory Cleft: Relations to Unilateral Orthonasal and Retronasal Olfactory Function

The opacification of the olfactory cleft (OC) has been associated with birhinal orthonasal olfaction in patients with chronic rhinosinusitis (CRS). The aim of this study was to determine the associations between monorhinal and birhinal orthonasal, and retronasal olfaction with radiological markers of the OC in a cohort of patients with CRS. Results were analyzed in a CRS-cohort including 13 patients with nasal polyposis (CRSwNP) and 12 patients with non-eosinophilic CRS (non-eCRS). Monorhinal and birhinal orthonasal olfactory function, and OC-air volume were higher in non-eCRS compared CRSwNP. OC-opacification was also higher in CRSwNP compared to non-eCRS. In the entire CRS-cohort, those with higher OC-opacification showed significantly lower orthonasal and retronasal olfactory test results compared to those with lower OC-opacification across all three coronal planes. Similarly, higher unilateral OC-opacification was also associated with lower ipsilateral orthonasal olfactory function. Correlation analysis further revealed a positive correlation between monorhinal and birhinal orthonasal olfaction with ipsilateral and overall OC-air volume. Likewise, birhinal and monorhinal orthonasal, and retronasal olfactory test results correlated negatively with the overall and ipsilateral Lund-Mackay scores. Monorhinal and birhinal orthonasal, and retronasal olfactory function were lower in CRS patients with higher ipsilateral and overall OC-opacification compared to those with lower OC-opacification

Bitter Taste Disrupts Spatial Discrimination of Piperine-Evoked Burning Sensations: A Pilot Study

Simple Summary The chemical senses smell, taste, and trigeminal sense enable us to interact with the environment and play an essential role in protecting us from hazardous events. It is theorized that capsaicin and piperine not only elicit burning, but also bitter sensations through bitter taste-responding gustatory receptor cells that possess special channels. Similar psychophysiological responses to capsaicin and piperine suggest that bitter taste might also disrupt the spatial discrimination to piperine-induced burning sensations. Results showed that bitter taste disrupted the spatial discrimination of piperine-evoked burning sensations, providing further evidence for a qualitative similarity between burning and bitter sensations and the usefulness of chemical irritants in spatial discrimination tasks. Abstract This study aimed to investigate the perceptual similarity between piperine-induced burning sensations and bitter taste using piperine-impregnated taste strips (PTS). This pilot study included 42 healthy participants. PTS of six ascending concentrations (1 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg piperine/dL 96% ethanol) were presented at the anterior tongue, and participants rated perceived intensity and duration. Then, participants performed a spatial discrimination task in which they had to report which of the two strips presented to the anterior tongue contained an irritating stimulus when one strip was always a PTS while the other strip was impregnated with either a single taste quality (sweet or bitter) or a blank strip. Repeated measures one-way ANOVA revealed that burning sensations of higher concentrated PTS were perceived more intense and more prolonged compared to lower concentrated PTS. McNemar’s test showed that PTS were identified correctly significantly less often when presented with bitter strips compared to when presented with blank (p = 0.002) or sweet strips (p = 0.017). Our results showed that bitter taste disrupts the spatial discrimination of piperine-evoked burning sensations. PTS might serve as a basis for further studies on disease-specific patterns in chemosensory disorders

Diagnostic and therapeutic advances in olfactory and gustatory dysfunction

Hintergrund Die chemischen Sinne des Menschen umfassen olfaktorische, gustatorische und trigeminale Funktionen und können chemische Moleküle in näherer Umgebung detektieren. Die wichtige Beteiligung des Riechvermögens an unserer Feingeschmackswahrnehmung wird vielfach unterschätzt. Folglich hat eine Riecheinschränkung einen starken Einfluss auf die Lebensqualität. Bis zu einem Fünftel der Allgemeinbevölkerung können von einer Riechstörung betroffen sein, und nicht in allen Fällen erfolgt eine medizinische Abklärung. Diese Thesis-Arbeit beinhaltet vier publizierte Studien zu dieser Thematik. Außerdem wird versucht einen umfassenden Überblick über die chemischen Sinne zu geben und weniger bekannte Aspekte hervorzuheben. Methodik In allen dargestellten Studien zur Riechleistung erfolgten Riechtestungen mittels Sniffin sticks. Diese wiederverwendbaren Filzstifte sind mit Duftstoffen befüllt und können zur Testung diverser „Riechdimensionen“ eingesetzt werden. Addierte Scores (TDI) helfen anosmische von hyposmischen Patienten zu unterscheiden. Im Fall von gustatorischen Tests kamen „taste strips“ zur Anwendung entweder in einem „forced-choice“ oder in einem „non-forced-choice“ Verfahren. Zu allen Teilnehmern wurden Fragebögen gesammelt in unterschiedlichem Ausmaß, abhängig vom Studiendesign. Resultate Die erste Studie erarbeitete Selbsttest-Strategien für die Riechdimensionen der Schwellentestung und der Diskriminationstestung, welche üblicherweise von Untersuchern durchgeführt werden. Die vorgeschlagene Strategie erscheint adäquat zur klinischen Selbst- Anwendung. Die zweite Studie fand signifikante Unterschiede der Bitter-Geschmack-Scores hinsichtlich des angewandten Verfahrens. Die dritte Studie validierte einen etablierten Test des Riechgedächtnisses, als Neuheit unter der Anwendung von Sniffin` sticks. Die vierte Studie fand 1/3 der inkludierten Patienten mit einer Riechstörung wären interessiert an einem Riech-Implantat auch in Anbetracht einer möglichen Schädeleröffnung. Schlussfolgerung Die chemischen Sinne sind essentiell, um Speisen genießen zu können und auch potentielle Gefahren zu detektieren. Die präsentierten Arbeiten suchen die klinische Betreuung von Patienten zu erleichtern. Weitere Studien sind, vor allem in Hinblick auf neue Therapieoptionen, dringend nötig, um auch die Lebensqualität dieser Patienten zu verbessern.Background The human chemical senses comprise olfactory, gustatory and trigeminal functions and are able to detect chemical molecules within the closer environment. Widely unknown the sense of smell valuably contributes to flavor perception. Olfactory dysfunction (OD) has a significant impact on quality of life. OD occurs in up to 1/5 of the general population, but only few patients actually seek medical consultation. The following work cumulates four published investigations in this field of interest. Additionally, this work attempts to provide a comprehensive overview on the chemical senses and point out interesting and not commonly known specific features. Methods For all included studies on olfactory function, Sniffin sticks were used to assess olfactory abilities. These reusable felt-tip pens have impregnated tips with odorant fluids and can be used to assess different olfactory dimensions. Composite scores (TDI) help categorizing patients into an anosmic and hyposmic group. For testing gustatory function, impregnated taste strips were used either in a forced-choice or a non-forced-choice paradigm. All included subjects were asked to complete questionnaires in variable extend, depending on study. Results The first study elaborated self-testing strategies for odor threshold and discrimination testing, which in general depend on an examiner. Proposed self-testing strategies seem feasible for clinical settings. The second study comparatively investigated on possible differences in paradigm selection when testing gustatory function. Significant differences were shown for bitter taste function in regard to paradigm. The third study sought to validate an established test for odor memory function now using Sniffin sticks. The fourth study focused on future treatment options in OD and elaborated possible factors in patients` decision towards invasive therapy options. Interestingly, one-third of included patients were interested in an olfactory implant device implicating a neurosurgical approach. Conclusion The chemical senses are essential in food enjoyment and detection of environmental hazards. Presented publications attempt to facilitate OD patient care in clinical settings. Further investigations, especially on treatment options, are needed to also improve quality of life in these patients.Abweichender Titel laut Übersetzung der Verfasserin/des VerfassersArbeit an der Bibliothek noch nicht eingelangt - Daten nicht geprüftMedizinische Universität Wien, Diss., 2019(VLID)440664

Factors Associated with Revision Sinus Surgery in Patients with Chronic Rhinosinusitis

Endoscopic sinus surgery (ESS) is performed in patients diagnosed with Chronic Rhinosinusitis (CRS) refractory to primary medical therapy to achieve adequate disease control. This study aimed to assess which factors and phenotypes of CRS are associated with revision surgery in patients undergoing ESS. This retrospective, single-center study included 667 patients undergoing ESS between 2012 and 2015. We performed group comparisons to detect differences between CRS patients undergoing primary or revision surgery and computed binary logistic regression models. Logistic regression analysis revealed higher odds for revision surgery in CRS patients with older age (p-value &lt; 0.001), male gender (p-value = 0.011), diagnosis of AERD (p-value = 0.005), and presence of asthma (p-value &lt; 0.001) or allergies (p-value = 0.031). Confirming previous studies, we found that the factors of age, CRSwNP, AERD, allergies, and asthma are associated with revision ESS and identified surgical techniques that were predominantly used in revision cases

The Laryngoscope / Olfactory implant : Demand for a future treatment option in patients with olfactory dysfunction

Objectives Therapeutic options in olfactory dysfunction (OD) are limited. Numerous studies have shown impact of OD on quality of life. Lately, various studies support benefits of olfactory training, but therapyrefractory cases leave doctors and patients locked in a stalemate. An olfactory implant (OI), in analogy to the widely successful cochlear implant, still seems far away from realization. The present study sought to evaluate the demand of OI in patients with OD. Methods Sixtyone patients (28 females and 33 males, mean age/standard deviation 54.9/17.6 years) with OD were recruited. We performed olfactory testing for threshold (T), discrimination (D), and identification (I) using Sniffin' Sticks; summed scores (TDI) allowed us to determine normosmia, hyposmia, and anosmia. We applied questionnaires on the importance of smell (IOS), on olfactory disorders (QOD) and on the interest/willingness for OI, considering the need for skull base/head surgery. Results Twentyone patients (34.4%) stated that OI could be a future treatment option for them. This decision significantly correlated with TDI, I, complaintrelated questions of the QOD, and IOS (P<.05). Conclusion With approximately onethird of patients considering OI as a therapy option, this study seems to indicate a demand for OI. In selected patients, with a high degree of complaints, low olfactory test scores, and maybe an additional occupational need for olfactory function, OI might be an option if future developments warrant safety of OI procedures.(VLID)341177

Body-Mass-Index Associated Differences in Ortho- and Retronasal Olfactory Function and the Individual Significance of Olfaction in Health and Disease

Odor (including flavor) perception plays a major role in dietary behavior. Orthonasal olfactory function (OOF) has been shown to decrease in obese subjects. Changes in retronasal olfactory function (ROF) after weight loss and in the individual significance of olfaction (ISO) in obesity are yet to be investigated. Firstly, 15 obese subjects were recruited in a pilot study and supported to conventionally lose weight. OOF (Sniffin’ Sticks) was measured at the beginning and after 5.6 ± 1.3 months. Eleven subjects re-visited but barely lost weight and no major changes in OOF were observed. Secondly, the body-mass-index (BMI), OOF, and ROF (Candy Smell Test, CST) were recorded in subjectively olfactory-healthy subjects (SOHSs) and additionally the ISO questionnaire was collected in patients with olfactory dysfunction (OD). BMI correlated significantly negatively with odor discrimination (p = 0.00004) in 74 SOHSs and negatively with CST (p 0.05). ISO scores were significantly higher in 52 OD patients in comparison to SOHSs (p = 0.0382). Not only OOF but also ROF may decline with higher BMI. ISO does not seem to alter with BMI, but olfaction becomes more important once it is consciously impaired

Association between olfactory function and quality of life in patients with olfactory disorders: a multicenter study in over 760 participants

Background: This cross-sectional, multi-centric study aimed to investigate the differences in quality of life among patients with olfactory dysfunction (OD) of different origin, and to identify factors associated with olfactory-related quality of life (QOL). Methods: Seven hundred sixty-three adults were recruited from 8 Smell & Taste clinics in Germany, Switzerland, and Austria. Olfactory-related QOL was assessed by the Questionnaire of Olfactory Disorders (QOD). Olfactory function was assessed with the Sniffin' Sticks test; self-assessment was performed with visual analog scales. Results: Patients with post-infectious and post-traumatic OD showed poorer olfactory-related QOL than patients with sinonasal and idiopathic OD. The olfactory-related QOL was positively associated with the Sniffin' Sticks test score, self-assessed olfactory function, disease duration, and age, with younger olfactory dysfunction patients showing lower QOL. Female patients presented with poorer olfactory-related QOL. In addition, the results showed that self-assessment of olfactory function explained more of the variance in olfactory-related QOL than olfactory function evaluated by the Sniffin' Sticks test. Conclusions: In addition to the psychophysical testing results, several factors such as disease cause, disease duration, sex, or self-assessed olfactory dysfunction should be taken into account when assessing the individual severity of the smell loss