Impact Assessment of Smell and Taste Disorders on Quality of Life in Thais Using the SF-36 Health Survey (Thai version)

Objective: Smell and taste defects adversely affect both physical and mental health. The Short Form (SF)-36 Health Survey is a widely used tool for the quality of life (QoL) assessment. The aim of this study was to investigate the impact of smell and taste disorders on QoL in Thais using the SF-36 Health Survey (Thai version). Methods: This retrospective chart review included the patients with smell and taste disorders that attended our clinic during 2011 to 2016. Smell ability was evaluated by phenyl ethyl alcohol odor detection threshold, and smell discrimination and identification tests. Taste ability was evaluated by electrogustometry, regional testing, and modified taste strips. SF-36 was used to assess QoL. Results: Three hundred fifty-five patients were included in the final analysis. The mean age was 50.8±15.5 years, and 64.2% were female. Most patients (78.59%) had smell disorder only, 15.78% had taste disorder only, and 5.63% had both disorders. Specific to taste disorders, QoL was significantly lower in the patient group than in healthy population for the following 6 domains: physical function, role-physical, bodily pain, general health, vitality, and role-emotional (all p<0.05). Conclusion: The four major causes of smell and taste disorders are nasal/sinonasal diseases, idiopathic causes, post-URI, and head trauma. Women are more often affected than men. Although smell and taste disorders both adversely affect physical and mental health, the taste disorders cause more adverse effect. An assessment tool that is specific to smell and taste disorders may facilitate more detailed elucidation of the effect of these conditions on QoL

Impact Assessment of Smell and Taste Disorders on Quality of Life in Thais Using the SF-36 Health Survey (Thai version)

Objective: Smell and taste defects adversely affect both physical and mental health. The Short Form (SF)-36 Health Survey is a widely used tool for the quality of life (QoL) assessment. The aim of this study was to investigate the impact of smell and taste disorders on QoL in Thais using the SF-36 Health Survey (Thai version). Methods: This retrospective chart review included the patients with smell and taste disorders that attended our clinic during 2011 to 2016. Smell ability was evaluated by phenyl ethyl alcohol odor detection threshold, and smell discrimination and identification tests. Taste ability was evaluated by electrogustometry, regional testing, and modified taste strips. SF-36 was used to assess QoL. Results: Three hundred fifty-five patients were included in the final analysis. The mean age was 50.8±15.5 years, and 64.2% were female. Most patients (78.59%) had smell disorder only, 15.78% had taste disorder only, and 5.63% had both disorders. Specific to taste disorders, QoL was significantly lower in the patient group than in healthy population for the following 6 domains: physical function, role-physical, bodily pain, general health, vitality, and role-emotional (all p<0.05). Conclusion: The four major causes of smell and taste disorders are nasal/sinonasal diseases, idiopathic causes, post-URI, and head trauma. Women are more often affected than men. Although smell and taste disorders both adversely affect physical and mental health, the taste disorders cause more adverse effect. An assessment tool that is specific to smell and taste disorders may facilitate more detailed elucidation of the effect of these conditions on QoL

Radiofrequency Inferior Turbinate Reduction Improves Smell Ability of Patients with Chronic Rhinitis and Inferior Turbinate Hypertrophy

Radiofrequency inferior turbinate reduction (RFITR) of inferior turbinate hypertrophy (ITH) is an effective way to treat patients with intractable nasal mucosal obstruction. The objective of this study was to assess smell ability, nasal symptoms, inferior turbinate grading (ITG), peak nasal inspiratory flow (PNIF) of patients with chronic rhinitis (CR), and ITH before and after RFITR. Patients with CR and ITH, aged 18–60 years, who underwent RFITR, were prospectively recruited. Smell ability (measured by smell detection threshold [SDT]), visual analog scale (VAS) of nasal symptoms, ITG, and PNIF before and 6–10 weeks after RFITR were compared. Forty-eight subjects were included. All nasal symptoms were significantly decreased after RFITR. After surgery, SDT (tested by phenyl ethyl alcohol) was worsened in 7 patients (14.6%), improved in 8 patients (16.7%), and did not change in 33 patients (68.7%). SDT after RFITR of six patients in the worsened SDT group were still within normal range (> −6.5). There was only one patient whose SDT changed from normosmia to mild hyposmia (–7.25 to −5.38). In the improved SDT group, two of eight patients had obviously better SDT after RFITR, which changed from moderate hyposmia to normosmia (–3.65 to −10; −3.73 to −10), whereas six of eight patients had little better SDT after RFITR. RFITR also significantly reduced ITG and improved PNIF. In conclusion, the treatment of patients with CR and ITH with RFITR significantly improved PNIF, ITG, and nasal symptoms assessed by VAS, although SDT after RFITR could be the same or improved or worsened

Characteristics and Clinical Presentations of Patients at the Siriraj Snoring Clinic

Objective: To describe characteristics and clinical presentations of patients in Siriraj snoring clinic and to analyze their relationships with obstructive sleep apnea (OSA) severity. Methods: Three hundred and seventy-three patients’self-administered questionnaires regarding sleep problems recorded between January 2012 and December 2013 and 275 polysomnographic reports were reviewed. Results: Among 373 respondents, there were 247 males (66.2%) and 126 females (33.8%), with an average age of 48 years and body mass index of 28.2 kg/m2.  Their most common complaints and comorbidities were snoring ≥3 nights/week (87.9%), worrying about complications from apnea (72.4%), dyslipidemia (36.7%), hypertension (34.3%), and diabetes mellitus (12.1%), respectively. Using apnea-hypopnea index (AHI) of ≥5 and ≥30 events/hour, there were 76.7% and 38.5% of patients diagnosed as OSA and severe OSA, respectively. While using respiratory disturbance index (RDI) with similar cut-off, almost everyone (98.8%) and 60.2% of patients will be diagnosed as OSA and severe OSA, respectively.  Characteristics significantly associated with AHI ≥15 events/hour were snoring ≥3 nights/week, witnessed apneas, and nocturia (p < 0.05). The comorbidities which significantly associated with OSA group were hypertension, diabetes, and dyslipidemia.  There were only weak significant relationships between AHI (and RDI) with ESS and quality of life. Conclusion: The most common complaints in our clinic were loud snoring and worrying about OSA consequences, not excessive daytime sleepiness. Based on RDI criteria, almost everyone were diagnosed as OSA; however, it had poor relationship with patients’symptoms, comorbidities and quality of life.  Thus, for better OSA evaluation, we should use data from several aspects, not only AHI nor RDI for proper patient management

Peak Nasal Inspiratory Flow: Reference Values for Thais

Objective: Nasal obstruction can be measured objectively by rhinomanometry and acoustic rhinometry, both complex techniques. Peak nasal inspiratory flow (PNIF) is also a tool for evaluating nasal obstruction. This study aimed to establish normal PNIF ranges for an Asian population accounting for sex, age, weight, and height. Methods: Using a portable Youlten peak flowmeter, PNIF was measured in 180 healthy Thais (ages 15-70 years). Normal ranges for male and female subjects, adjusted for weight and height, were determined using multiple regression analysis. Results: Body mass index values (mean ± S.D.) of the 82 male and 98 female subjects were 24.9 ± 4.5 and 21.7 ± 4.3 kg/m2 , respectively. PNIF was significantly higher in males than in females (139 ± 37.6 vs. 97.1 ± 27.1 l/ min, p<0.001). After adjusting for weight and height, PNIF reference ranges (lower and upper limits with 95% confidence intervals, respectively) were 126.8 (124.5 to 129.1) and 151.2 (148.9 to 153.5) l/min for males and 82.5 (80.0 to 85.0) and 111.7 (109.2 to 114.3) l/min for females. Conclusion: Sex, height, and weight affected the PNIF rate. This study has provided normal PNIF ranges for healthy male and female Thai population that account for weight and height