Search Results (72)

Background/Objectives: During pregnancy, the body undergoes numerous physiological changes, many of which are driven by significant hormonal shifts. Pregnancy rhinitis is a condition characterized by nasal congestion that occurs during pregnancy without any other signs of respiratory infection or known allergic causes. The aim of the study was to examine the impact of pregnancy rhinitis on the sense of smell. Specifically, it focused on determining how the nasal congestion associated with pregnancy rhinitis may alter olfactory perception in pregnant people. Methods: The study group comprised fifty women, aged 18 to 41, all in their third trimester of pregnancy. The control group was made up of 25 non-pregnant women between the ages of 25 and 31. Olfactory function was assessed using Sniffin’ Sticks, and each participant completed the SNOT-22 questionnaire. Additionally, ENT examination, nasofiberoscopy, rhinomanometry were performed. Results: The comparison between the control and study groups in terms of detection, discrimination, and identification test scores revealed statistically significant differences. The study group demonstrated lower odor average test scores, indicating worse olfactory acuity and poorer identification abilities, with these effects being strong. In addition, the study group showed a lower discrimination test score compared to the study group, though this effect was weak. On the other hand, the control group showed a higher level of discrimination test score compared to the study group, though this effect was weak. However, the pregnant women did not perceive any subjective impairment in their sense of smell even though they had smell disturbances confirmed in the Sniffin Stick test. The SNOT-22 questionnaire results indicated that the study group reported subjectively worse nasal patency compared to the control group. Conclusions: This controlled study demonstrated that olfactory disturbances, confirmed by the Sniffin’ Sticks test, affected half of the pregnant participants, with reduced smell sensitivity observed in advanced pregnancy compared to non-pregnant controls. Notably, more than half of the women with objectively confirmed olfactory deficits did not report subjective complaints, highlighting the need for greater clinical awareness of sensory changes during pregnancy. Pregnancy-related swelling of the nasal mucosa leads to impaired upper airway airflow, contributing to a reduction in olfactory sensitivity. Full article

Background/Objectives: This systematic review and meta-analysis evaluated the effectiveness of olfactory training (OT) using standardized protocols in patients with post-COVID-19 olfactory dysfunction. The objective was to assess whether OT, compared to no treatment, placebo, or alternative therapies, improved olfactory function as measured using validated smell tests, including UPSIT, Sniffin’ Sticks (TDI score), CCCRC, and B-SIT. Methods: A systematic search of PubMed, Web of Science, and Ovid Medline was conducted through February 2025 in accordance with PRISMA guidelines. Eight randomized controlled trials (RCTs) met the inclusion criteria. Data were extracted on study characteristics (author, year, country, design, sample size), population details (age, sex, post-COVID-19 cause), intervention type (training method, frequency, duration), comparators, outcome measures (baseline and post-intervention olfactory scores), follow-up duration, and reported adverse effects. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. Meta-analyses were performed using RevMan and Open Meta-Analyst. Results: Olfactory training significantly improved the olfactory scores compared to those of the controls. The greatest improvement was observed when OT was combined with PEA-luteolin (MD = 4.62, 95% CI: 2.17–7.06, p = 0.0002), followed by EDTA (MD = 2.33, 95% CI: 0.58–4.08, p = 0.009). Corticosteroids showed a borderline benefit (MD = 1.34, 95% CI: 0.01–2.67, p = 0.05), while alpha-lipoic acid had no significant effect. Combination therapies were associated with higher recovery rates (RR = 1.65, 95% CI: 1.13–2.42, p = 0.01). Conclusions: Olfactory training is an effective treatment for post-COVID-19 smell dysfunction. When paired with specific adjunct therapies, particularly PEA-luteolin, it may yield superior recovery outcomes. Further large-scale, standardized RCTs are needed to define optimal treatment protocols. Full article

Background: Cystic Fibrosis (CF) is an autosomal recessive inherited disease caused by mutations of the CF–transmembrane conductance regulator (CFTR), leading to impaired chloride ion trafficking, thickened secretions, and chronic rhinosinusitis (CF-CRS). CF-CRS was historically managed with intranasal corticosteroids (INCS) and endoscopic sinus surgery (ESS). Nowadays, the triple highly effective modulator therapy elexacaftor–tezacaftor–ivacaftor (ETI) is showing promising results in improving CF-CRS. Methods: This is a monocentric, retrospective study comparing Sinonasal Outcome Test-22 (SNOT-22), Nasal Polyps Score (NPS), modified Lund–Kennedy score (mLKS), sniffin’ sticks identification test (SSIT), and Lund–Mackay score (LMS) in patients affected by CF-CRS and treated with ESS or ETI. ETI patients were further subdivided based on previous surgery. Results: A total of 25 patients were surgically treated, and 54 were treated with ETI (specifically, 17 surgically naïve and 37 post-FESS patients). Patients undergoing ESS and those receiving ETI experienced statistically significant improvements in SNOT-22, SSIT, and LMS with no differences between groups and regardless of genetic or demographic characteristics. Conversely, ESS patients experienced significantly higher mean changes in NPS and mLKS. Conclusions: ETI and FESS were safe and effective in reducing the symptomatologic burden of CF-CRS. Even in the ETI epoch, surgery may play a crucial role in managing CF-CRS, particularly in patients not eligible for ETI or experiencing severe disease not adequately controlled with medical therapy alone. Full article

In humans, food choice, nutrient intake, and meal size are strongly influenced by sense of smell. It is known that individuals differ in their olfactory abilities and may show a normal, reduced, or absent sense of smell. Previous findings have also suggested that males are more deficient than females in their olfactory performance. Recent studies have shown that humans could perceive the odor of free fatty acids, providing information about the nutritional content of foods. The aim of this research was to study the orthonasal perception of palmitic, oleic, and linoleic fatty acids in 70 healthy subjects (38 females and 32 males). First, participants were classified as normosmic or hyposmic by means of the Sniffin’ Sticks test. Second, the ability to detect the odor of fatty acids was assessed using the gas chromatography–olfactometry technique, a combination of sensory and instrumental analysis that allows for simultaneous chromatographic separation and odor evaluation by a human subject. Finally, the olfactory threshold to fatty acids was also evaluated by means of a three-way forced-choice test, using a presentation procedure of ascending concentration with seven dilution steps. The results highlighted differences in perception ability, perception intensity, and olfactory threshold in relation to the lipophilicity of the molecule, olfactory function, and sex. Our findings confirm the human ability to perceive the odor of fatty acids, with females and normosmic individuals performing better than males and hyposmic ones, respectively. They also show that the intensity of perception increases with the decreasing lipophilicity of fatty acids; consequently, the olfactory perception threshold also decreases. Full article

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory disorder of the upper airways, severely impacting quality of life. Dupilumab, targeting type 2 inflammatory pathways, is effective in managing severe, uncontrolled CRSwNP. However, the comparative accuracy of endoscopic scoring systems in monitoring therapeutic response to dupilumab remains unclear. This study compared the accuracy of the nasal polyp score (NPS) and the modified Lund–Kennedy endoscopic score (M-LKS) in assessing dupilumab response. Methods: A retrospective cohort analysis included 66 severe CRSwNP patients treated with dupilumab at Padua University. Endoscopic scores (NPS and M-LKS), patient-reported outcome mesures (PROMs), and clinician-reported outcome measures (CROMs), including peak nasal inspiratory flow (PNIF) and the Sniffin’ Sticks test, were evaluated at baseline and over 24 months. Results: Both NPS and M-LKS showed significant reductions over time (p < 0.001), significantly correlating with PNIF (p < 0.001). Given time and patient, PNIF emerged to be the only covariate related to endoscopic scores. No significant differences were observed between NPS and M-LKS regarding clinical outcome associations, suggesting equivalent accuracy. PNIF was identified as a critical predictor of endoscopic improvement, highlighting its clinical utility. These findings reinforce the role of standardized endoscopic metrics in assessing the efficacy of biologic therapies for CRSwNP. Full article

Background: Olfactory recovery plays an important role in improving the quality of life in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP), and Dupilumab therapy shows promising results. The Nasal Polyp Score (NPS), Visual Analog Scale (VAS) for olfactory disorders (ODs), and the Sniffin’ Sticks 16-item identification test (SS-I) are three of the main indices of efficacy in CRSwNP treatment. Although mechanical obstruction appears to be a major cause of olfactory disorders in this condition, the three indices can often vary with different trends. Aim: The aim is to assess whether there is a correlation between the sense of smell recovery and the volumetric reduction in polyps and to assess how the reduction in NPS affects the improvement in olfactory symptoms. Methods: An observational monocentric retrospective cohort study was conducted on a sample of 50 patients, enrolled in treatment with Dupilumab for 12 months at the ENT Unit of Rodolico Hospital. We investigated the relationship between NPS changes and olfactory recovery using the Sniffin’ Stick 16-item identification test and the VAS for ODs at baseline and follow-up endpoints (1-, 3-, 6-, 9-, and 12-month assessments). Results: During the follow-up, according to the data in the literature, the patients showed a faster improvement in terms of SS-I and VAS for ODs than expressed in terms of NPS variation. Conclusions: This study shows that, in patients treated with Dupilumab, there is no strong correlation between the reduction in NPS and the recovery of the sense of smell evaluated by an improvement in the SS-I and VAS for ODs in the 12 months of follow-up, suggesting that, in patients with CRSwNP, the improvement in olfactory symptoms following treatment with Dupilumab is mainly related to its anti-inflammatory effects and not to the reduction in mechanical obstruction caused by nasal polyps. Full article

Background/Objectives: Olfactory decline is common in normal aging and frequent in neurodegenerative diseases such as Alzheimer’s disease (AD). Therefore, it has been suggested as a marker for the Mild Cognitive Impairment (MCI) progression to AD. Although suggested, the relationship between olfactory deficits and cerebral atrophy in MCI conversion to AD is still debated. This study aims at investigating the olfaction-related morphological and behavioural alterations in MCI in order to understand whether they can predict the progression to AD. Methods: Twenty-seven MCI patients and thirty-five healthy controls (HCs) took part in the study, with follow-up showing conversion to AD in thirteen patients (converter-MCI, cMCI). The Burgarth Sniffin’ Sticks Tests (threshold—TT, discrimination—DT, identification—IT) assessed the olfactory capacities. The Voxel-Based Morphometry (VBM) analysis investigated the atrophic patterns. Results: The Receiving Operating Characteristics analyses demonstrated that DT and IT could distinguish HC from MCI (DT Area Under Curve—AUC = 0.8; IT AUC = 0.8), as well as cMCI from sMCI (stable) patients (DT AUC = 0.7; IT AUC = 0.6), similarly to memory and executive functions tests. Olfactory performance positively correlated with memory tests in sMCI (all rhos ≥ 0.8, all ps < 0.01), whereas it positively correlated with executive functions in cMCI (all rhos ≥ 0.6, all ps < 0.05). VBM results revealed distinct atrophic patterns in cMCI, especially in the olfactory cortex, that were already present at the MCI diagnosis, before AD conversion. A larger volume of the olfactory cortex was associated with better memory and executive functions. Conclusions: Quantitative olfactory and morphological patterns represent non-invasive, predictive biomarkers of the MCI progression to AD; thus, their assessments at MCI onset allows earlier interventions for MCI patients. Full article

Background: Sour taste is associated with acid-base homeostasis, which is critical to cell metabolism and health conditions. Vinegar, which contains acetic acid as the main component, is a sour food considered the second most common condiment in Italy. Objectives: The aim of the study was to assess differences in sourness perception in subjects with olfactory deficits compared to controls and evaluate myrtle aromatization’s potential effect in modulating sourness perception in subjects with hyposmia. Methods: To this end, olfactory function was assessed with the Sniffin’ Sticks test and gustatory function by the Taste Strips test. Sensory perception of a traditional white wine vinegar (WV) and a WV aromatized with myrtle (AWV) was evaluated. The sourness perception of the two vinegars was estimated through the rates of odor and taste pleasantness, intensity, and familiarity using a labeled hedonic Likert-type scale. Results: Our data indicated that in patients with hyposmia, a significant decrease was observed only in sour taste perception compared to controls. The increase in vinegar aroma due to the myrtle aromatization modulated sourness perception in patients with hyposmia. Conclusions: Myrtle aromatization increased the number of significant correlations between odor and the taste dimensions of the vinegar in controls and in patients with hyposmia in a different manner. Full article

Background/Objectives: Olfactory dysfunction (OD) is associated with a variety of neurologic deficits and impacts socialization decisions, mood, and overall quality of life. As a common symptom comprising the long COVID condition, persistent COVID-19-associated olfactory dysfunction (C19OD) may further impact the presentations of neuropsychiatric sequelae. Our study aims to characterize the longitudinal burden of depression, anxiety, and neuropsychiatric symptoms in a population with C19OD. Methods: Individuals with perceived C19OD completed a psychophysical screening evaluation of their sense of smell using the comprehensive Sniffin’ Sticks olfactory assessment. Only those with validated psychophysical OD were included in this prospective longitudinal study for baseline and one-year follow-up. Participants also completed PHQ-9, Beck Anxiety Inventory (BAI), and neuropsychiatric symptom questionnaires at each time point. Anxiety, depression, and neuropsychiatric symptom prevalence was calculated and compared between time points with Pearson’s chi-squared, Fisher’s exact, and Wilcoxon rank sum tests. Results: Each neuropsychiatric symptom evaluated in this study was reported by 13–49% of longitudinal cohort participants at both baseline and follow-up, except for seizure (0% at baseline and follow-up) and word-finding difficulty (61–68% at baseline and follow-up). Word-finding and focus difficulties were the most commonly reported symptoms. In total, 41% of participants reported some level of depression at baseline and 38% of participants reported depression at one-year follow-up, while 29% and 27% of participants reported some level of anxiety at respective time points. Conclusions: Individuals with C19OD are at risk for developing persistent neuropsychiatric conditions. These neurologic and psychiatric sequelae are persistent with repeated longitudinal assessment, even at nearly 2.5 years following initial COVID-19 diagnosis. Full article

Introduction: This study aims to investigate the relationship between olfactory identification (OI) and cognitive impairment by examining OI abilities across various stages of cognitive deterioration. Methods: A total of 264 participants were divided into three groups based on cognitive status: cognitively healthy, subjective cognitive, and mild cognitive impairment. All participants were assessed using the Sniffin’ Sticks Olfactory Identification test and a comprehensive neuropsychological test battery. Results: Our results highlight the main effects of age and cognitive status on OI scores. Regarding cognitive abilities, OI is associated with measures of short-term memory, long-term, working memory, and selective attention. Finally, logistic regression models showed that OI is a significant predictor for discriminating SCD from CH, MCI from CH, and MCI from SCD. Discussion: These findings suggest the addition of olfactory identification measures in neuropsychological assessments could improve the early detection of individuals at risk for cognitive impairment. Full article

Objective: Childhood epilepsy with centrotemporal spikes (CECTS) is associated with cognitive, behavioral, and language difficulties. These epileptic discharges predominantly occur in the temporal lobe, which is known to be involved in olfactory functions. This study aims to assess olfactory dysfunction in patients with CECTS. Methods: This study included patients diagnosed with CECTS who were attending follow-ups at the Department of Child Neurology between January 2022 and July 2023. Olfactory function was evaluated using the Sniffin’ Sticks (Burghart GmbH, Wedel, Germany) 12-point screening test, which was administered to 44 patients and 35 controls. The smell test and the final control EEGs were performed simultaneously. Results: A total of 44 patients and 35 control subjects were enrolled in this study. The smell scores were significantly lower in the patient group compared to the control group (p = 0.029). The patient group had a very high prevalence of anosmia compared to the control group. The normosmia rate in the control group was significantly higher. No significant difference was observed in the smell scores based on EEG findings or antiepileptic drug type. Conclusions: Olfactory dysfunction was identified in patients with CECTS compared to healthy controls, yielding results consistent with findings for other types of epilepsy. Olfactory dysfunction was detected in a greater frequency among the patients diagnosed with CECTS than among the healthy control group, and similar results were obtained with other types of epilepsy. It was deduced that these patients may experience problems with smell sensitivity throughout their lives. The most important result of this study is that this condition should be taken into account in regard to patients’ well-being and lives. Full article

One of the still-debated topics regarding the olfactory function concerns the presence or absence of sex-related differences in individuals. In this study, we checked for a relationship between the olfactory function of females and males and their ability to perceive single molecules, and researched how this can influence the intensity with which the complex odor formed by a set of single molecules is perceived. First, females and males were classified as normosmic or hyposmic based on the TDI olfactory score obtained using the Sniffin’ Sticks test. Subsequently, the headspace of roasted coffee beans, as a complex olfactory stimulus, was broken down into single molecules by means of a chromatographic column; these were simultaneously conveyed to a mass spectrometer (for their subsequent classification) and to the human nose, which acts as a chemical sensor by means of an olfactometer port. The results obtained with this gas chromatography–olfactometry approach show both qualitative and quantitative differences between females and males, with females performing better than males. In addition, the odor intensity reported by females when sniffing pen #10, containing coffee aroma, is significantly higher than that reported by males. In conclusion, these data highlight that the human ability to perceive both single compounds and complex odors is strongly conditioned, not only by the olfactory function of individuals, but also by their sex. Full article

Background: Different previous studies indicated olfactory function as a predictor of several types of cognitive impairment, in particular related to neurodegenerative disease. However, scanty data are available on the role of odor threshold (OT), odor discrimination (OD), and odor identification (OI) as a predictor of cognitive impairment. The aim of this study was to evaluate potential correlations between each factor of the olfactory function versus each specific cognitive domain of the Montreal Cognitive Assessment (MoCA) test on healthy subjects in relation to gender and age. Methods: Sniffin’ Sticks and MoCA tests were used to determine olfactory function and cognitive abilities, respectively. Results: In men, significant correlations were found in OT versus language index score and OI versus language and executive index score, while in women, OD and OI were correlated to visuospatial index score. Conclusions: Our data suggested that olfactory function (OT, OD, and OI) may be considered a predictor for cognitive impairment in relation to gender and age. Full article

Background: Olfactory dysfunction is a well-known phenomenon in neurological diseases with anosmia and hyposmia serving as clinical or preclinical indicators of Alzheimer’s disease, Parkinson’s disease, and other neurodegenerative disorders. Since glaucoma is a neurodegenerative disease of the visual system, it may also entail alterations in olfactory function, warranting investigation into potential sensory interconnections. Methods: A review of the current literature of the last 15 years (from 1 April 2008 to 1 April 2023) was conducted by two different authors searching for topics related to olfaction and glaucoma. Results: three papers met the selection criteria. According to these findings, patients with POAG appear to have worse olfaction than healthy subjects. Furthermore, certain predisposing conditions to glaucoma, such as pseudoexfoliation syndrome and primary vascular dysregulation, could possibly induce olfactory changes that can be measured with the Sniffin Stick test. Conclusions: the scientific literature on this topic is very limited, and the pathogenesis of olfactory changes in glaucoma is not clear. However, if the results of these studies are confirmed by further research, olfactory testing may be a non-invasive tool to assist clinicians in the early diagnosis of glaucoma. Full article

Chronic rhinosinusitis with nasal polyps (CRSwNP) in the severe forms is associated with a poor quality of life. Dupilumab has been suggested as an add-on treatment option for severe CRSwNP. Severe CRSwNP patients treated with Dupilumab in different rhinological units were considered for this study via their evaluation at the baseline at first and the consequential follow-up at 6-, 12-, and 24 months from the first administration. At baseline (T0) and at each follow-up, patients underwent NPS, Sinonasal Outcome Test (SNOT)-22, Visual Analogue Scale (VAS) for smell, and Sniffin’ sticks identification test (SSIT). The SNOT-22 domains for function and emotion were also analysed separately. Two hundred and seventeen patients with at least 6 months of follow-up were included. All parameters have improved during treatment (p < 0.0001). Noticeably, both the function and emotion SNOT-22 domains have improved within 6 months of treatment and have continued to progress during every interval within 12 months from the baseline, positively influencing patients’ emotivity and augmenting their social and economic performances. Dupilumab improves the QoL of CRSwNP patients with good effects on the reported productivity and emotional health. Clinicians should pay attention to these two aspects when dealing with patients affected by severe CRSwNP. Full article