Chemosensory function assessed with psychophysical testing and event-related potentials in patients with atrophic rhinitis.
ABSTRACT Atrophic rhinitis (AR) is a chronic inflammation of the nose characterized by an atrophy of the nasal mucosa. This is typically associated with an impaired sense of smell and a subjective sensation of poor nasal breathing. The aim of this study is to assess chemosensory function in patients suffering from AR using psychophysical testings and event-related potentials (ERP) responses. A cohort of nine patients was extensively studied. Eight out of nine had secondary AR sequela of a bilateral total inferior turbinectomy whereas one patient had a primary AR. All the patients had a clinical evaluation using Sniffin' Sticks test and a retro-olfaction test and an electrophysiological evaluation based upon ERPs obtained after both olfactory and trigeminal stimuli. All the patients complained of a poor nasal breathing and presented a distortion of the chemosensory function. Actually, the orthonasal psychophysical testing showed that four patients out of nine had anosmia, three out of nine had hyposmia and two out of nine were normosmic. All the patients demonstrated retro-olfaction scores inferior to the normal values. The chemosensory ERP showed that seven patients had no olfactory response whereas six had no trigeminal response. Four patients had neither olfactory nor trigeminal ERP response. In conclusion, this study demonstrates that most patients with AR secondary to a total bilateral inferior turbinectomy have a reduction of the chemosensory function measured objectively by psychophysical testings and ERP [corrected].
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ABSTRACT: The objective of this study was to reduce the recording duration of chemosensory event-related potentials (CSERP) and thereby to make the method more suitable for routine clinical use. Measurements were performed in the Department of Otorhinolaryngology of the university hospital of Cologne. Two protocols with different sequences [inter-stimulus intervals (ISI)-standard sequence: 30 s; PRS-15: pseudo-randomized sequence, mean ISI of 15 s] were applied to 40 volunteers to record CSERPs. To compare CSERP recordings under optimal and adverse test conditions, 20 younger/normosmic adults and 20 older/hyposmic participants were included in this study. Olfactory function was gauged using the "Sniffin'Sticks" test. For CSERP recordings, phenylethyl alcohol, hydrogen sulfide and carbon dioxide were used for olfactory or trigeminal stimulation, respectively. Both ISI protocols allowed recording CSERPs under optimal and adverse test conditions and distinguishing both groups by latencies (p ≤ 0.015). The time requirement for the recording of CSERPs with the PRS-15 sequence was less than 30 min. The pseudo-randomized sequence allowed the recording of diagnostically conclusive CSERPs in both groups and saved approximately 40% of the measuring time. This seems to be especially useful in cases where a yes/no answer (e.g., medical reports, exclusion of anosmia) is required. Shortening the time requirement significantly allows applying CSERPs to larger populations of patients with olfactory impairment.Archives of Oto-Rhino-Laryngology 01/2012; 269(10):2209-17. · 1.29 Impact Factor