olfaction
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Vyšetření čichu není obvykle prováděno standardním postupem. Demonstrujeme vlastní metodu subjektivní kvalitativní olfaktometrie, kterou jsme vypracovali na základě literárních znalostí a dostupných prostředků. Pomocí parfémovaných fixů a námi zvoleného standardního postupu jsme vyšetřili 100 osob. Soubor byl tvořen personálem a pacienty z Kliniky otorinolaryngologie a chirurgie hlavy a krku, Neurologického oddělení a z Centra pracovního lékařství. Soubor jsme rozdělili do dvou skupin. První skupina sloužila k vytvoření normy a byli do ní zařazeny lidé, kteří neudávali poruchu čichu, netrpěli onemocněním, které by mohlo čich ovlivnit a byli nekuřáky (zdraví nekuřáci – ZN). Všichni ostatní byli zařazeni do skupiny druhé (ostatní – OS). V testu bylo možné získat podle odpovědí vyšetřovaných osob nula až 27 bodů, přitom vyšší bodový zisk znamenal lepší rozlišení a identifikaci pachových látek. Ve skupině ZN byl průměrný zisk 20,7 bodů, ve skupině OS 14,2. Skupina zdravých nekuřáků byla rozdělena do tří podskupin podle věku. Nejnižšší průměrný bodový zisk byl v nejstarší skupině (nad 60 let věku). Ve skupině OS bodový zisk koreloval se subjektivním pocitem stupně poruchy čichu. Na základě prvních výsledků usuzujeme, že test umožňuje orientační zhodnocení funkce čichu pacienta.
We examined olfaction in 100 people using perfumed markers (six odours), which are commonly available in stationeries. The test consists of two parts, odour discrimination and odour identification. The test of odour discrimination was conducted with two of the six markers. One of them was presented two times and person was asked to tell the sequence of the odour, which he/she smelled only once. The sequence was changed then and examination was repeated with the other four markers. The highest score to reach was 9 points. The test of odour identification was conducted with three of the six markers. The examined person was asked to name the odours first. Then he/she was presented with the same odours, but in different sequences and was asked to recognize them. This part was repeated with the other three markers. The highest score a person could get in the odour identification part was 18 points. Our set of the examined people was compounded from staff and patients from Department of Otolaryngology and Head and Neck Surgery, Neurology and Centre of Occupational Medicine. The range of points the people could gain was from zero to 27. a Higher score meant a better odour discrimination and identification. People (50 persons), who did not smoke and did not suffer from any disease, which could influence smell ability (healthy and non smokers – HN) reached average score 20.7 points. The rest of the patients (RP, 50 persons) reached average score 14.2 points. HN were divided in three subgroups depending on their age. The lowest average score reached people older than 60 years. The score of the RP was in correlation with the subjectively assessed smell ability. Based on our first results we conclude that our test can serve for orientational evaluation of the olfaction.
Zhoršení čichu snižuje bezpečnost a kvalitu života jedince. Poruchy čichu jsou četnější ve stáří, vliv věku na vnímání libosti pachových látek však není plně prozkoumán. Cílem studie bylo zhodnotit čich u seniorů standardní metodou subjektivní olfaktometrie a srovnat hodnocení libosti pachů s mladší věkovou skupinou. Celkem bylo vyšetřeno 79 osob (30 mužů a 49 žen) průměrného věku 53 let. Z toho bylo 40 osob ve věkové skupině nad 65 let. Kontrolní skupinu tvořilo 39 osob průměrného věku 31 let. K vyšetření čichu jsme použili Test parfémovaných fixů (Odourized Markers Test – OMT). Ke zhodnocení libosti pachových látek byl vytvořen speciální Test libosti pachů (Test of Odour Pleasantness – TOP) obsahující výrazně hédonicky zabarvené vůně a zápachy. Osoby měly za úkol udat, zda látka voní, je neutrální, zapáchá nebo výrazně zapáchá. Normální hodnoty byly stanoveny na základě odpovědí kontrolní skupiny. Medián bodového zisku v testu OMT byl u seniorů 9 bodů, u kontrolní skupiny 10 bodů. Senioři v počtu nejčetnějších odpovědí získali v Testu libosti pachů nižší bodový zisk. Medián bodového zisku v Testu libosti pachů byl u seniorů 17 bodů, u kontrolní skupiny 21 bodů. Senioři oproti kontrolní skupině téměř neoznačovali pachové látky jako neutrální a silně zapáchající. Korelace TOP a věku ukazuje pokles čichových schopností se stoupajícím věkem. Test parfémovaných fixů i Test libosti pachů prokázaly nižší čichové schopnosti u seniorů. Výrazné zápachy označovali senioři jako mírné, což může upozornit na rizika související s bezpečností starších osob, například konzumací zkažené stravy.
Deterioration of the olfaction reduces the safety and quality of human life. Olfaction disorders occur more frequently at old age but effects of the age on perceiving the pleasant quality of substances determining the odour has not yet been completely investigated. The target of the study presented here was an evaluation of the olfaction in seniors by using a standard method of subjective olfactometry and comparing the assessment of the pleasant nature of odours with a younger age group. Total of 79 persons (30 men and 49 women) aged 53 years on average were examined. Forty of them belonged to an age group of 65 years plus. The control group included 39 persons aged 31 years on average. For the olfaction evaluation, we employed the Odourized Markers Test (OMT). The pleasant nature of substances determining the odour was evaluated with the use of the Test of Odour Pleasantness (TOP) including considerably hedonically biased consideration of pleasant and unpleasant odours. The persons were supposed to express whether the substance exerts pleasant, neutral, unpleasant or considerably unpleasant odour. Normal values were established based on answers of control persons. In the OMT test, the median numbers of points acquired were of 9 points in seniors and 10 points in controls. A lower gain of points was acquired by seniors in the number of most frequent answers in the TOP test. Median numbers of points acquired in the Test of Odour Pleasantness were of 17 points in seniors and 21 points in controls. Seniors, compared to controls, almost did not use indication of substances as neutral and strongly unpleasant. The correlation between the TOP and age suggest that there is a decrease in the olfaction capability with increasing age. The Odourized Markers test as well as the Test of Odour Pleasantness demonstrated lower olfaction capability in seniors. Considerably unpleasant odours were indicated by seniors as mild, which can indicate risks associated with the safety of elderly persons, for example due to ingestion of bad food.
- Klíčová slova
- subjektivní olfaktometrie, vyšetření čichu, senior,
- MeSH
- čich * fyziologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- odoranty * analýza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzorické prahy klasifikace MeSH
- věkové faktory * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- hodnotící studie MeSH
U diabetu jsou přítomny poruchy čichu a chuti. V případě chuti spíše porucha souvisí se specifickými komplikacemi diabetu, u čichu spíše s diabetickou makroangiopatií. Patologické pocení při jídle (gustatory sweating) je dnes nejdůležitějším fenoménem z oblasti čichu a chuti v diabetologii. Poruchy čichu a chuti hrají podle experimentů asi určitou úlohu v oblasti patogeneze diabetu a jeho komplikací. Ovlivnění čichu a chuti je i oblastí potenciální významnou pro léčbu diabetu.
Ciba Foundation symposium ; 200
X, 331 s. : obr., tab., grafy ; 24 cm
OBJECTIVES: Olfactory dysfunction (OD) is common and carries significant personal and societal burden. Accurate assessment is necessary for good clinical and research practice but is highly dependent on the assessment technique used. Current practice with regards to UK/international clinical assessment is unknown. We aimed to capture current clinical practice, with reference to contemporaneously available guidelines. We further aimed to compare UK to international practice. DESIGN: Anonymous online questionnaire with cross-sectional non-probability sampling. Subgroup analysis according to subspeciality training in rhinology ('rhinologists' and 'non-rhinologists') was performed, with geographical comparisons only made according to subgroup. PARTICIPANTS: ENT surgeons who assess olfaction. RESULTS: Responses were received from 465 clinicians (217 from UK and 17 countries total). Country-specific response rate varied, with the lowest rate being obtained from Japan (1.4%) and highest from Greece (72.5%). Most UK clinicians do not perform psychophysical smell testing during any of the presented clinical scenarios-though rhinologists did so more often than non-rhinologists. The most frequent barriers to testing related to service provision (e.g., time/funding limitations). Whilst there was variability in practice, in general, international respondents performed psychophysical testing more frequently than those from the UK. Approximately 3/4 of all respondents said they would like to receive training in psychophysical smell testing. Patient reported outcome measures were infrequently used in the UK/internationally. More UK respondents performed diagnostic MRI scanning than international respondents. CONCLUSIONS: To our knowledge, this is the most comprehensive UK-based, and only international survey of clinical practice in the assessment of OD. We present recommendations to improve practice, including increased education and funding for psychophysical smell testing. We hope this will promote accurate and reliable olfactory assessment, as is the accepted standard in other sensory systems.
- MeSH
- čich * fyziologie MeSH
- hodnocení výsledků péče pacientem MeSH
- lidé MeSH
- poruchy čichu * diagnóza MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- stupeň vzdělání MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Clinical examination, including pre- and postoperative assessment of olfaction, is essential in evaluating surgical outcomes in patients with olfactory groove meningiomas (OGMs). A review of a recent series revealed a lack of assessment of olfaction in most of the studies. Tests determining olfactory detection should be used to reveal olfactory dysfunction. Specialized examination techniques (e.g., electro-olfactography, olfactory evoked potentials, and functional magnetic resonance imaging) are currently used in research. METHODS: Prospective analysis of 13 patients who underwent surgical resection of OGMs from December 2013 to December 2017 was performed. Data on clinical presentation, pre- and postoperative neurologic examinations, complications, recurrences, adjuvant treatment, and follow-up outpatient examinations were recorded. Olfactory function was assessed using the Sniffin' Sticks odor identification test preoperatively, postoperatively, and 1 year after surgery. RESULTS: All the meningiomas were resected via unilateral craniotomy, and gross total resection was achieved in all cases. Surgery-related permanent morbidity was 7.7% and overall mortality 0%. For the eight patients with preoperative normosmia, five remained normosmic (62.5%), one deteriorated to hyposmia (12.5%), and two deteriorated to anosmia (25%). For the two patients with preoperative hyposmia, one remained hyposmic and one deteriorated to anosmia. For the three anosmic patients, two remained anosmic, and one improved to hyposmia.The intact olfactory function preoperatively was associated with a better olfactory outcome. Overall, 62.5% of these patients remained normosmic, and none of the hyposmic or anosmic patients normalized their olfaction.Higher meningioma volume is associated with worse olfactory function before surgery (normosmia in 16.7% versus 100.0% in less voluminous) and following the surgery (normosmia in 16.7% versus 57.1% less voluminous).The unilateral surgical approach enabled the anatomical preservation of the contralateral olfactory nerve in 76.9% of our patients. Functional normosmia was achieved in 50% and hyposmia in 30% of these cases. CONCLUSIONS: Assessment of olfactory function is both vital in preoperative decision making (surgical approach, radicality of resection) and when evaluating surgical outcome. Preoperative normosmia seems to be the most important prognostic factor for functional olfactory outcome. In normosmic patients the olfaction was preserved in 62.5% of cases. Moreover, higher meningioma volume is associated with worse olfactory function before and following the surgery. The greatest advantage of the unilateral surgical approach is anatomical preservation of the contralateral olfactory nerve with a satisfactory functional outcome. These results support a proactive approach, with early surgical resection using a unilateral approach even in cases with less voluminous OGMs that enables the preservation of olfactory function in a significant proportion of patients.
- MeSH
- čich fyziologie MeSH
- dospělí MeSH
- kraniotomie škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- meningeální nádory diagnostické zobrazování patofyziologie chirurgie MeSH
- meningeom diagnostické zobrazování patofyziologie chirurgie MeSH
- pooperační komplikace etiologie patofyziologie MeSH
- pooperační období MeSH
- poruchy čichu etiologie patofyziologie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
