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Smell Perception/Anosmia/Parosmia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Anosmia is the complete loss of smell. Nasal congestion is a common cause of temporary anosmia. Loss of smell from nasal polyps, sinusitis, upper respiratory tract infection, or fractures is due to intranasal swelling or other obstruction that prevents odors from gaining access to the olfactory area. Neurologic causes include head trauma and viral infections, as well as aging or Alzheimer's. A number of other conditions can cause anosmia as well. Parosmia, or dysosmia, describes a distortion or perversion of the sense of smell. What typically happens is that natural and pleasant odors are perceived as offensive and disgusting. Additional causes can include Alzheimer's, Huntington's, or Parkinson's, and olfactory damage from head injury, bacterial or viral infection, toxic chemicals, radiation, or chemotherapy, etc. Neurologists have used sodium valproate, gabapentin, and pregabalin to treat parosmia for decades with good results.1
Chemosensory Disorders and Nutrition
Published in Alan R. Hirsch, Nutrition and Sensation, 2023
Carl M. Wahlstrom, Alan R. Hirsch, Bradley W. Whitman
Since the first report appeared in 1864 (Jackson 1864), much has been written about this complication. In a survey of 1,000 head trauma victims, an estimated 7.2% suffered some form of olfactory dysfunction following their injury (Leigh 1943). The cause of the dysosmia was originally believed to be the shearing of olfactory nerve axons, specifically the fila olfactoria at the cribriform plate, which occurs during trauma when the brain is rapidly accelerated against the skull (Russell 1960). Pathological changes in the olfactory nerves have been well identified following such injuries (Jafek, Eller, Esses, and Moran 1989).
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Hyperosmia is heightened sense of smell. Dysosmia (or parosmia) is abnormally perceived sense of smell. Phantosmia (olfactory hallucination) is smell perception in the absence of an odor stimulus. Olfactory agnosia is the inability to recognize olfactory sensory information in the setting of intact olfactory function.
Dysgeusia and dysosmia in asymptomatic COVID-19 patients for contact tracing and isolation
Published in Infectious Diseases, 2021
Between 15th July and 15th August 2020, 320 adult patients without alleged symptoms of illness, but found to be PCR positive for SARS-CoV-2 by naso/oropharyngeal swabs in an environmental test situation were quarantined in one of the non-medical isolation facilities in Chennai. They were asked about any sudden new changes in their taste or smell. On enquiry, many patients reported that they felt new changes in their taste or smell from 0 to 2 days before or after they tested positive. The patients’ age ranged between 19 and 70 years and there were 190 (59.4%) males and 130 (40.6%) female patients. Among 190 males, taste changes were present in 18 (9.5%) and smell changes in 10 (5.3%), and among 130 females, taste changes were present in 12 (9.2%) and smell changes were present in 7 (5.4%). Both taste and smell changes were present in males 6 (3.2%) and females 4 (3.1%). In the total sample, dysgeusia occurred in 30 (9.4%) and dysosmia was in 17 (5.3%) patients, but the incidence within the male and female groups were almost similar.
Assessment of olfactory function after traumatic brain injury: comparison of single odour tool with detailed assessment tool
Published in Brain Injury, 2018
Owing to the complex nature of the olfactory system, disruption of either the peripheral or the central pathway can manifest with a variety of different dysfunctional features. The predominant descriptive terms used in olfactory disturbance (OD) refer to a global inability to sense and recognise olfactory stimuli. This inability may be total, termed anosmia, or partial, referred to as hyposmia. Other forms of OD include the inability to recognise and differentiate odours—dysosmia—and the inappropriate perception of an odour—phantosmia (2).
Dupilumab in chronic rhinosinusitis with nasal polyposis: current status, challenges, and future perspectives
Published in Expert Review of Clinical Immunology, 2023
Tong Li, Jiali Yin, Yujuan Yang, Guangkuo Wang, Yu Zhang, Xicheng Song
Severe CRSwNP is often accompanied by type 2 inflammation. This type of patient suffers from great pain due to complications, and it is difficult to achieve an ideal treatment effect by ordinary methods such as INCS and polypectomy. Therefore, effective therapies for CRSwNP are being actively sought. Monoclonal antibodies have shown significant therapeutic effects in other chronic diseases involving eosinophil inflammation, such as chronic urticaria and asthma. Such accurate targeted therapy is worth popularizing and applying in a wide range of diseases. Dupilumab, which stood out among the monoclonal antibodies, took the lead in completing a phase III clinical trial in treatment of CRSwNP. Unfortunately, patients who have suffered from CRSwNP for an extended time period often have severe dysosmia, which was previously almost irreversible. After receiving dupilumab in treatment of CRWwNP, the recovery of sense of smell will undoubtedly greatly improve the quality of life of those patients, and also confirm the unique advantages of using monoclonal antibodies in treatment of chronic sinusitis. We believe that future monoclonal antibody-related clinical trials should include a larger sample size to better test the therapeutic effects of biological agents under conditions of long-term treatment and followup. At the same time, more studies should focus on making direct or horizontal comparisons between monoclonal antibodies and current standard treatments such as INCS, oral corticosteroids, or a combination of both. It is worth noting that although the effectiveness and safety of monoclonal antibodies have been confirmed in clinical trials, they will often be used for a long time period, and physicians must by vigilant for their potential side effects. In addition, when used as a method of long-term treatment, it needs to be determined whether the efficacy of a biologic agent will change due to an accumulation of dose, and whether it is necessary to adjust the frequency and dose of medication. However, these uncertainties are typical for all novel therapeutic agents and should not distract from the enormous clinical value that new treatment options bring to CRSwNP patients.