• BMB Reports
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• 제54권6호
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• pp.295-304
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• 2021

Olfactory neuropathology is a cause of olfactory loss in Alzheimer's disease (AD). Olfactory dysfunction is also associated with memory and cognitive dysfunction and is an incidental finding of AD dementia. Here we review neuropathological research on the olfactory system in AD, considering both structural and functional evidence. Experimental and clinical findings identify olfactory dysfunction as an early indicator of AD. In keeping with this, amyloid-β production and neuroinflammation are related to underlying causes of impaired olfaction. Notably, physiological features of the spatial map in the olfactory system suggest the evidence of ongoing neurodegeneration. Our aim in this review is to examine olfactory pathology findings essential to identifying mechanisms of olfactory dysfunction in the development of AD in hopes of supporting investigations leading towards revealing potential diagnostic methods and causes of early pathogenesis in the olfactory system.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.92-96
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• 2017

Background: All nasal bone fractures have the potential for worsening of olfactory function. However, few studies have studied the olfactory outcomes following reduction of nasal bone fractures. This study evaluates posttraumatic olfactory dysfunction in patients with nasal bone fracture before and after closed reduction. Methods: A prospective study was conducted for all patients presenting with nasal bone fracture (n=97). Each patient consenting to the study underwent the Korean version of Sniffin' Sticks test (KVSS II) before operation and at 6 month after closed reduction. The nasal fractures were divided according to the nasal bone fracture classification by Haug and Prather (Types I-IV). The olfactory scores were compared across fracture types and between preoperative and postoperative settings. Results: Olfactory dysfunction was frequent after nasal fracture (45/97, 46.4%). Our olfactory assessment using the KVSS II test revealed that fracture reduction was not associated with improvements in the mean test score in Type I or Type II fractures. More specifically, the mean posttraumatic Threshold, discrimination and identification score decreased from 28.8 points prior to operation to 23.1 point at 6 months for Type II fracture with septal fracture. Conclusion: Our study has revealed two alarming trends regarding post-nasal fracture olfactory dysfunction. First, our study demonstrated that almost half (46.4%) of nasal fracture patients experience posttraumatic olfactory dysfunction. Second, closed reduction of these fractures does not lead to improvements olfaction at 6 months, which suggest that olfactory dysfunction is probably due to factors other than the fracture itself. The association should be further explored between injuries that lead to nasal fracture and the mechanism behind posttraumatic olfactory dysfunction.

• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.107-111
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• 2015

Objective : Patients treated with surgical clipping for anterior communicating artery (A-com) aneurysm often complain of anosmia, which can markedly impede their quality of life. We introduce a simple and useful technique to reduce postoperative olfactory dysfunction in A-com aneurysm surgery. Methods : We retrospectively reviewed the medical records of patients who underwent surgical clipping for unruptured aneurysm from 2011-2013 by the same senior attending physician. Since March 2012, olfactory protection using gelfoam and fibrin glue was applied in A-com aneurysm surgery. Therefore we categorized patients in two groups from this time-protected group and unprotected group. Results : Of the 63 enrolled patients, 16 patients showed postoperative olfactory dysfunction-including 8 anosmia patients (protected group : unprotected group=1 : 7) and 8 hyposmia patients (protected group : unprotected group=2 : 6). Thirty five patients who received olfactory protection during surgery showed a lower rate of anosmia (p=0.037, OR 10.516, 95% CI 1.159-95.449) and olfactory dysfunction (p=0.003, OR 8.693, 95% CI 2.138-35.356). Superior direction of the aneurysm was also associated with a risk of olfactory dysfunction (p=0.015, OR 5.535, 95% CI 1.390-22.039). Conclusion : Superior direction of aneurysm appears associated with postoperative olfactory dysfunction. Olfactory protection using gelfoam and fibrin glue could be a simple, safe, and useful method to preserve olfactory function during A-com aneurysm surgery.

• 대한한의학원전학회지
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• 제35권2호
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• pp.99-120
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• 2022

Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1570-1576
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• 2000

Objective : To evaluate objectively the sites of injury in patients with posttraumatic olfactory deficits and to suggest the diagnostic procedure for evaluation of posttraumatic anosmia. Methods : Ten patients with posttraumatic olfactory dysfunction were examined by means of olfactory testing, sinoscopy, contrast filled paranasal sinus computed tomography(contrast filled PNS CT) and magnetic resonance imaging(MRI). Five normal persons without olfactory dysfunction were also evauluated. The aerodynamic patency of olfactory cleft was examined by contrast filled PNS CT. The olfactory system(oflactory bulbs, olfactory tracts, inferior frontal region, hippocampi, or temporal lobes) was investigated in detail with MRI. The difference in the size of the olfactory bulb between normal volunteers and anosmic patients was evaluated by Student's t test. Results : Contrast filled dynamic CT scan was useful method for the evaluation of dynamic patency of the olfactory cleft. Paranasal CT scan of the all anosmic patients showed dynamic reflux of contrast media in olfactory cleft on valsalva maneuver. For the largest cross-sectional area and great height, the difference in olfactory bulb size between normal volunteers and patients was statistically significant(p<0.001) in MRI study. Conclusion : Posttraumatic anosmia was completely evaluated by olfactory testing, sinoscopy, and contrast filled CT scan for differentiation between conductive type and neurogenic type. Neurogenic anosmia was confirmed by perfect localization with MRI study.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제62권2호
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• pp.75-81
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• 2019

The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I²=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I²=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I²=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I²=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

• The Korean Journal of Pain
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• 제26권1호
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• pp.57-61
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• 2013

Background: Olfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment. Methods: This was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale. Results: Out of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was $9.6{\pm}0.7$, VAS-A was $5.1{\pm}4.2$, and VAS-C was $2.7{\pm}$2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%). Conclusions: SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.678-689
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• 1995

Chromium is one of the representative toxic substance by occupational exposure which damage the mucosa of respiratory tract including nasal septal perforation. The aim of this study is to evaluate the effect of chromium exposure on olfactory function and to obtain the fundamental information about chromium exposure. The authors performed olfactory function test, laboratory tests and questionnaire interview on the subject of three groups, that is, two exposed groups and one nonexposed group from May 1 to June 30, 1994. Exposed group 1 was 15 male workers without nasal septal perforation, exposed group 2 was 15 male workers with nasal septal perforation among 103 workers in 22 chromium plating factories, and nonexposed group was 15 male medical students. The gathered informations were histories of chromium exposure, habits of smoking and alcohol drinking, the concentrations of chromium in serum and urine, and asparate aminotransferase(AST), alanine aminotransferase(ALT), gamma-glutamyl transferase, etc. Olfactory function was checked by T and T olfectometer using phenyl ethyl alcohol(material A), methyl cyclopentenolone(material B), iso-valeric acid(material C), $\gamma$-undecalactone(material D), skatole(material E) and the results were expressed by detection threshold(DT) and recognition threshold(RT). There was a significant difference between exposed groups and nonexposed group in A, B, C, D, E substances by DT and in A, B, C, D substances by RT(P<0.01). The degree of olfactory dysfunction was highest in the exposed group 2 and lowest in the nonexposed group in all five substances by DT and it was same in A B, D substances RT and the difference of RT and DT. As summary, olfactory dysfunction by chromium exposure was recognized and the degree of olfactory dysfunction was higher in the exposed group with nasal septal perforation. Therefore, it would be helpful to apply olfactory function test for the early detection of olfactory dysfunction, and this test would be considered as the basic tool within workers' compensation system.

• Journal of Rhinology
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• 제25권2호
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• pp.63-68
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• 2018

본 종설에서는 부비동 수술 후 후각 회복에 영향을 미치는 인자들에 대해 서술 하였으며, 이들을 숙지함으로써 술 전에 후각 회복 여부를 예측할 수 있고, 술 후 후각 회복율을 높이는데 도움을 주고자 하였다. 부비동 내시경 수술 후 후각 기능은 다양한 치료 결과를 나타내고, 호전되었다고 하더라도 저후각증 상태로 남아있는 경우도 많은데, 이는 반복적인 감염과 상피조직의 손상이 후각신경세포들의 불가역적인 손상이나 편평상피화 및 섬유화를 초래함으로써 기인할 수 있다. 수술 후에도 지속되는 점막의 부종이나 후열 부위의 염증도 후각 회복을 저해할수 있다. 술 전 후각이 무후각증 일수록, 비용종이 있을수록, CT상 후열 혼탁이 경도일수록, 부비동 수술 과거력이 없을수록, 후각장애 기간이 짧을수록, 비호산구성 부비동염, 상처 회복이 순조로울수록 수술 후 후각 회복율이 높다고 할 수 있다. 만성부비동염에 동반되는 후각 장애는 환자나 의사 모두에게 해결이 힘든 문제이자 수술 후 결과를 정확하게 예측하기 어려운 문제로 남아있으며, 향후 더 많은 연구가 필요할 것으로 생각한다.

• 한국자연치유학회지
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• 제9권2호
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• pp.37-45
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• 2020

목적 : 특발성파킨슨병(PD)은 운동증상(떨림, 운동 완서, 경직)과 비운동증상(통찰력과 인지 장애, 기분의 불편함, 우울증, 불안증, 후각 기능장애)이 있다. 이 연구는 호흡, 명상 및 기공 치유로 PD 비운동증상의 개선 효과를 탐색하는 것이 목적이다. 방법 : PD가 있는 대상자(11명)에게 An's-4444힐링호흡, An's관정힐링명상, An's힐링기공치유의 3단계를 1회에 80분 동안 12회 수행하고 치유 전후, 1개월 경과 후 3회 측정하여 측정치를 비교 평가하였다. 결과 : 12회 치유 후 통찰력과 인지장애에 대한 통합 파킨슨병 등급척도(UPDRSI) 수치는 69%, 우울증척도(HAMD)는 61%, 불안증(HAMA)은 64%, 후각 기능장애 냄새식별 테스트(TSI)는 82%로 각각 개선되었다. 치유 1개월 경과 후의 수치는 4개 척도 모두 차이가 없었다. 이는 치유 후 1개월 경과 후까지 효과가 유지됨을 의미한다. 결론 : An's 호흡, 명상 및 기공요법으로 PD비운동증상이 유의성 있게 개선되었다. 특히 후각기능장애 개선으로, 향기를 맡게 되어 삶의 만족도가 향상되었다. 결과는 호흡, 명상 및 기공요법이 PD의 비운동성 증상을 개선 및 치유하는 자연요법으로 가치가 있다고 판단하며, 의생명과학적 추가 연구가 필요하다.