No abstract

Hyposmia is a fairly common complaint in patients with long-continuing allergic or nonallergic rhinitis. Other factors such as aging, smoking, or nasal surgery may affect olfaction, but these have been little studied in rhinitis-related hyposmia. The purpose of this study was to measure and compare olfactory thresholds in 105 rhinitis patients and 104 healthy controls and to analyze possible relationships between the sense of smell and rhinitis, age, sex, smoking, prick-test results, nasal resistance, and history of nasal or paranasal surgery. The olfactory threshold was assessed with a commercially available kit of squeeze-bottle pairs. The most important variables associated with the sense of smell were determined with stepwise multiple regression analysis, and intergroup differences were assessed with analysis of variance. The reference interval of olfactory thresholds by age was estimated with regression analysis. Nasal resistance was measured by active anterior rhinomanometry. Age and rhinitis were the only variables with significant effect on the olfactory threshold in the whole series. Both the proportion of hyposmic persons and the degree of the impairment of the sense of smell were significantly higher in the rhinitis group than in the control group. The nonallergic patients' sense of smell was poorer than that of seasonal or perennial allergic rhinitis patients. A history of operations for nasal polyposis was associated with hyposmia, but operations for chronic maxillary sinusitis were not. Neither smoking habits nor sex were related to olfactory thresholds. In conclusion, hyposmia in rhinitis patients is partly attributable to age-related changes, but our results indicate that the disease itself impairs the sense of smell.

Over the past few decades there has been some controversy over the relationship between subjective assessment and objective measurement of nasal airway obstruction. To study the hypothesis that there is a close relationship between the two parameters, we analysed changes in nasal patency following histamine challenge. One hundred and two subjects with a history of allergic or non-allergic rhinitis assessed their nasal patency on a visual analogue scale during nasal histamine provocation. Active anterior rhinomanometry was performed immediately after each patient assessment. At all points, significant correlations were observed between subjective and objective assessments of nasal obstruction. Regression analysis also provided strong evidence of a close relationship between the two parameters. We conclude that rhinomanometry can be used as an objective tool in determining nasal patency.

On the basis of the present study, esmolol-bolus + infusion during alfentanil-isoflurane anaesthesia in healthy, middle-aged patients is a useful treatment in circumstances where an increase of the heart rate, prolongation of the QTc interval and cardiac arrhythmias should be avoided.

Triamcinolone acetonide prevents regrowth of nasal polyps after polyp surgery in acetylsalicylic acid-tolerant patients, but not in acetylsalicylic acid-intolerant patients.