Olfactory and Gustatory Function in Patients With Different Types of Maxillofacial Trauma

Abstract

Objectives/Hypothesis To investigate olfactory and gustatory function in patients with maxillofacial trauma and associated fractures. Study Design Retrospective cohort study. Methods Olfactory and gustatory function was assessed psychophysically in 124 patients who had sustained maxillofacial trauma with an associated fracture. Five groups were defined based on the fracture type: Le Fort, mandibular, nasal, orbital, and zygomatic. Olfaction was measured with Sniffin' Sticks (threshold, discrimination, identification [TDI] score) and gustation with the taste spray method. Patients self‐rated olfactory and gustatory function on a visual analog scale prior to formal testing. Results Ten out of 124 patients were found to be anosmic (8%), with half of them found in the Le Fort (skull base) group. The Le Fort fracture group had significantly lower olfactory function than other fracture types (TDI score = 22.4 ± 10.7; P = .01; possible range = 1–48). The mean gustatory spray test score was 3.82 ± 0.4 (possible range = 0–4) without any intergroup differences. Self‐rated olfactory function showed a correlation with the measured scores (r = 0.61, P < .001) across all groups. Conclusions The present data show a significant effect of maxillofacial fracture type on the development of anosmia. Maxillofacial fractures involving the skull base, such as Le Fort fractures, are more likely to cause permanent smell loss, whereas the other fracture types are rarely associated with anosmia. Level of Evidence 4 Laryngoscope, 131:E331–E337, 2021

Self-Reported Olfactory Dysfunction and Diet Quality: Findings from the 2011–2014 National Health and Nutrition Examination Survey (NHANES)

“…Similarly, self-reported smell function is strongly correlated with measured olfaction, and has previously been shown to be associated with important health outcomes such as increased risk of 10-year mortality [14] and dementia [15]. In 6,000+ patients from an otolaryngology practice in Dresden, Germany, self-rated olfaction showed good correlation with measured function [16] with up to 80% accuracy when compared against an odor identification test [17]. Self-rated olfaction also shows good correlation with measured function in patients undergoing chemotherapy across multiple studies [16].…”

“…Here, we examined associations between self-reported OD and diet quality in a nationally representative sample of US adults using data from questions included in the 2011-2014 NHANES. Self-reported olfactory function based on a single question, or multiple questions as in NHANES, has been shown to correspond reasonably well with measured function [12,[16][17][18]. Additionally, subjective assessments of smell alterations are clinically relevant as they are the only means to capture individuals with smell distortions such as phantosmia (smell hallucinations) or parosmia (altered perceptual quality), intermittent smell losses, and those who likely experience an impact of smell alteration from a health or functional perspective.…”

“…In 6,000+ patients from an otolaryngology practice in Dresden, Germany, self-rated olfaction showed good correlation with measured function [16] with up to 80% accuracy when compared against an odor identification test [17]. Self-rated olfaction also shows good correlation with measured function in patients undergoing chemotherapy across multiple studies [16]. In addition, a large Swedish population-based prospective study (n = 903) conducted among older adults without cognitive impairment found that subjective olfactory decline was significantly associated with decline in odor identification function over a 10-year time period [18].…”

Olfaction in patients with Parkinson’s disease: a new threshold test analysis through turning points trajectories

“…We evaluated 135 consecutive PD patients at the Department of Neuroscience, Verona University Hospital, Italy. Inclusion criteria were: (a) diagnosis of idiopathic PD; (b) no PD-associated dementia (Jellinger 2018 ); (c) no coexisting reasons (e.g., delirium, cerebrovascular disease, head trauma, metabolic abnormalities, medication adverse effects) that could have influenced olfaction and/or cognition (Litvan et al 2012 ; Drareni et al 2020 ); (d) no other PD-related conditions (e.g., severe motor impairment, psychosis, severe motor fluctuations or dyskinesia, excessive daytime sleepiness) that could have influenced assessment of cognition (Litvan et al 2012 ; Federico et al 2017 ) and olfaction; (e) no history of ear nose and throat disorders, middle ear surgery, head or face trauma, Bell’s palsy, systemic diseases or any other clinical condition that could have interfered with olfaction and taste evaluation, and (f) no current smoking (Ajmani et al 2017 ).…”

Taste and Smell Disorders: A Critical Look at Olfactory and Gustatory Dysfunction

“…In the United States, there are currently 2.7 million adults with an olfactory dysfunction and 1.1 million adults with a gustatory dysfunction. These dysfunctions are also known to have a higher prevalence in older adults, with more than half of those between the ages of 65 and 80 years and more than 75% of those over 80 years old having a demonstrable decline in their sense of smell [ 1 , 2 ] These conditions, which affect the vital human senses of smell and taste, have unfortunately been overlooked and overshadowed amidst the focus on more widely-known diseases and treatment breakthroughs [ 3 , 4 , 5 , 6 ]. However, disorders of smell and taste deserve dedicated attention and research, as they can severely impact patients’ quality of life, safety, nutrition, and emotional well-being [ 7 ].…”