OBJECTIVE: To observe the clinical efficacy of Tongtiao acupuncture-moxibustion method for long COVID-19 olfactory dysfunction. METHODS: A total of 28 patients with long COVID-19 olfactory dysfunction were selected and treated with Tongtiao acupuncture-moxibustion therapy (regulating orifices, invigorating the brain, and regulating qi and blood). Acupoints included Yintang (GV24⁺), Baihui (GV20), Fengfu (GV16), Qihai (CV6) and bilateral Yingxiang (LI20), Fengchi (GB20), Xuehai (SP10), Zusanli (ST36). Deep needling to the periosteum of the nasal bone was performed at Yintang (EX-HN3), with warming needle moxibustion applied. Each treatment lasted 40 min, administered once daily for 6 days per week, followed by a 1-day rest, over 4 consecutive weeks. T&T olfactory test scores, TCM symptom scores, serum cortisol levels, Hamilton depression scale (HAMD) scores, and Hamilton anxiety scale (HAMA) scores were compared before and after treatment. Clinical effect was evaluated based on T&T olfactory test grading. RESULTS: Compared before treatment, the T&T olfactory test scores, each TCM symptom scores, HAMD scores, and HAMA scores were decreased after treatment (P<0.01, P<0.05), while serum cortisol level was increased (P<0.01). The total effective rate was 96.4% (27/28). CONCLUSION Tongtiao acupuncture method could effectively alleviate symptoms of long COVID-19 olfactory dysfunction, increase serum cortisol level, and relieve anxiety and depressive symptoms.
Humans ; Moxibustion ; Male ; Female ; COVID-19/therapy* ; Acupuncture Therapy ; Middle Aged ; Adult ; Acupuncture Points ; Olfaction Disorders/virology* ; Aged ; SARS-CoV-2/physiology* ; Treatment Outcome

INTRODUCTION: Odour recognition is influenced by culture. Odour identification tests need to be adapted to a population to accurately assess olfactory function. This study's objectives were to validate the Singapore version of the Sniffin' Sticks (SS-Sg) and a locally-developed odour recognition test (Scentsor) for Singapore. METHOD: This prospective study was performed in 3 otolaryngology outpatient clinics in 3 phases (1 May to 15 November 2024). Phase 1 was a survey evaluation of 93 odour descriptors to identify familiar odour descriptors to be used in the tests (n=414); Phase 2 evaluated and finalised SS-Sg and Scentsor to ensure test odours were recognised by ≥75% of healthy controls (n=130); and Phase 3 validated both tests on healthy controls (n=473) to obtain normative data, to determine test-retest reliability (n=50), and to assess the ability to distinguish patients with olfactory loss (n=67). RESULTS: In Phase 1, the unmodified SS blue and purple sets had 15/32 (46.9%) unfamiliar test odours and 25 unfamiliar distractors combined. In Phase 2, after modification, all odours in SS-Sg and Scentsor were correctly identified by ≥75% of controls. In Phase 3, normative data (age 21-83 years) was obtained. Both tests had good test-retest reliability (Pearson's correlation coefficient of 0.88 with<0.001 for SS-Sg; and at 0.90 with<0.001 for Scentsor). Both tests differentiated among normosmia, hyposmia and anosmia (SS-Sg scores: 12.6 [±2.4] versus [vs] 9.8 (±3.2) vs 6.0 [±2.3] respectively,<0.001; Scentsor scores: 14.3 [±1.8] vs 11.3 [±2.8] vs 5.8 [±3.4] respectively,<0.001). CONCLUSION SS-Sg and Scentsor have been validated to assess olfaction in Singapore.
Humans ; Singapore ; Male ; Female ; Odorants/analysis* ; Middle Aged ; Prospective Studies ; Olfaction Disorders/diagnosis* ; Adult ; Reproducibility of Results ; Aged ; Smell/physiology* ; Young Adult

Olfactory disorders are a common symptom in patients with chronic rhinosinusitis, and their diagnosis and treatment have garnered extensive attention from both patients and doctors. Currently, there are various evaluation and treatment methods for olfactory dysfunction; however, choosing a simpler and more accurate assessment, as well as an effective treatment, remains a clinical challenge. In this article, we review the assessment and treatment methods commonly used in clinical practice in recent years to provide better support for the diagnosis and treatment of olfactory disorders.
Humans ; Olfaction Disorders/etiology* ; Sinusitis/complications* ; Chronic Disease ; Rhinitis/complications* ; Rhinosinusitis

Objective:To explore the influencing factors related to olfactory dysfunction secondary to different types of chronic rhinosinusitis（CRS）. Methods:A retrospective analysis was conducted on 185 CRS patients treated at the Department of Otolaryngology-Head and Neck Surgery of Shanxi Provincial People's Hospital from July 2023 to July 2024. Based on the presence or absence of nasal polyps, CRS was divided into two groups: chronic rhinosinusitis with nasal polyps（CRSwNP） and chronic rhinosinusitis without nasal polyps（CRSsNP）. Further, based on whether olfactory dysfunction was present, the CRSwNP and CRSsNP groups were divided into subgroups with olfactory dysfunction and normal olfaction. General data, laboratory tests, and modified sinus CT scores were compared between the subgroups. Logistic regression analysis was conducted to identify independent influencing factors based on the results of univariate analysis combined with clinical significance, and two nomogram models were established. The area under the curve of the receiver operating characteristic（ROC） curve, calibration curves, and decision curve analysis were used to assess the diagnostic performance, calibration, and clinical utility of the predictive model. Results:The proportion of blood eosinophils, blood urea nitrogen, and total modified CT scores of the bilateral olfactory region were identified as independent influencing factors in the CRSwNP group; the proportion of blood monocytes and modified CT scores of the bilateral posterior region were independent influencing factors in the CRSsNP group. The nomogram prediction model showed good diagnostic performance, calibration, and clinical utility in both the CRSwNP and CRSsNP groups. Conclusion:Olfactory dysfunction in CRSwNP patients is closely related to the proportion of blood eosinophils, blood urea nitrogen, and total modified CT scores of the bilateral olfactory region, while olfactory dysfunction in CRSsNP patients is closely related to the proportion of blood monocytes and modified CT scores of the bilateral posterior region. Moreover, the predictive model established in this study demonstrates good clinical performance and can be used for early identification and risk prediction of olfactory dysfunction secondary to CRS.
Humans ; Sinusitis/complications* ; Chronic Disease ; Retrospective Studies ; Olfaction Disorders/etiology* ; Nasal Polyps/complications* ; Rhinitis/complications* ; Female ; Male ; Logistic Models ; Middle Aged ; Smell ; Adult ; ROC Curve ; Nomograms ; Eosinophils ; Tomography, X-Ray Computed

Objective:To explore the influencing factors of olfactory impairment in patients with obstructive sleep apnea（OSA） and establish a nomogram prediction model. Methods:A total of 100 OSA patients were enrolled. Snap&Sniff olfactory test was used to evaluate the olfactory identification function and olfactory threshold of the patients. According to the scoring criteria, either olfactory identification scores below 14 points or olfactory threshold scores below 3 points was defined as olfactory impairment. Multivariate logistic regression analysis was used to explore the influencing factors of olfactory impairment in OSA. The nomogram model was constructed by using the R 4.4.2 software package. ROC curve, calibration curve and decision curve were used to evaluate the predictive efficacy, consistency and clinical utility of the model. Results:A total of 55 of 100 OSA patients had olfactory impairment. The results of multivariate logistic regression analysis showed that age, ESS score, MoCA score, and apnea-hypopnea index（AHI） were the influencing factors of olfactory impairment in OSA. Based on the above parameters, a nomogram model was established. The ROC curve analysis showed that the AUC was 0.897（95%CI 0.834-0.961）, indicating that the model had good predictive ability. The calibration curve showed that the predicted probability of the model fits the actual probability well. Decision curve analysis showed that when the threshold probability was in the range of 0-0.9, the model had a high clinical net benefit rate. Conclusion:Age, ESS score, MoCA score and AHI are the influencing factors of olfactory impairment in patients with OSA. The nomogram model constructed based on the above factors has good predictive value, which is conducive to the clinical multi-angle understanding of OSA and the formulation of scientific prevention and treatment measures.
Humans ; Sleep Apnea, Obstructive/physiopathology* ; Nomograms ; Olfaction Disorders/etiology* ; Logistic Models ; Middle Aged ; Male ; Female ; ROC Curve ; Adult ; Aged

Total laryngectomy is a crucial surgical intervention for patients with advanced malignant tumors of the larynx and nasopharynx. Despite its effectiveness, this procedure permanently severs the connection between the nasal cavity and the lower respiratory tract, leading to the cessation of nasal airflow. This disruption significantly impairs the patient's sense of smell and adversely affects their quality of life. Although olfactory loss is common in these patients, the assessment and rehabilitation of their olfactory function are often overlooked. This article reviews relevant literature on evaluating olfactory function and rehabilitation methods following total laryngectomy, with the aim of providing a theoretical foundation to enhance olfactory rehabilitation and overall quality of life for these patients.
Humans ; Laryngectomy/rehabilitation* ; Quality of Life ; Smell ; Laryngeal Neoplasms/surgery* ; Olfaction Disorders/etiology*

Objective:To analyze the influencing factors and perform the prediction of olfactory disorders in patients with chronic rhinosinusitis（CRS） based on artificial intelligence. Methods:The data of 75 patients with CRS who underwent nasal endoscopic surgery from October 2021 to February 2023 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. There were 53 males and 22 females enrolled in the study, with a median age of 42.0 years old. The CRS intelligent microscope interpretation system was used to calculate the proportion of area glands and blood vessels occupy in the pathological sections of each patient, and the absolute value and proportion of eosinophils, lymphocytes, plasma cells and neutrophils. The patients were grouped according to the results of the Sniffin' Sticks smell test, and the clinical baseline data, differences in nasal mucosal histopathological characteristics, laboratory test indicators and sinus CT were compared between the groups. Determine the independent influencing factors of olfactory disorders and receiver operating characteristic curves（ROC） were used to evaluate the performance of the prediction model. Statistical analysis was performed using SPSS 25.0 software. Results:Among the 75 CRS patients, 25 cases（33.3%） had normal olfaction and 50 cases（66.7%） had olfactory disorders. Multivariate Logistic regression analysis showed that tissue eosinophils percentage（OR=1.032, 95%CI 1.002-1.064, P=0.036）, Questionnaire of olfactory disorders-Negative statement（QOD-NS）（OR=1.079, 95%CI 1.004-1.160, P=0.040） and Anterior olfactory cleft score（AOCS）（OR=2.672, 95%CI 1.480-4.827, P=0.001） were independent risk factors for olfactory disorders in CRS patients. Further research found that the area under the ROC curve（AUC） of the combined prediction model established by the tissue eosinophil percentage, QOD-NS and AOCS was 0.836（95%CI 0.748-0.924, P<0.001）, which is better than the above single factor prediction model in predicting olfactory disorders in CRS. Conclusion:Based on pathological artificial intelligence, tissue eosinophil percentage, QOD-NS and AOCS are independent risk factors for olfactory disorders in CRS patients, and the combination of the three factors has a good predictive effect on CRS olfactory disorders.
Male ; Female ; Humans ; Adult ; Retrospective Studies ; Artificial Intelligence ; Rhinosinusitis ; Rhinitis/complications* ; Nasal Polyps/complications* ; Sinusitis/complications* ; Olfaction Disorders/etiology* ; Smell ; Chronic Disease

Humans ; Olfaction Disorders/etiology* ; Smell

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female ; Humans ; Adolescent ; SARS-CoV-2 ; Smell ; COVID-19/complications* ; Cross-Sectional Studies ; COVID-19 Vaccines ; Incidence ; Olfaction Disorders/etiology* ; Taste Disorders/etiology* ; Prognosis

Olfactory epithelium, which detects and transmits odor signals, is critical for the function of olfactory system. Olfactory epithelium is able to recover spontaneously after injury under normal circumstances, but this ability is dampened in certain diseases or senility, which causes olfactory dysfunction. The olfactory epithelium consists of basal cells, sustentacular cells and olfactory sensory neurons. In order to develop an olfactory epithelial organoid containing multiple olfactory cell types in vitro, we used three-dimensional culture model and small molecules screening. This organoid system consists of horizontal basal-like cells, globose basal-like cells, sustentacular-like cells and olfactory sensory neurons-like cells. Through statistical analysis of clone diameter, immunofluorescence staining and qPCR detection of the expression level of related marker genes. We identified a series of growth factors and small molecule compounds that affected the proliferation, composition and gene expression of the organoids. CHIR-99021, an activator of Wnt signaling pathway, increased the colony formation and proliferation rate of olfactory epithelial organoids and the expression level of marker genes of olfactory sensory neurons-like cells. In addition, each factor in the culture system increased the proportion of c-Kit-positive globose basal-like cell colonies in organoids. Moreover, EGF and vitamin C were both beneficial to the expression of horizontal basal-like cell marker genes in organoids. The established olfactory epithelial organoid system mimicked the process of olfactory epithelial stem cells differentiating into various olfactory epithelial cell types, thus providing a research model for studying olfactory epithelial tissue regeneration, the pathological mechanism of olfactory dysfunction and drug screening for olfactory dysfunction treatment.
Humans ; Olfactory Mucosa/metabolism* ; Epithelial Cells ; Organoids/metabolism* ; Olfaction Disorders/metabolism*