Jan Vodička

Position Paper on Olfactory Dysfunction

Background Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following: • Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy with small diameter endoscopes. • Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability. • Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour threshold, and/or one of odour identification or discrimination. • Comprehensive chemosensory assessment should include gustatory screening. • Smell training can be helpful in patients with olfactory loss of several aetiologies. Conclusions We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.

Smell impairment after tick-borne encephalitis vaccination: Case report

We present a case of hyposmia following administration of a tick-borne encephalitis (TBE) vaccine. The olfactory impairment did not recover during 1-year follow up. In the literature, there is no report of smell deterioration after vaccination against TBE. Physicians should be aware of this rare neurological complication.

VYŠETŘENÍ ČICHU PO ÚRAZU HLAVY PARFÉMOVANÝMI FIXY

Head trauma can lead to an olfactory loss. Physicia ns usually don‘t put much attention to this sensory deficit de spite the fact that it can persist without improvement. To me asure olfaction we introduced at our department easy, che ap and available test of olfactometry (Odorized Markers Te st – OMT). We decided to compare OMT with standard olfactory t est Sniffin‘ Sticks used in Germany. From 1 st of January 2005 to 31 st of December 2007 we examined olfaction in 27 patients after head trauma and 178 healthy subjects. Average age of all subjects was 41.3 year s (patients after head trauma 40.7; healthy subjects 41.4). The youngest participant was 16 and the oldest 85 years old. To measure olfaction OMT and Sniffin‘ Sticks test (part thresh old and identification) were used. Patients suffering from posttraumatic olfactory los s scored on average 4.3 and healthy subjects 10.1 points in OMT . Using Sniffin‘ Sticks test (part threshold), average scor es were 2.3 and 7.9 in posttraumatic and healthy subjects, resp ectively. Average score in part identification were 5.6 and 1 2.1 in posttraumatic and healthy subjects, respectively. B ased on

Development of an International Odor Identification Test for Children: The Universal Sniff Test

Objective To assess olfactory function in children and to create and validate an odor identification test to diagnose olfactory dysfunction in children, which we called the Universal Sniff (U‐Sniff) test. Study design This is a multicenter study involving 19 countries. The U‐Sniff test was developed in 3 phases including 1760 children age 5‐7 years. Phase 1: identification of potentially recognizable odors; phase 2: selection of odorants for the odor identification test; and phase 3: evaluation of the test and acquisition of normative data. Test—retest reliability was evaluated in a subgroup of children (n = 27), and the test was validated using children with congenital anosmia (n = 14). Results Twelve odors were familiar to children and, therefore, included in the U‐Sniff test. Children scored a mean ± SD of 9.88 ± 1.80 points out of 12. Normative data was obtained and reported for each country. The U‐Sniff test demonstrated a high test—retest reliability (r27 = 0.83, P < .001) and enabled discrimination between normosmia and children with congenital anosmia with a sensitivity of 100% and specificity of 86%. Conclusions The U‐Sniff is a valid and reliable method of testing olfaction in children and can be used internationally.