Abstract
Atrophic rhinitis (AR) is a chronic inflammation of the nose characterized by an atrophy of the nasal mucosa. This is typically associated with an impaired sense of smell and a subjective sensation of poor nasal breathing. The aim of this study is to assess chemosensory function in patients suffering from AR using psychophysical testings and event-related potentials (ERP) responses. A cohort of nine patients was extensively studied. Eight out of nine had secondary AR sequela of a bilateral total inferior turbinectomy whereas one patient had a primary AR. All the patients had a clinical evaluation using Sniffin’ Sticks test and a retro-olfaction test and an electrophysiological evaluation based upon ERPs obtained after both olfactory and trigeminal stimuli. All the patients complained of a poor nasal breathing and presented a distortion of the chemosensory function. Actually, the orthonasal psychophysical testing showed that four patients out of nine had anosmia, three out of nine had hyposmia and two out of nine were normosmic. All the patients demonstrated retro-olfaction scores inferior to the normal values. The chemosensory ERP showed that seven patients had no olfactory response whereas six had no trigeminal response. Four patients had neither olfactory nor trigeminal ERP response. In conclusion, this study demonstrates that most patients with AR secondary to a total bilateral inferior turbinectomy have a reduction of the chemosensory function measured objectively by psychophysical testings and ERP. Moreover, the trigeminal responses were absent in all the cases.
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Jaswal A, Jana AK, Sikder Biswajit, Nandi TK, Sadhukhan SK, Das A (2008) Novel treatment of atrophic rhinitis: early results. Eur Arch Otorhinolaryngol 265(10):1211–1217
Hildenbrand T, Weber RK, Brehmer D (2011) Rhinitis sicca, dry nose and atrophic rhinitis: a review of the literature. Eur Arch Otorhinolaryngol 268(1):17–26. doi:10.1007/s00405-010-1391-z
Houser SM (2007) Surgical treatment for empty nose syndrome. Arch Otolaryngol Head Neck surgery 133(9):858–863
Passali D, Lauriello M, Anselmi M, Bellussi L (1995) Treatment of hypertrophy of the inferior turbinate: long term result in 382 patients randomly assigned to therapy. Ann Otol Rhinol Laryngol 108:569–575
Oburra HO (1995) Complications following bilateral turbinectomy. East Afr Med J 72:101–102
Manzoor T, Asghar A, Aslam S, Ali M, Ayub W (2008) Partial inferior turbinectomy; a better management option for hypertrophied inferior turbinates. Prof Med J 15(4):512–517
Ophir D (1990) Resection of obstructing inferior turbinates following rhinoplasty. Plast Reconstruct Surg 85:724–727
Cook PR, Begegni A, Bryant WC, Davis WE (1995) Effect of partial middle turbinectomy on nasal airflow and resistance. Otolaryngol Head Neck Surg 113:413–419
Garcia GJ, Bailie N, Martins DA, Kimbell JS (2007) Atrophic rhinitis: a CFD study of air conditioning in the nasal cavitty. J Appl Physiol 103(3):1082–1092
Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the Sniffin Sticks including test of odor identification, odor discrimination and or odor thresholds: an upgrade based on a group of more than 3000 subjects. Eur Arch Otorhinolaryngol 264:237–243
Heilmann S, Strelle G, Rosenheim K, Damm M, Hummel T (2002) Clinical assessment of retronasal olfactory function. Arch Otolaryngol Head Neck Surg 128:414–418
Rombaux P, Mouraux A, Collet S, Eloy P, Bertrand B (2009) Usefulness and feasibility of psychophysical and electrophysiological olfactory testing in the rhinology clinic. Rhinology 47:23–35
Hummel T, Barz S, Lötsch J, Roscher S, Kettenmann B, Kobal G (1996) Loss of olfactory function leads to a decrease of trigeminal sensitivity. Chem Senses 21:75–79
Doty RL, Brugger WPE, Jurs PC, Orndorff MA, Snyder PJ, Lowry LD (1978) Intranasal trigeminal stimulation from odours volatiles: psychometric responses from anosmic and normal humans. Physiol Behav 20:175–185
Hummel T, Livermore A (2002) Intranasal chemosensory function of the trigeminal nerve and aspects of its relation to olfaction. Int Arch Occup Environ Health 75:305–313
Wrobel BB, Leopold DA (2005) Olfactory and sensory attributes of the nose. Otolaryngol Clin North Am 38(6):1163–1170
Leopold DA, Hummel T, Schwob JE, Hong SC, Knecht M, Kobal G (2000) Anterior distribution of human olfactory epithelium. Laryngoscope 110:417–421
Livermore A, Hummel T (2005) The influence of training on chemosensory event-related potentials and interactions between the olfactory and trigeminal systems. Chem Senses 29:41–51
Cain WS, Murphy C (1980) Interaction between chemoreceptive modalities of odour and irritation. Nature 284:255–257
Bensafi M, Frasnelli J, Reden J, Hummel T (2007) The neural represention of odor is modulated by the presence of a trigeminal stimulus during odor encoding. Clin Neurophysiol 118:696–701
Iannilli E, Gerber J, Frasnelli J, Hummel T (2007) Intranasal trigeminal function in subjects with and without and intact sense of smell. Brain Res 1139:235–244
Rombaux P, Mouraux A, Keller T, Hummel T (2008) Trigeminal event related potentials in patients with an olfactory dysfunction. Rhinology 46(3):170–174
Frasnelli J, Hummel T (2007) Interactions between the chemical senses: trigeminal function in patients with olfactory loss. Int J Psychophysiol 65(3):177–181
Stuck BA, Frey S, Freiburg S, Hörmann K, Zahnert T, Hummel T (2006) Chemosensory event-related potentials in relation to side of stimulation, age, sex, and stimulus concentration. Clin Neurophysiol 117(6):1367–1375
Hummel T, Barz S, Pauli E, Kobal G (1998) Chemosensory event-related potentials change as a function of age. Electroencephalogr Clin Neurophysiol 108:208–217
Covington J, Geilser M, Polich J, Murphy C (1999) Normal aging and odor intensity effects on the olfactory event-related potentials. Int J Psychophysiol 32:205–214
Morgan CD, Covington JW, Geisler MW, Polich J, Murphy C (1997) Olfactory event-related potentials: older males demonstrate the greatest deficits. Electroencephalogr Clin Neurophysiol 104:351–358
Lötsch J, Hummel T (2006) The clinical significance of electrophysiological measures of olfactory function. Behav Brain Res 170:78–83
Hussner A, Frasnelli J, Welge-Lüssen A, Reiss G, Zahnert T, Hummel T (2006) Loss of trigeminal sensitivity reduces olfactory function. Laryngoscope 116(8):1520–1522
Subramaniam RP, Richardson RB, Morgan KT, Kimbell JS, Guilmette RA (1998) Computational fluid dynamics simulations of inspired airflow in human nose and nasopharynx. Inhal Toxicol 10:91–120
Wolf M, Naftali S, Schroter RC, Elad D (2004) Air-conditioning characteristics oft he human nose. J Laryngol Otol 118:87–92
Boyce J, Eccles R (2006) Do chronic changes in nasal airflow have any physiological or pathological effect on the nose and paranasal sinuses? A systematic review. Clin Otolaryngol 31:15–19
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An erratum to this article can be found at http://dx.doi.org/10.1007/s00405-011-1752-2
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Huart, C., Eloy, P., Collet, S. et al. Chemosensory function assessed with psychophysical testing and event-related potentials in patients with atrophic rhinitis. Eur Arch Otorhinolaryngol 269, 135–141 (2012). https://doi.org/10.1007/s00405-011-1670-3
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DOI: https://doi.org/10.1007/s00405-011-1670-3