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Philippe Rombaux, MD; Heike Weitz, MD; Andre Mouraux, MD, PhD; George Nicolas, MD; Bernard Bertrand, MD; Thierry Duprez, MD; Thomas Hummel, MD

Arch Otolaryngol Head Neck Surg. 2006;132:1346-1351.

Objective  To investigate whether differences in olfactory function between healthy individuals and patients with olfactory loss could be detected by various diagnostic tests.

Design  Psychophysical testing of orthonasal and retronasal olfactory functions, magnetic resonance imaging of olfactory bulb (OB) volume, and chemosensory event–related potential (ERP) measurement performed between January 1, 2005, and October 31, 2005.

Setting  Academic tertiary referral medical center.

Patients  Eleven healthy individuals with normal olfactory function (NL) and 11 patients with nasal polyposis (NP), 11 with posttraumatic olfactory loss (PT), and 11 with postinfectious olfactory loss (PI) were included in this study.

Main Outcome Measures  Orthonasal and retronasal olfactory test results, magnetic resonance imaging–based OB volume, and ERPs to both olfactory and intranasal trigeminal stimulation.

Results  Orthonasal and retronasal testing revealed that NL individuals had higher scores than patients with NP, PT, or PI. Retronasal scores were higher in NP patients compared with PT and PI patients. The OB volumes were higher in NL individuals compared with NP, PT, and PI patients. The OB volumes in PT patients were significantly lower than those from NP and PI patients. Olfactory ERPs were different between NL individuals and NP, PT, and PI patients, and trigeminal ERPs were significantly different when comparing NL individuals with NP patients. For the entire cohort, a significant correlation was found between orthonasal testing and OB volume, between retronasal testing and OB volume, and between both orthonasal and retronasal testing and olfactory ERP amplitudes. Olfactory ERPs were recorded in the 11 NL individuals and in 3 NP, 3 PT, and 4 PI patients, defined as responders. Orthonasal and retronasal test scores, OB volume, and olfactory ERPs were significantly larger in responders compared with nonresponders.

Conclusions  Significant differences in various tests that evaluate olfactory function were detectable in a cohort of NL individuals and NP, PT, and PI patients. This finding suggests that these diagnostic tools provide information in terms of the clinical assessment of olfactory function. Future studies will investigate their combined use in terms of the prognosis of olfactory function in patients with olfactory loss.

Author Affiliations: Departments of Otorhinolaryngology (Drs Rombaux, Nicolas, and Bertrand), Neurophysiology (Dr Mouraux), and Radiology (Dr Hummel), Cliniques Universitaires Saint Luc, Brussels, Belgium; and Department of Otorhinolaryngology, Smell and Taste Clinic, Dresden, Germany (Drs Weitz and Hummel).

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