SAT FEB 15,1992 11:34 AM LIST REFERENCES LIST REFERENCES A) ANOSMIAS 2 F) ABSTRACT ONLINE 2746693 B) ANOSMIA 868 G) 1985...92 2354446 C) *SUM AB 870 H) *SUM DE 590 D) ANOSMIA/ET... 529 I) *ON F&G&H 87 E) ANOSMIA /TH/DT 61 *** *** *****ANNALS OF OTOLOGY, RHINOLOGY AND LARYNGOLOGY***** (REFERENCE 1 OF 13) 90178995 Yamagishi M Nakamura H Suzuki S Hasegawa S Nakano Y Immunohistochemical examination of olfactory mucosa in patients with olfactory disturbance. Ann Otol Rhinol Laryngol 1990 Mar;99(3 Pt 1):205-10 The olfactory mucosa was examined by immunohistochemistry in patients with olfactory disturbance: anosmia due to choanal atresia and chronic sinusitis, early-stage common cold, late-stage common cold, and head trauma. The results indicate that the olfactory mucosa of patients with olfactory disturbance shows specific kinds of immunoreactive patterns and that immunohistochemistry is useful for examining the degree of degeneration of pathologic human olfactory mucosa and for clarification of prognosis. Institutional address: Department of Otolaryngology Niigata University School of Medicine Japan. *****ARCHIVES OF NEUROLOGY***** (REFERENCE 2 OF 13) 89149479 Jafek BW Eller PM Esses BA Moran DT Post-traumatic anosmia. Ultrastructural correlates. Arch Neurol 1989 Mar;46(3):300-4 Five patients suffering post-traumatic anosmia were studied at the University of Colorado Health Sciences Center, Denver. Each patient underwent psychophysical testing, clinical evaluation, and olfactory biopsy. The biopsy specimens were examined ultrastructurally and were found to vary from normal tissues. The overall appearance of the olfactory epithelium in the post-traumatic patient is disrupted and the receptor cells are distorted. Large numbers of axons are located near the basement membrane and can often be found in bundles throughout the epithelium, extending even to the mucosal surface. Olfactory cilia are rarely seen in epithelia obtained from post- traumatic patients. Bald olfactory vesicles, often containing basal bodies, are frequently observed. We postulate that in these cases, the olfactory epithelium regenerates following head trauma and the receptor cells attempt to send axons centrally. However, the cribriform plate has undergone fibrotic healing and the axons are unable to penetrate it and make contact with olfactory bulb neurons. Institutional address: Department of Otolaryngology/Head and Neck Surgery University of Colorado School of Medicine Denver 80262. *****ARCHIVES OF OTOLARYNGOLOGY***** (REFERENCE 3 OF 13) 85148745 Moran DT Jafek BW Rowley JC 3d Eller PM Electron microscopy of olfactory epithelia in two patients with anosmia. Arch Otolaryngol 1985 Feb;111(2):122-6 Ultrastructural alterations were present in biopsy specimens of olfactory epithelia taken from two patients with anosmia. In both cases, the olfactory epithelia presented a disorganized appearance when viewed by transmission electron microscopy. The number of ciliated olfactory receptors was reduced; few olfactory vesicles were present at the epithelial surface. Where present, the olfactory vesicles usually lacked cilia. Since both patients had a history of head trauma, we speculate that the fila olfactoria may have been severed at the level of the cribriform plate. The histopathologic changes in the olfactory receptors that were revealed by electron microscopy may have resulted from the inability of regenerating axons to reach their normal site of synaptic contact--the second-order neurons (mitral cells) in the olfactory bulb of the brain. *****ARCHIVES OF OTOLARYNGOLOGY -- HEAD AND NECK SURGERY***** (REFERENCE 4 OF 13) 87100526 Wright HN Characterization of olfactory dysfunction. Arch Otolaryngol Head Neck Surg 1987 Feb;113(2):163-8 Management of dysosmic patients frequently is hampered by an incomplete description of their chief complaint and sometimes inadequate qualitative analysis of their symptoms. Qualitative analysis of olfactory dysfunction by an Odorant Confusion Matrix helps to characterize more fully sense of smell in the dysosmic patient. It is well grounded in psychophysical theory, thereby permitting physiological inferences about specific neural dysfunctions. The quantitative measure derived from the matrix correlates well with another quantitative measure of olfactory ability, the Smell identification Test, and provides the opportunity for valid comparisons among and within patients. Examination of illustrative case reports demonstrates that the qualitative features of the Odorant Confusion Matrix offer additional insights to support etiologic diagnoses of disturbances in sense of smell. *****BRAIN***** (REFERENCE 5 OF 13) 86001478 Levin HS High WM Eisenberg HM Impairment of olfactory recognition after closed head injury. Brain 1985 Sep;108 ( Pt 3):579-91 To investigate the effects of closed head injury (CHI) on olfactory identification, we administered a test of olfactory naming and forced choice recognition to 52 CHI patients who had no evidence of anosmia. The Olfactory Identification Test consisted of 'scratch and sniff' labels of familiar nonirritant odorants. In comparison with a normal control group (n = 19) of similar age, olfactory naming and recognition were impaired in the CHI series, particularly in patients with moderate or severe head injury. The presence of a haematoma or contusion in the frontal/temporal region was also related to impaired olfactory recognition. We suggest that nonmissile head injury can produce at least a partial impairment of olfactory recognition despite relatively preserved olfactory detection. *****MEDICAL CLINICS OF NORTH AMERICA***** (REFERENCE 6 OF 13) 92047726 Mott AE Leopold DA Disorders in taste and smell. Med Clin North Am 1991 Nov;75(6):1321-53 Although many conditions and medications have been associated with chemosensory disturbances, data from major chemosensory clinical research centers support three major disorders as being causative: nasal and paranasal sinus disease (21%), post-upper respiratory tract viral infection (19%), and head trauma (14%). Despite extensive evaluation, 22% of patients do not demonstrate identifiable causation. Institutional address: Department of Medicine University of Connecticut Health Center Farmington. *****NATURE***** (REFERENCE 7 OF 13) 86311269 Weinstock RS Wright HN Spiegel AM Levine MA Moses AM Olfactory dysfunction in humans with deficient guanine nucleotide- binding protein. Nature 1986 Aug 14-20;322(6080):635-6 The guanine nucleotide-binding stimulatory protein (Gs) couples hormone-receptor interaction to the activation of adenylate cyclase and the generation of cyclic AMP. Studies using frog neuroepithelium indicate that the sense of smell is mediated by a Gs-adenylate cyclase system, and this prompted us to test olfaction in the only known model of Gs deficiency in the animal kingdom, Gs-deficient (type 1a) pseudohypoparathyroidism (PHP), which occurs in humans. Such patients are resistant to the cAMP-mediated actions of several hormones. (Although Henkin has reported disturbances in the sense of smell in six patients with PHP, currently available biochemical measurements such as the cAMP response to parathyroid hormone (PTH) and determination of Gs activity were not reported and olfactory testing was limited.) In the present study, we found that all Gs- deficient patients had impaired olfaction when compared with PHP patients who had normal Gs activity (type 1b PHP, in which patients are resistant only to the action of PTH in the kidney). This is the first evidence of human olfactory impairment which can be related to Gs deficiency and suggests that Gs-deficient PHP patients may be resistant to cAMP-mediated actions in other non-endocrine systems. *****OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA***** (REFERENCE 8 OF 13) 87174324 Estrem SA Renner G Disorders of smell and taste. Otolaryngol Clin North Am 1987 Feb;20(1):133-47 This article describes the anatomy and physiology of the gustatory and olfactory organs in man. Dysfunction of these senses is closely examined with respect to etiology, diagnosis, and treatment. Taste and smell are closely interrelated. An influence on the function of one sense often affects the function of the other sense. *** *** *****AMERICAN JOURNAL OF OTOLARYNGOLOGY***** (REFERENCE 9 OF 13) 87097755 Feldman JI Wright HN Leopold DA The initial evaluation of dysosmia. Am J Otolaryngol 1986 Nov-Dec;7(6):431-44 Patients with disturbances in their sense of smell often represent a bewildering array of alternative diagnoses. The existing knowledge of olfactory disorders has been schematized into a systematic history approach toward the development of a differential diagnosis for dysosmic patients. Its components should elicit essential elements of the history which, according to the literature, have been associated with dysosmia. The ability to update the details of specific components permits it to be adapted to the needs of the individual practitioner. *****ARCHIVES OF OTO-RHINO-LARYNGOLOGY***** (REFERENCE 10 OF 13) 89227756 Yamagishi M Hasegawa S Nakano Y Examination and classification of human olfactory mucosa in patients with clinical olfactory disturbances. Arch Otorhinolaryngol 1988;245(5):316-20 To determine objectively the degree of olfactory disturbance, we biopsied the olfactory mucosa from patients who complained of anosmia. The olfactory disturbances in this study were caused by choanal atresia, chronic sinusitis, viral inflammation, and head trauma, as well as by congenital and idiopathic anosmia. The biopsy specimens were examined by light microscopy and the degree of mucosal degeneration present was classified according to five grades. The clinical courses of the patients studied paralleled the changes found in the olfactory mucosa. Institutional address: Department of Otolaryngology Niigata University School of Medicine Japan. *****EAR, NOSE, AND THROAT JOURNAL***** (REFERENCE 11 OF 13) 90336584 Jafek BW Gordon AS Moran DT Eller PM Congenital anosmia. Ear Nose Throat J 1990 May;69(5):331-7 Seven patients with congenital anosmia underwent detailed chemosensory evaluation, followed by the performance of biopsies of the olfactory region. Olfactory epithelium was not found in any of the biopsy specimens. It appears therefore that patients with congenital anosmia lack any olfactory epithelium. Several possible explanations for this finding are discussed. The most attractive hypothesis is that the olfactory placode forms either normally or abnormally during development but later degenerates and is replaced with respiratory epithelium. Only one patient in our series had congenital anosmia in association with a syndrome (Kallmann's syndrome), indicating that congenital anosmia is found more often as an isolated symptom. Institutional address: Department of Otolaryngology Head and Neck Surgery University of Colorado School of Medicine Denver. *****LARYNGOLOGIE, RHINOLOGIE, OTOLOGIE***** (REFERENCE 12 OF 13) 87114761 Fikentscher R Rasinski C [Parosmias--definition and clinical picture] Parosmien--Begriffsbestimmung und klinisches Bild. Laryngol Rhinol Otol (Stuttg) 1986 Dec;65(12):663-5 (Published in German) The paper proposes the definition and technical terms with greater precision for the description of qualitative smelling disturbances. Thereafter, parosmias are relevant only for the ENT specialist. Their further classification seems to be unnecessary or even false. These parosmias are always described to be troublesome for the patient since he feels the abnormality of the olfactory sensation. Thus, a clear distinction against phantosmias (olfactory hallucinations) and pseudoosmias (olfactory illusions) is given. The cause of parosmias is frequently speculative. Most frequently there occur traumas and influenza. Their treatment is equally the same as in postinfluenza hyposmias. Additionally, the dripping of 4% novocaine or 10% cocaine on the olfactory mucosa is performed. The parosmia is defined to be an independent entity of disorder, not only accompanying hyposmia. The parosmia may occur separately, too, and it does not necessarily recede together with hyposmia and anosmia. *****RHINOLOGY***** (REFERENCE 13 OF 13) 89186437 Hendriks AP Olfactory dysfunction. Rhinology 1988 Dec;26(4):229-51 Otolaryngologists, neurologists and other medical practitioners are often not well equipped for assessing olfactory (dys)function. They either use no or inadequate olfactory tests. This problem of inadequate olfactory testing was systematically attacked by American psychologists in the early 80's and led to the construction of odour identification tests which are easy to administer. Combining the advantages of two of these American tests we developed a Dutch odour identification test (GITU), consisting of two subsets of 18 natural odourants and applicable in two ways: one for use in the ENT clinic, the other for industrial purposes. The first results of this test indicate that the incidence of serious olfactory disorder among adults in the Netherlands may be conservatively estimated at about 1%. The GITU readily discriminates between patients and controls and is sensitive to variables known to affect olfaction (gender, age). The recognition of olfactory dysfunction as a major problem has led in the U.S.A. to the establishment of clinical research centers for the study of human chemoreception. Evaluation results of four of those clinics together with data of three more case series--with a total number of patients of 4000--show that two thirds of all patients fall into three etiological categories: 1. Nasal disease and/or paranasal sinus disease. 2. Viral infection of the upper respiratory pathway. 3. Head trauma. For each of the three categories the literature is reviewed in order to arrive at a clearer picture of the olfactory patient with respect to age, gender, degree of olfactory deficit, spontaneous recovery, effectiveness of therapy and localization of the defect along the olfactory pathway. Finally an appeal is made to clinicians with interest in the subject to exchange more information with research scientists in olfaction. Such exchange is considered essential to making progress in this field. Institutional address: Psychological Laboratory University of Utrecht The Netherlands.