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Orthonasal and retronasal olfactory function in olfactory cleft obstructions.

J H Juratli1, C Huart2, V Hox3

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Summary

Respiratory adenomatoid epithelial hamartoma (REAH) significantly impairs both orthonasal and retronasal olfactory function more than other olfactory cleft obstructions. Chronic rhinosinusitis and olfactory cleft syndrome also affect smell, with differences more pronounced in orthonasal function.

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Area of Science:

  • Otolaryngology
  • Olfactory Neuroscience
  • Rhinology

Background:

  • Olfactory cleft obstruction significantly impacts olfactory function.
  • Conditions studied include olfactory cleft syndrome, chronic rhinosinusitis (with or without nasal polyps), and respiratory adenomatoid epithelial hamartoma (REAH).

Purpose of the Study:

  • To investigate and compare orthonasal and retronasal olfactory function in patients with various olfactory cleft obstructions.
  • To determine the specific impact of REAH and chronic rhinosinusitis on olfactory pathways.

Main Methods:

  • Ninety-three patients with olfactory cleft obstruction underwent nasal endoscopy, chemosensory event-related potential recordings, and radiologic assessment.
  • Orthonasal and retronasal olfactory function were evaluated using the complete Sniffin' Sticks test and a powder-based test, respectively.

Main Results:

  • Patients with REAH exhibited significantly lower orthonasal and retronasal olfactory function compared to those with chronic rhinosinusitis with polyps in the olfactory cleft.
  • Olfactory cleft syndrome alone resulted in higher orthonasal scores than combined conditions, but retronasal function was not significantly different.
  • Concurrent chronic rhinosinusitis did not significantly alter olfactory function in patients with REAH.

Conclusions:

  • REAH is associated with more severe olfactory dysfunction, affecting the olfactory mucosa beyond simple airflow disruption.
  • The distinction between chronic rhinosinusitis and olfactory cleft syndrome on olfactory function is more evident in orthonasal than retronasal assessments.