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      Association Between Olfactory Function and Asthma in Adults

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          Abstract

          Purpose

          Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) are common asthma-associated upper airway diseases. Olfactory dysfunction, a common symptom among these patients, is an increasingly recognized condition that is associated with a reduced quality of life and major health outcomes. However, there are few studies on the association between olfactory function and asthma. We investigated the relationship between asthma and olfactory function.

          Patients and Methods

          A total of 146 patients with asthma aged >18 years were retrospectively analyzed from August 2019 to February 2020. Olfactory function was assessed using the Sniffin’ stick test or the YSK olfactory function test. We compared the clinical parameters of patients with olfactory dysfunction and patients with normosmia.

          Results

          Of the total participants, 68 (46.6%) showed olfactory dysfunction (hyposmia, n=31; anosmia, n=37). The patients with olfactory dysfunction were older, had longer durations of asthma, and a higher proportion of those with poor general health, CRS, and nasal polyps compared to patients with normosmia. However, there were no significant differences in the socioeconomic status, lung function, asthma severity, and use of inhaled corticosteroids or intranasal steroids between the two groups. Age (odds ratio: 1.044, 95% confidence interval: 1.009–1.081, P=0.012), poor general health (3.304, 1.231–8.863, P=0.018), CRS (2.589, 1.155–5.804, P=0.021), and nasal polyps (3.306, 1.1–9.94, P=0.033) were significantly associated with olfactory dysfunction.

          Conclusion

          Olfactory dysfunction was quite frequently observed in adults with asthma. Age, poor general health, CRS, and nasal polyps were significantly associated with olfactory dysfunction.

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          Most cited references37

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          European Position Paper on Rhinosinusitis and Nasal Polyps 2012.

          The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed.
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            Prevalence of olfactory dysfunction: the skövde population-based study.

            Patients with olfactory dysfunction appear repeatedly in ear, nose, and throat practices, but the prevalence of such problems in the general adult population is not known. Therefore, the objectives were to investigate the prevalence of olfactory dysfunction in an adult Swedish population and to relate dysfunction to age, gender, diabetes mellitus, nasal polyps, and smoking habits. Cross-sectional, population-based epidemiological study. A random sample of 1900 adult inhabitants, who were stratified for age and gender, was drawn from the municipal population register of Skövde, Sweden. Subjects were called to clinical visits that included questions about olfaction, diabetes, and smoking habits. Examination was performed with a smell identification test and nasal endoscopy. In all, 1387 volunteers (73% of the sample) were investigated. The overall prevalence of olfactory dysfunction was 19.1%, composed of 13.3% with hyposmia and 5.8% with anosmia. A logistic regression analysis showed a significant relationship between impaired olfaction and aging, male gender, and nasal polyps, but not diabetes or smoking. In an analysis of a group composed entirely of individuals with anosmia, diabetes mellitus and nasal polyps were found to be risk factors, and gender and smoking were not. The sample size of the population-based study was adequate, with a good fit to the entire population, which suggests that it was representative for the Swedish population. Prevalence data for various types of olfactory dysfunction could be given with reasonable precision, and suggested risk factors analyzed. The lack of a statistically significant relationship between olfactory dysfunction and smoking may be controversial.
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              The association between smoking and smell and taste impairment in the general population.

              The aim of this study was to evaluate the effect of smoking on taste and smell impairment in a large population- based study. Cross-sectional survey in Dortmund, Germany. The population sample was randomly drawn from the city's central registration office. Following a standardized interview, validated taste and smell tests were performed. Descriptive statistics and logistic regression was used in the analysis. Among the 1312 study participants, 3.6 % were functionally anosmic, and 18 % had olfactory dysfunction. Approximately 20 % recognized only three or less of the four tastes when presented at suprathreshold concentrations, indicating signs of taste impairment. Current smoking in general increased the risk for impairment of olfactory function (odds ratio 1.71, 95 % CI 1.19-2.47), but not the risk for taste impairment. Heavy smokers of 20 or more cigarettes/day had significant increased risks for impairment in both senses. Our results reveal that both olfactory and gustatory function are compromised in a significant proportion of the general population. Smoking increases significantly the risk of impairment of olfactory function. Our findings add an important detail to the large body of evidence that describes adverse health effects of smoking.
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                Author and article information

                Journal
                J Asthma Allergy
                J Asthma Allergy
                jaa
                jaa
                Journal of Asthma and Allergy
                Dove
                1178-6965
                31 March 2021
                2021
                : 14
                : 309-316
                Affiliations
                [1 ]Department of Internal Medicine, College of Medicine, Dong-A University , Busan, Korea
                [2 ]Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University , Busan, Korea
                Author notes
                Correspondence: Young-Hee Nam Department of Internal Medicine, College of Medicine, Dong-A University , 26 Daesingongwon-Ro, Seo-Gu, Busan, KoreaTel +8251-240-5860Fax +82-51-242-5864 Email yhnam@dau.ac.kr
                Author information
                http://orcid.org/0000-0003-0905-4649
                http://orcid.org/0000-0001-8759-2982
                Article
                299796
                10.2147/JAA.S299796
                8020128
                33833532
                2a450382-a28e-42b6-85fd-cf67a0ce8ab2
                © 2021 Rhyou et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 11 January 2021
                : 12 March 2021
                Page count
                Figures: 1, Tables: 10, References: 37, Pages: 8
                Funding
                Funded by: the Dong-A University research fund;
                This work was supported by the Dong-A University research fund.
                Categories
                Original Research

                Immunology
                asthma,chronic rhinosinusitis,olfactory dysfunction
                Immunology
                asthma, chronic rhinosinusitis, olfactory dysfunction

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