An Ageusia and Dysosmia Patient Treated by Acupuncture

Occurrence of ageusia, a disease characterized by complete or severe loss of the subjective sense of taste and frequently accompanied with olfaction disorders, is increasing at the rate of 140 thousand more cases every year in Japan according to the latest congressional data, 2002. There may be many reasons for this, such as influenza, diabetes, adverse reaction of antimicrobial drugs, smoke, depression, etc. Disorders of taste and smell could not only cause uncomfort, but also result in a loss of body weight in the patients, and may be harmful to their quality of life.

Neuropathophysiology of COVID-19

The COVID-19 pandemic has strained health systems all over the world. The SARS-CoV-2 which causes the disease is a corona virus that predominantly affects the respiratory systems. Since the outbreak of the novel disease in December, 2019 the scientific world has intensified efforts to elucidate its pathophysiology, mode of transmission, clinical manifestations, best mode of prevention and treatment options. Very little is known about its neuropathophysiology even though a significant number of patients come down with obvious neurological signs and symptoms. The virus has been reported to affect the nerves, muscles, the special senses and the central nervous system with a wide range of clinical manifestations. The mechanisms by which the virus causes all these are still not clear. This article attempts to review and articulate all possible existing theories surrounding the neurological effects of COVID-19.

Post-COVID-19 persistent olfactory,gustatory,and trigeminal chemosensory disorders:Definitions,mechanisms,and potential treatments

The nose and the oral cavities are the main sites for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry into the body.Smell and taste deficits are the most common acute viral manifestations.Persistent smell disorders are the most common and bothersome complications after SARS-CoV-2 infection,lasting for months to years.The mechanisms and treatment of persistent post-coronavirus disease 2019(COVID-19)smell and taste disorders are still challenges.Information sources for the review are PubMed,Centers for Disease Control and Prevention,Ovid Medline,Embase,Scopus,Web of Science,International Prospective Register of Systematic Reviews,Cumulative Index to Nursing and Allied Health Literature,Elton Bryson Stephens Company,Cochrane Effective Practice and Organization of Care,Cooperation in Science and Technology,International Clinical Trials Registry Platform,World Health Organization,Randomized Controlled Trial Number Registry,and MediFind.This review summarizes the up-to-date information about the prevalence,patterns at onset,and prognoses of post-COVID-19 smell and taste disorders,evidence for the neurotropism of SARS-CoV-2 and the overlap between SARSCoV-1,Middle East respiratory syndrome coronavirus,and SARS-CoV-2 in structure,molecular biology,mode of replication,and host pathogenicity,the suggested cellular and molecular mechanisms for these post-COVID19 chemosensory disorders,and the applied pharmacotherapies and interventions as trials to treat these disorders,and the recommendations for future research to improve understanding of predictors and mechanisms of these disorders.These are crucial for hopeful proper treatment strategies.

Evaluation of children and adults with post-COVID-19 persistent smell,taste and trigeminal chemosensory disorders:A hospital based study

BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019(COVID-19)complications.AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.METHODS Assessment was done to 185 patients(adults=150,age:31.41±8.63 years;children=35;age:15.66±1.63 years).Otolaryngology and neuropsychiatric evaluations were done.Measurements included:A clinical questionnaire(for smell and taste);sniffin'odor,taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS).RESULTS Duration of disorders was 11.53±3.97 ms(6-24 ms).Parosmia(n=119;64.32%)was developed months after anosmia(3.05±1.87 ms).Objective testing showed anosmia in all,ageusia and flavor loss in 20%(n=37)and loss of nasal and oral trigeminal sensations in 18%(n=33)and 20%(n=37),respectively.Patients had low scoring of sQOD-NS(11.41±3.66).There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.CONCLUSION The course of small and taste disorders are supportive of the nasal and oral neuronal compromises.Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders.Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders.There were no demographics,clinical variables at onset or specific profile of these disorders in children compared to adults.

化疗致味觉改变评估及护理的最佳证据总结

目的总结化疗所致味觉改变(CITA)评估及护理的相关证据,为临床护理人员对味觉改变展开规范化评估和管理提供参考。方法针对CITA的护理提出循证问题,通过美国国家综合癌症网络(NCCN)、Best Practice、美国指南网(NGC)、澳大利亚循证卫生保健中心(JBI)、Cochrane数据库检索近10年CITA的相关研究。对符合质量标准的文献进行资料提取和证据归纳。结果纳入8篇文献,包含2篇证据总结、1篇最佳实践推荐及5篇系统评价。总结出在特定临床情景下具备可行性及适宜性的最佳证据共7条,包括CITA的筛查与评估、预防及干预等。结论护理人员可遵循最佳证据来完善肿瘤内科CITA的管理,促进化疗相关症状的循证实践。

特比萘芬治疗甲癣致可逆性味觉缺失

1例68岁男性患者,近1年来一直服用缬沙坦80mg/d治疗高血压。因甲癣给予患者特比萘芬0.25g/d口服。治疗20d后,患者出现味觉减退;12周后味觉完全丧失。停用特比萘芬,2个月后患者味觉有所恢复。

特比萘芬致味觉丧失

1名55岁女性,因患甲癣口服特比萘芬250mg,1次/d。约1个月后,患者感觉对咸、苦等味道不敏感。继续服药1月余,其味觉完全丧失,遂停药。随访20d,患者味觉未恢复。

Measurement of chemosensory function

Although hundreds of thousands of patients seek medical help annually for disor-ders of taste and smell, relatively few medical practitioners quantitatively test their patients' chemosensory function, taking their complaints at face value. This is clearly not the approach paid to patients complaining of visual, hearing, or balance problems. Accurate chemosensory testing is essential to establish the nature, degree, and veracity of a patient's complaint, as well as to aid in counseling and in monitoring the effectiveness of treatment strategies and de-cisions. In many cases, patients perseverate on chemosensory loss that objective assessment demonstrates has resolved. In other cases, patients are malingering. Olfactory testing is crit-ical for not only establishing the validity and degree of the chemosensory dysfunction, but for helping patients place their dysfunction into perspective relative to the function of their peer group. It is well established, for example, that olfactory dysfunction is the rule, rather than the exception, in members of the older population. Moreover, it is now apparent that such dysfunction can be an early sign of neurodegenerative diseases such as Alzheimer's and Parkin-son's. Importantly, older anosmics are three times more likely to die over the course of an ensuring five-year period than their normosmic peers, a situation that may be averted in some cases by appropriate nutritional and safety counseling. This review provides the clinician, as well as the academic and industrial researcher, with an overview of the available means for accurately assessing smell and taste function, including up-to-date information and normative data for advances in this field.

Post-tonsillectomy taste dysfunction: Myth or reality?

Lingual branches of the glossopharyngeal nerve (CN Ⅸ) are at risk of injury during ton-sillectomy due to their proximity to the muscle layer of the palatine tonsillar bed. However, it is unclear how often this common surgery leads to taste disturbances. We conducted a literature search using PubMed, Embase, Cochrane Library, Google Scholar, PsychInfo, and Ovid Medline to evaluate the available literature on post-tonsillectomy taste disorders. Studies denoting self-reported dysfunction, as well as those employing quantitative testing, i.e., chemogustometry and electrogustometry, were identified. Case reports were excluded. Of the 8 original articles that met our inclusion criteria, only 5 employed quantitative taste tests. The highest prevalence of self-reported taste disturbances occurred two weeks after surgery (32%). Two studies reported post-operative chemical gustometry scores consistent with hypogeusia. However, in the two studies that compared pre- and post-tonsillectomy test scores, one found no difference and the other found a significant difference only for the left rear of the tongue 14 days post-op. In the two studies that employed electrogustometry, elevated post-operative thresholds were noted, although only one compared pre- and post-operative thresholds. This study found no significant differences. No study employed a normal control group to assess the influences of repeated testing on the sensory mea-sures. Overall, this review indicates that studies on post-tonsillectomy taste disorders are limited andambiguous.Future researchemploying appropriate control groups andtaste testingprocedures are needed to define the prevalence, duration, and nature of post-tonsillectomy taste disorders.