Potential oscillation elicited by i.v. olfaction and its applicability as an objective clinical olfaction test.
OBJECTIVE
Alinamin has long been applied in Japan for testing i.v. olfaction and to diagnose olfactory disorders. The test is subjective, each subject being asked about the presence or absence of olfaction. The credibility of the answers is highly questionable in some cases; as a result, the reliability of the test is poor. Recent studies demonstrated an induced electric potential in the scalp during i.v. olfactory testing. Some patients complain of the pain of the injection during i.v. olfactory testing; therefore, the effect of this pain must be considered with respect to measurement of the i.v. olfaction-elicited potential (IVOP).


METHODS
This investigation involved 179 subjects with various olfaction levels. Each subject received an Alinamin injection; the elicited potential amplitude was compared before and after the injection and the increasing ratio (IR) was computed. Gender, age, level of olfactory disorder, the presence or absence of olfaction and the presence or absence of the pain of injection were considered as factors affecting IR.


RESULTS
IR showed significant increases in groups characterized by the presence of olfaction as well as in groups reporting pain of injection. The test subjects were further divided into four groups based on their olfaction and pain of injection patterns as follows: Group A, no smell and no pain; Group B, smell and no pain; Group C, no smell and pain; and Group D, smell and pain. Subjects exhibiting no recognizable olfaction or pain of injection (Group A) revealed no increase in IVOP following injection. Subjects with either recognizable olfaction or pain of injection (Groups B and C) exhibited a slight increase in IVOP following injection. Subjects with both noticeable olfaction and pain of injection (Group D) demonstrated a significant increase in IVOP following the injection with a very high value of IR (>2). Furthermore, there were significant differences between the four groups in terms of IR level, with the exception of Groups B and C.


CONCLUSIONS
Olfaction is largely involved with the generation of IVOP. However, pain resulting from injection of Alinamin is considered to be a significant factor. IVOP showed significant effectiveness for diagnosing olfactory disorders in cases who did not experience pain of injection.
Department of Otorhinolaryngology, Kanazawa University School of Medicine, Japan. hatanaka@orl.m.kanazawa-u.ac.jp
Sachiko
S
Hatanaka
Tadashi
T
Ishimaru
Tsuyoshi
T
Yata
Takaki
T
Miwa
Mitsuru
M
Furukawa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000175:diagnosis*; D009833:Olfactory Pathways / Q000187:drug effects* / Q000502:physiology*; D010147:Pain Measurement; D012535:Scalp; D012677:Sensation; D013268:Stimulation, Chemical; D013831:Thiamine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology
C013294:prosultiamine; D013831:Thiamine