High prevalence of olfactory dysfunction detected in treatment-naive patients with head and neck cancer

Abstract

Background

Previous studies demonstrated the difficulty of patients with Head and Neck Cancer (HNC) in sensing food taste, a function in which olfaction has a significant role. However, neither study employed psychophysical tests or control groups to establish the veracity of such complaints.

Aims/objectives

In this study, we quantitatively tested the olfactory function of HNC individuals and compared their function to that of healthy controls.

Methods

Thirty-one HNC naïve treatment patients and thirty-one controls, matched for sex, age, schooling, and smoking, were tested with the University of Pennsylvania Smell Identification Test (UPSIT).

Results

The olfactory function was significantly worse among the patients diagnosed with head and neck cancer [UPSIT cancer = 22.9(CI 95%: 20.5–25.4) vs. UPSIT controls = 29.1(CI 95%: 26.9–31.3); p < .001]. Most patients with HNC had olfactory disorders (n = 29, 93.5%). The risk of olfactory loss was higher in the cancer group [OR: 10.5(CI 95%: 2.1–51.9; p = .001)].

Conclusion and significance

Olfactory disorders can be detected in more than 90% of patients with head and neck cancer when evaluated using a well-validated olfactory test. Smell disorders may be a potential marker for early diagnosis of HNC.

Chinese Abstract

背景：先前的研究证明了头颈癌(HNC) 患者在感知食物味道方面的困难, 嗅觉在这一功能上起着重要作用。 然而, 这些研究还没有采用心理物理测试或控制组来确定此类主诉的真实性。

目的：在这项研究中, 我们定量测试了 HNC 患者的嗅觉功能, 并将其与健康对照组进行了比较。

方法：使用宾夕法尼亚大学气味识别测试 (UPSIT) 对 31 名 HNC 初治患者和 31 名对照组进行了性别、年龄、教育和吸烟方面的匹配测试。

结果：诊断为头颈癌的患者嗅觉功能明显较差 [UPSIT 癌症 = 22.9（CI 95%：20.5–25.4）相较于UPSIT 对照 = 29.1（CI 95%：26.9–31.3）；p <.001]。 大多数 HNC 患者有嗅觉障碍（n = 29, 93.5%）。 嗅觉丧失的风险在癌症组更高 [OR: 10.5(CI 95%: 2.1–51.9; p = .001)]。

结论及意义：使用经过充分验证的嗅觉测试, 90%以上的头颈癌患者可检出嗅觉障碍。 嗅觉障碍可能是HNC 早期诊断的潜在标志物。

Keywords:

• Smell
• head and neck neoplasms
• olfactory mucosa
• anosmia
• olfaction disorders

Acknowledgements

The authors thank the multidisciplinary team at the Cancer Hospital of Londrina for making this study possible.

Disclosure statement

Richard L. Doty is a consultant to Eisai Co, Ltd, Merck, the Michael J. Fox Foundation for Parkinson’s Research, Septodont, and Johnson & Johnson. He receives royalties from Cambridge University Press, Johns Hopkins University Press, and John Wiley & Sons, Inc. He is president of, and a major shareholder in, Sensonics International, a manufacturer and distributor of smell and taste tests.