Features of olfactory function assessment in children

Background. The smell is the most important "signaling" function, and its deterioration significantly reduces the quality of life. Available methods of subjective olfactory assessment, which do not require special expensive equipment, allow for primary "screening" in outpatient settings and at home. Considering the causes of impairment and especially the lack of smell, it is crucial to be aware of congenital anosmia (isolated and familial, requiring examination of the child's blood relatives) in pediatric practice.

Aim. To evaluate the results of "family" subjective olfactometry.

Materials and methods. Subjective olfactometry was performed in patients who visited an otorhinolaryngologist and their parents/legal representatives after history taking and a routine ENT examination/endoscopy of ENT organs (in all children and adults, in case of acute or exacerbation of chronic ENT condition at the time of examination), using a professional kit consisting of 12 odorants and cards with four response options for each of the proposed odors. The obtained results were recorded in Excel spreadsheets for further statistical processing.

Results. We examined 64 families: 132 subjects (64 children and 68 adults), including 31 girls and 33 boys aged 6 to 17 years and 64 women and 4 men aged 32 to 47 years. The reason for visiting an otorhinolaryngologist was symptoms related to the ENT organs in children and smell impairment in 1 (1.6%) case. Olfactory disorders were detected only in children: hyposmia (59.4%) and a single (1.6%) case of anosmia. When identifying odors in "child-parent" pairs, the match of "misidentified" odorants was noted only in 19 (29.65%) families; in 34 (53.1%) pairs, children performed better than their parents. The list of difficult-to-perceive odorants almost matched in children and adults, but there were differences in the frequency of "recognition" of a particular smell.

Conclusion. "Family" subjective olfactometry is necessary to confirm/exclude congenital familial/hereditary olfactory impairment, while only data obtained from the consanguineous relatives of the child should be considered. The presence and involvement of parents/legal representatives in the examination process increase the child's compliance and contribute to greater psychological comfort, which improves the test performance. Repeated/multiple use of odorants unfamiliar to the subject (olfactory training) may improve the re-examination results. The data obtained (the match of "misidentified odorants" and a child and a parent in 29.65% of cases and the correct choice of an odorant by a child with an incorrect parent's answer in 53.1%) do not support the hypothesis of family "ignorance" of a particular odorant.