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Otology/Neurotology

(346) Olfactory Dysfunction in Adults Undergoing Cochlear Implantation

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Aaron S. Wallace, MD

    Resident
    University of Chicago
    Chicago, Illinois, United States

  • JP

    Jayant M. Pinto, MD

    Professor and Dean of Faculty Affairs
    Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences Division
    Chicago, Illinois, USA

    • Co-Author(s)

  • Michael B. Gluth, MD

    Professor
    University of Chicago
    Chicago, IL, United States

    • Senior Author(s)

  • Ted Imbery, MD

    Assistant Professor of Surgery
    University of Chicago
    Chicago, Illinois, United States

Disclosure(s):
Aaron S. Wallace, MD: No relevant relationships to disclose.
Terence Imbery, MD: No relevant relationships to disclose.


Introduction: Pre-operative cognitive impairment leads to worse hearing outcomes after cochlear implantation (CI). Olfactory dysfunction is another classical sensory modality that predicts early cognitive dysfunction. We tested whether olfactory function signals hearing performance after CI.

Methods: We performed a prospective study of adults (> 50 years old) meeting criteria for CI (either bilateral or unilateral) at our academic center. At the preoperative visit, a five-item smell identification test ("Sniffin Sticks") was administered. At 6 and 12-month follow-up, post-operative speech testing (AzBio or CNC in quiet for implanted ear) was performed. Our outcome measurement was improvement in speech scores on AzBio/CNC testing at these timepoints. We used linear regression to analyze the relationship between preoperative smell function and improvement in speech scores. Patient enrollment began in July 2022 and is ongoing.

Results: Eight patients have been enrolled to date (mean age 79.9 years [range 66-94 years old], there were 5 females; duration of hearing loss: 14-80 years). Causes of hearing loss included: presbycusis (50%), sudden (38%), and noise induced (13%). All 8 patients had impaired olfaction: 3 patients had anosmia and 5 patients had hyposmia (median score 2, range 0 to 2/5). No patients identified the scent of rose correctly, while peppermint was commonly correctly identified (63%). Only 1 patient reported a history of COVID (with no associated change in olfaction); 3 patients reported a history of serious head trauma; and none reported other confounders (chronic rhinosinusitis/allergic rhinitis or previous sinus/brain surgery).

Conclusions: In this sample of adults undergoing CI, the rate of smell dysfunction was 100%, with 38% retaining no chemosensory ability. Thus, multisensory dysfunction may be common in CI candidates and could share a common pathophysiology. A short smell test eminently feasible to administer in clinic may be useful to identify patients at risk for poor hearing outcomes for enrollment into intensive aural rehabilitation.