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    Evaluation of olfactory bulb volume in patients with diabetic olfactopathy and comparison with healthy individuals
    (AVES, 2021) Gürbüz, Defne; Kesimli, Mustafa Caner; Bilgili, Ahmet Mert; Durmaz, Hacı Ömer
    Objective: Diabetic olfactopathy is defined as olfactory dysfunction in patients with diabetic neuropathy. In this study, we evaluated the olfactory bulb volume (OBV) using magnetic resonance imaging in patients with diabetic olfactopathy and compared the results with those of healthy individuals. Methods: This study included 12 patients who were diagnosed with type 2 diabetes mellitus (T2DM) and were found to have diabetic olfactopathy using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test (Group 1); their OBV was evaluated using MRI. For comparison, 13 healthy individuals of a similar age, without any medical problems, were included as a control group (Group 2); their OBV and olfactory functions were also evaluated. Results: Total CCCRC scores were 4.27 +/- 0.67 in Group 1 and 6.42 +/- 0.31 in Group 2; these scores significantly differed between the groups. The mean CCCRC scores in Groups 1 and 2 were moderately hyposmic and normosmic, respectively. The mean OBV values were 65.04 +/- 6.97 mm(3) and 76.46 +/- 11.36 mm(3) in Groups 1 and 2, respectively. Group 1 had significantly lower OBV values and CCCRC scores, compared with Group 2 (p < 0.01 for both groups). Conclusion: The OBV was lower in patients with T2DM who developed diabetic olfactopathy than that in healthy individuals; the olfactory bulb was adversely affected by diabetes mellitus. This is the first study to demonstrate that the olfactory bulb is adversely affected by the presence of diabetic olfactopathy.
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    Olfactory rehabilitation and olfactory bulb volumechanges in patients after total laryngectomy:a prospective randomized study
    (Elsevier, 2021) Gürbüz, Defne; Kesimli, Mustafa Caner; Bilgili, Ahmet Mert; Durmaz, Hacı Ömer
    Introduction: After total laryngectomy, decreased olfactory function and olfactory bulb volume shrinkage have been reported to occur due to olfactory deprivation caused by nasal airflow interruption. There is evidence that the olfactory system can be modulated by repeated exposure to odors in a procedure called olfactory training. However, it is not known whether any recovery of the lost olfactory bulb volume is possible by eliminating olfactory deprivation via olfactory rehabilitation long after laryngectomy. Objective: This study examined the recovery of olfactory function and the change in olfactory bulb volume via long-term olfactory rehabilitation after total laryngectomy. Methods: Possible causes of olfactory dysfunction in the study participants were evaluated by collecting detailed anamnesis. As olfactory tests, orthonasal butanol threshold and odor discrimination tests were performed. Three-dimensional olfactory bulb volumes were calculated using manual segmentation on T2-weighted coronal magnetic resonance images. In olfactory rehabilitation, four different odors were applied to all patients orthonasally, using a larynx bypass technique for 30 min per day for 6 months. Olfactory tests were performed before the rehabilitation and after 6 months of rehabilitation, and olfactory bulb volume measurements were performed using magnetic resonance images. Results: Eleven patients diagnosed with advanced laryngeal cancer who underwent total laryngectomy and postoperative radiotherapy with a follow-up of 5-10 years were included in the study. All patients were male, and the mean age was 58.18 ± 4.17 years. In total laryngectomized patients, the olfactory bulb volumes measured on magnetic resonance images were 42.25 ± 12.8 mm3 before and 55.5 ± 11.22 mm3 after rehabilitation, and this increase was highly significant. Olfactory test scores were 2.3 ± 1.27 before and 4.39 ± 0.86 after rehabilitation, and this increase was also highly significant. Conclusion: As a result of the olfactory rehabilitation applied by providing orthonasal air flow, the olfactory function lost after total laryngectomy was improved considerably, and the olfactory bulb volume was significantly increased. The increase in olfactory bulb volume in total laryngectomy patients via olfactory rehabilitation to eliminate olfactory deprivation due to nasal airflow interruption was demonstrated for the first time in this prospective longitudinal study.