Xian Leonard Leong Sang, Nallaluthan Vasu, De Jun Yong, Lin-Wei Ooi, Halim Sanihah Abdul, Chuan Chee Yong, Idris Zamzuri, Ghani Abdul Rahman Izaini, Abdullah Jafri Malin
Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Malays J Med Sci. 2020 Oct;27(5):124-129. doi: 10.21315/mjms2020.27.5.12. Epub 2020 Oct 27.
Olfactory or smell dysfunction is often overlooked by clinicians despite being prevalent in the population. To date in Malaysia, there is no standard and reliable test to examine the function of olfaction. Tests used at developed countries such as the Sniffin' Sticks Test (SST), the Connecticut Chemosensory Clinical Research Center (CCCRC) test, the University of Pennsylvania Smell Identification Test (UPSIT) and the Brief Smell Identification Test (B-SIT) are not readily available in this region and may be costly to procure. The first cranial nerve can be tested using commonly available materials to assess: i) the function of odour detection; ii) the odour discrimination; and iii) the odour identification. An abnormal odour detection threshold test generally indicates a peripheral olfactory problem while the odour discrimination and identification test attribute the problem to the cerebral cortex. An olfactory complaint should not be taken lightly and a proper olfactory function examination is important: i) to determine the legitimacy of a patient's complaint; ii) to monitor the progress of patient's olfactory function; iii) to establish insurance payout for disability; and iv) to characterise the specific nature of the problem. A video has been produced to demonstrate the examination techniques explained in this article.
嗅觉或嗅觉功能障碍在人群中很普遍，但往往被临床医生忽视。在马来西亚，迄今为止，尚无标准且可靠的测试来检查嗅觉功能。在发达国家使用的测试，如嗅棒测试（SST）、康涅狄格化学感觉临床研究中心（CCCRC）测试、宾夕法尼亚大学嗅觉识别测试（UPSIT）和简易嗅觉识别测试（B-SIT），在该地区不易获得，采购成本可能也很高。可以使用常用材料对第一对脑神经进行测试，以评估：i）气味检测功能；ii）气味辨别能力；iii）气味识别能力。异常的气味检测阈值测试通常表明存在外周嗅觉问题，而气味辨别和识别测试则将问题归因于大脑皮层。嗅觉方面的主诉不应被轻视，进行适当的嗅觉功能检查很重要：i）确定患者主诉的合理性；ii）监测患者嗅觉功能的进展；iii）确定残疾保险赔付；iv）明确问题的具体性质。已制作了一段视频来演示本文所解释的检查技术。
