Adaptation of the Pediatric Smell Wheel to Evaluate Olfactory Function in Brazilian Children

Overview

Journal Braz J Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2021 Nov 10

PMID 34756795

Authors

Marco A Fornazieri

Lucas K Ebara

Rafael Goulart de Araujo

Joao Vitor Fernandes Lima

Felipe B Favareto

Fabio R Pinna

Richard L Voegels

Richard L Doty

Affiliations

Soon will be listed here.

Abstract

Objective: Olfaction influences nutrition, safety, and the cognitive development of children. Presently there are few olfactory tests for children, and normative reference values are generally lacking. In this study, we validate the Pediatric Smell Wheel (PSW) to evaluate olfactory function in Brazilian children.

Methods: We modified and validated the PSW, a test developed in the United States, for administration in Brazil, and established normative data for Brazilian children. The validation process consisted of five phases. First, we identified odorants familiar to Brazilian children. Second, we established the test-retest reliability of the Brazilian PSW test that employed these odorants. Third, we compared the test scores of healthy children to those microsmic from adenoid hypertrophy. Fourth, we examined the test's ability to detect improvement in olfactory function before and after adenoidectomy. Finally, we determined a normative 10th percentile cut point for defining microsmia in a sample of 169 healthy Brazilian children between 5 and 12 years of age.

Results: Eleven odors were identified for inclusion in the test. The test-retest reliability was modest (r = 0.54, p < 0.001), although likely attenuated based on the inclusion of only data from children with normal function. The test clearly differentiated the olfactory function of children with adenoid hypertrophy from that of healthy children and demonstrated the return of function after adenoidectomy. An overall score <7 was found useful in defining hyposmia, although additional age-related cut-points were also defined.

Conclusion: A Brazilian version of the PSW was developed and validated and found to be efficacious in detecting smell dysfunction in children ranging in age from 5 to 12 years.

Level Of Evidence: 1b (Diagnosis).

References

Lawless H . Sensory development in children: research in taste and olfaction. J Am Diet Assoc. 1985; 85(5):577-82, 585. View

Doty R, Shaman P, Applebaum S, Giberson R, Siksorski L, Rosenberg L . Smell identification ability: changes with age. Science. 1984; 226(4681):1441-3. DOI: 10.1126/science.6505700. View

Doty R, Tourbier I, Ng V, Neff J, Armstrong D, Battistini M . Influences of hormone replacement therapy on olfactory and cognitive function in postmenopausal women. Neurobiol Aging. 2015; 36(6):2053-9. PMC: 4640930. DOI: 10.1016/j.neurobiolaging.2015.02.028. View

Schriever V, Agosin E, Altundag A, Avni H, Cao Van H, Cornejo C . Development of an International Odor Identification Test for Children: The Universal Sniff Test. J Pediatr. 2018; 198:265-272.e3. DOI: 10.1016/j.jpeds.2018.03.011. View

Fornazieri M, dos Santos C, Bezerra T, Pinna F, Voegels R, Doty R . Development of normative data for the Brazilian adaptation of the University of Pennsylvania Smell Identification Test. Chem Senses. 2014; 40(2):141-9. DOI: 10.1093/chemse/bju068. View

Martinec Novakova L, Fialova J, Havlicek J . Effects of diversity in olfactory environment on children's sense of smell. Sci Rep. 2018; 8(1):2937. PMC: 5811485. DOI: 10.1038/s41598-018-20236-0. View

Fornazieri M, Pinna F, Bezerra T, Antunes M, Voegels R . Applicability of the University of Pennsylvania Smell Identification Test (SIT) in Brazilians: pilot study. Braz J Otorhinolaryngol. 2010; 76(6):695-9. PMC: 9443775. View

Marty L, Bentivegna H, Nicklaus S, Monnery-Patris S, Chambaron S . Non-Conscious Effect of Food Odors on Children's Food Choices Varies by Weight Status. Front Nutr. 2017; 4:16. PMC: 5425594. DOI: 10.3389/fnut.2017.00016. View

Cameron E . Olfactory perception in children. World J Otorhinolaryngol Head Neck Surg. 2018; 4(1):57-66. PMC: 6051253. DOI: 10.1016/j.wjorl.2018.02.002. View

10.

Cameron E, Doty R . Odor identification testing in children and young adults using the smell wheel. Int J Pediatr Otorhinolaryngol. 2012; 77(3):346-50. DOI: 10.1016/j.ijporl.2012.11.022. View

11.

Doty R, Cameron E . Sex differences and reproductive hormone influences on human odor perception. Physiol Behav. 2009; 97(2):213-28. PMC: 2693767. DOI: 10.1016/j.physbeh.2009.02.032. View

12.

Salihoglu M, Kurt O, Ay S, Baskoy K, Altundag A, Saglam M . Retro- and orthonasal olfactory function in relation to olfactory bulb volume in patients with hypogonadotrophic hypogonadism. Braz J Otorhinolaryngol. 2017; 84(5):630-637. PMC: 9452275. DOI: 10.1016/j.bjorl.2017.07.009. View

13.

Doty R, Kamath V . The influences of age on olfaction: a review. Front Psychol. 2014; 5:20. PMC: 3916729. DOI: 10.3389/fpsyg.2014.00020. View

14.

Hummel T, Kobal G, Gudziol H, Mackay-Sim A . Normative data for the "Sniffin' Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol. 2006; 264(3):237-43. DOI: 10.1007/s00405-006-0173-0. View

15.

Fornazieri M, Araujo R, Fernandes Lima J, Favareto F, Pinna F, Voegels R . The effects of adenoidectomy on the smell perception of children. Int Forum Allergy Rhinol. 2018; 9(1):87-92. DOI: 10.1002/alr.22209. View

16.

Silveira-Moriyama L, Azevedo A, Ranvaud R, Barbosa E, Doty R, Lees A . Applying a new version of the Brazilian-Portuguese UPSIT smell test in Brazil. Arq Neuropsiquiatr. 2010; 68(5):700-5. DOI: 10.1590/s0004-282x2010000500005. View