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Olfactory Dysfunction in Leprosy

Authors

  • Anupam Mishra MBBS, MS, DNB,

    Corresponding author
    1. Department of Otorhinolaryngology Head and Neck Surgery, King George's Medical University, Lucknow, India
    • Dr. Anupam Mishra, Assistant Professor, Department of Otolaryngology and Head and Neck Surgery, King George's Medical University, Lucknow, India
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    • 1Dr. Anupam Mishra is Assistant Professor (Otolaryngology) and currently a Visiting Faculty member and International UICC (American Cancer Society) Fellow at the Department of Head and Neck Surgery, UT MD Anderson Cancer Center, Houston, Texas 77030.

  • Kenji Saito BA,

    1. Smell and Taste Center, Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
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    • 2Kenji Saito is currently an MD, JD, candidate at Temple University School of Medicine, Philadelphia, PA and Rutgers School of Law, Camden, New Jersey.

  • Scott E. Barbash BS,

    1. Department of Otorhinolaryngology Head and Neck Surgery, King George's Medical University, Lucknow, India
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  • Nimisha Mishra MD, MS,

    1. Hahnemann University Hospital (Drexel University), Philadelphia, Pennsylvania
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    • 3Dr. Nimisha Mishra is currently a clinical fellow (infectious diseases), Hahnemann University Hospital (Drexel University), Philadelphia, Pennsylvania.

  • Richard L. Doty PhD

    1. Smell and Taste Center, Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
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  • r.l.d. is a major shareholder in Sensonics, Inc., the manufacturer and distributor of the olfactory test used in this study.

    Supported in part by the following grants from the National Institutes of Health: RO1 DC04278, R01 AG17496, and R01 DC007434.

Abstract

Leprosy (Hansen's disease) is associated with a high incidence of nasal pathology. Despite this fact, the influence of this disorder on the sense of smell is poorly understood. In this study, we administered a standardized 12-item odor identification test to 77 patients with three types of leprosy: tuberculoid (n = 9), borderline (n = 42), and lepromatous (n = 26). All three types exhibited significantly lower test scores than their respective age-, sex-, and smoking–habit-matched controls. Patients with lepromatous leprosy exhibited significantly lower test scores than those with the other two types. Only patients with lepromatous leprosy exhibited meaningful improvement in smell function after treatment. No association between disease duration, per se, and the severity of the olfactory deficit was present. Overall, 100% of the patients exhibited olfactory dysfunction, suggesting that earlier prevalence estimates based on nonstandardized olfactory testing have underestimated the prevalence of this problem.

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