December Meeting on "Smell and Taste" supported by the Working Group on Olfaction and Gustation of the German ENT society, 4./5. December 2020 in Marburg

Invitation

Dear colleagues:

We would like to invite you to the December Meeting on "Smell and Taste" which is supported by the Working Group on Olfaction and Gustation of the German ENT society, on the 4./5. December 2020. The program starts on Friday at 15.00h and finishes on Saturday at 11:40h.

The meeting on Friday starts at 15:00h and ends at 17:00h – please use this link, Meeting-ID: 828 910 3856 , passcode is 1

The meeting on Saturday starts at 9:00h and ends at 11:40h – please use this link, Meeting-ID: 828 910 3856, passcode is 1

A few rules for the meeting:

Upon entry please show your face, your microphone has to be disabled.

For comments and questions, please use the CHAT function of the ZOOM window. The chair of the session will then present some of the questions / comments from the CHAT to the speaker. Because we are a small group you may also be able to ask your questions directly through the microphone, but this is up to the session chair, depending on the schedule of the meeting.

For the speakers:  Please keep the time! You have 5-6 min for your presentation! You will be able to share your screen with the audience. Please do that only when this is requested by the session chair.

For the chairs: Please interrupt the speakers after 6 min!

For the ArGe Sitzung: If you have anything that should be discussed in that forum please mention it there! And if there are any questions, please let us know!

The meeting will be international, congress languages are German and English. Talks may be presented in German or English, but we kindly request slides to be written in English.

Fee

There will be no fee for participation.


 

Contact

Prof. Dr. med. Boris Stuck

  Department of Otorhinolaryngology
  University Hospital Marburg, Philipps-Universität Marburg
email

Prof. Dr. med. Thomas Hummel

  Department of Otorhinolaryngology
  University of Dresden Medical School
  Fetscherstrasse 74, 01307 Dresden
  Germany
  thummel@mail.zih.tu-dresden.de

Scientific program

Invited speakers are:

Additional plenary talks will focus on

• Biologicals in olfactory dysfunction
• COVID-19 and olfactory loss

Download program

Abstracts

Sania Eylander, Alia Korth, PD Dr. Martin Laudien, Klinik für HNO-Heilkunde, Kopf-und Halschirurgie der  Christian-Albrechts-Universität und des UKSH Campus Kiel                                                           

Langzeitfolgen einer SARS-CoV-2-Infektion auf die Chemosensorik 

Einordnung 

Die landesweite COVIDOM-Studie hat das Ziel, die Langzeitauswirkungen einer SARS-CoV-2-Erkrankung auf den Gesundheitszustand sowie die Lebensqualität der Erkrankten zu untersuchen.  Die Durchführung erfolgt mit Unterstützung durch das NUM (Netzwerk Universitätsmedizin zur Erforschung von COVID-19) und dem in diesem Rahmen gegründeten Nationalen Pandemie Kohorten Netz an den Universitätskliniken (NAPKON). Das Projekt ist zunächst bis März 2021 durch das Bundesministerium für Bildung und Forschung sowie von der Landesregierung 
Schleswig-Holstein gefördert und erfolgt in Kooperation mit den Standorten Berlin und Würzburg. 

Durchführung 

Alle in Schleswig-Holstein mit SARS-CoV-2 infizierten Personen werden durch die Gesundheitsämter der Kreise rekrutiert (11/2020: ca. 8.000 Genesene; erwartete Rücklaufquote 30- 50%). Für Interessierte Schleswig-Holsteiner*innen gelten folgende Einschlusskriterien zur Studienteilnahme: 

• molekularer Nachweis von SARS-CoV-2 aus Abstrich oder Körpersekret (PCR) ODER
• negativer molekularer Nachweis UND charakteristische radiologische Befunde UND
  Infektion der Atemwege UND Fehlen einer wahrscheinlicheren Krankheitsursache UND
• negativer Test auf Influenza (sofern durchgeführt)
• UND Alter > 18 Jahre 

Neben einer Erstbefragung (telefonisch oder online) zu Symptomen, Lebensqualität, Vorerkrankungen, seelischer Gesundheit und Lebensstil erfolgt 6-9 Monate nach Infektion vor Ort  im Studienzentrum am UKSH Kiel die klinische Untersuchung in sieben verschiedenen Modulen (Pulmologie, Neurologie, Anthropometrie, Kardiologie, Leber, HNO sowie Geriatrie für Patienten ab  65 Jahren) 

Klinische Untersuchung der Chemosensorik: das HNO-Modul 

Zur Untersuchung der Infektionsfolgen von COVID auf die Chemosensorik und die damit 
verbundene Auswirkung auf die Lebensqualität werden durch die Probanden zunächst spezifische  Fragebögen zu Verlauf, Umgang mit und Auswirkungen der Infektion ausgefüllt: 

• Self-MOQ 
• SNOT22
• QOD (Mattos 2019)
• spezifische Anamnese zu Veränderungen des Riech- und Schmeckvermögens 

Zudem erfolgt die Testung der Chemosensorik, bestehend aus drei Teilen: 

1. Geruchstestung (Sniffin’Sticks Fa. Burghart, SDI) 
2. Geschmackstestung (Taste strips Fa. Burghart) 
3. Testung der trigeminalen Funktion (AmmoLa-Riechampullen) 

Abschließend wird eine 30°-Endoskopie der Nasenhaupthöhlen (inkl. Riechrinnen) sowie der  Mundhöhle durchgeführt und nach vorgegebenen Befundparametern (inkl. Olfactory Cleft Endoscopy Scale) ausgewertet. Es erfolgt zudem die Gewebeentnahme von  Nasenschleimhautepithel mittels Bürstenbiopsie, um diese auf verschiedene Rezeptoren als mögliche SARS-CoV-2-Eintrittspforten zu untersuchen.
Bei einer auffälligen Befundkonstellation wird die weiterführende Diagnostik mittels MRT zur Analyse einer möglichen ZNS-Beteiligung verfolgt.
Patienten, bei denen Auffälligkeiten in der Chemosensorik diagnostiziert wurden, werden planmäßig  in einem 1-Jahres-Follow-up nachuntersucht. 

Spezifische Zielsetzungen 

Ziel der Erhebungen im Rahmen des HNO-Moduls ist es, über die Erfassung langfristiger klinischer  Veränderungen nach einer SARS-CoV-2-Infektion Hinweise auf die pathologischen Mechanismen von SARS-CoV-2 zu erlangen. 

Hierzu erfolgt zunächst die Prävalenzbestimmung von Einschränkungen der Chemosensorik 6 bis 9  Monate nach SARS-CoV-2-Infektion sowie die Untersuchung einer möglichen Korrelation zur subjektiv empfundenen Lebensqualität. Des Weiteren soll ein Zusammenhang zwischen einer (funktionellen) Ansosmie/Hyposmie und morphologischen Veränderungen der zentralen Verarbeitungsareale überprüft werden.  

Gerold Besser¹, MD, PhD; David T. Liu¹, MD; Bertold Renner^2,3, MD; Thomas Hummel⁴, MD; Christian A. Mueller¹, MD

Reversible obstruction of the olfactory cleft: impact on olfactory perception and nasal patency

¹Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Austria

²Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

³Institute of Clinical Pharmacology, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

⁴Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany

Background: Temporary disruption of sensory input can be studied relatively easily for vision or hearing by covering the eyes or ears. In contrast, closing the nostrils affects not only the sense of smell, but also the ability to breathe through the nose and humidify and warm inhaled air. We hypothesized that filling the olfactory cleft (OC) with dissolvable nasal dressing (foam) would temporarily block olfaction while respecting nasal airflow.

Methods: In 30 healthy volunteers, the OC was unilaterally obstructed in a back-to-front fashion. Ortho- and retronasal olfactory function were tested before and after foam application. Ratings of odors and subjective nasal patency (SNP) were collected. Peak nasal inspiratory flow (PNIF) was used to measure nasal patency.

Results: Foam was safely applied in every case using minimal instruments. No complications were reported. Ortho- and retronasal test results decreased significantly in overall participants (all p < 0.0008). Indicating temporary anosmia, 3 subjects reached the lowest possible score for odor-threshold testing, with corresponding drops in retronasal test scores. PNIF values before and after foam application were not significantly different (p = 0.11). SNP ratings decreased slightly, but not significantly (p = 0.052). Odor-intensity ratings dropped significantly (all p < 0.05).

Conclusion: The olfactory cleft can be safely obstructed with dissolvable nasal dressing, resulting in a decrease in odor-intensity and ortho- and retronasal olfactory function test scores. This procedure may serve as a hyposmia model that maintains normal nasal airflow.

AG Beule, LM Merkle, S Langner, H Völzke, C Rudack, W Hosemann

Dimension of the olfactory bulb and the olfactory sulcus depth in an epidemiological MRI cohort: Protocol development and first results

Background: Smell dysfunctions have a large prevalence of 18 – 19 % and are early symptoms of sinonasal and further diseases. The volume of the olfactory bulb (OBV) is an indicator of the olfactory function. Nevertheless, information about normal OBV and olfactory sulcus depth (OSD) in human populations are still missing. In this study, a standardized messing procedure is presented and validated. Furthermore, norm values for OBV and OSD are published and it was investigated, whether there exists any correlation between OBV or OSD and the existence of shadows in the maxillary or frontal sinus as a surrogate for sinonasal diseases.

Methodology / Principal: In 212 MRT´s, the olfactory bulb was constituted and measured by planimetric contouring in all coronar planes. The OSD was measured in the posterior tangent through the eyeballs. Intra- and interrater reliability was proved due to repeated measurements.

Results: The mean OBV was 104,6 mm³ (SD = 44,9 mm³) and the mean OSD was 8,39 mm (SD = 1,71 mm). The interrater reliability of OSD was excellent (ICC= 0,79 – 0,89), whereas the measurements of the OBV consumed lots of time and ICC was 0,46 – 0,64. There was no significant correlation between OSD or OBV and the existence of shadows in the maxillary or frontal sinus.

Conclusions: Measurements of theOSD were reliable and practicable whereas for the measurement of the OBV a semiautomatical method is recommended. For further studies, duration of clinical symptoms should be included when nasal sinus are considered.

Gillmeister A, Meesa P, Nagai MH, Matsunami H, Hummel T; Dresden

Olfactory training in specific anosmia: association with genetic variations of OR7D4

Background: Short-term, repeated exposure to odors, “olfactory training” (OT), improves olfactory function. This study aimed to investigate whether OT-related changes in the perception of androstenone (AND) are associated with genetic variations of the olfactory receptor OR7D4.

Methods: So far 237 healthy, normosmic volunteers participated. Participants performed OT with four odors that were selected based on previous work establishing high levels of specific anosmia within the general population: bacdanol (BAC), benzylsalicylate (BENZ), 3-hydroxy-2-methyl-4-pyrone (3H2M4P), and AND. Among other characteristics these odors differ in molecular weight. Detection thresholds were measured for the four odors before and after OT. Buccal swabs were taken to examine whether the OR7D4 genotype (GT) is associated with perceptual changes of AND in relation to OT.

Results: 64/237 participants showed specific anosmia for AND, 36 for BENZ, 33 for BAC and 10 for 3H2M4P. The rate of specific anosmia correlated with the molecular weight of the odorants (r=0,94). Out of 43 subjects initially anosmic for androstenone 30 perceived AND after OT based on detection threshold; 20 became more sensitive for BENZ, 24 for BAC and 18 for 3H2M4P.

40 samples of these 43 subjects were analyzed so far for OR7D4 GT; 24 showed the RT/RT GT, 13 RT/WM, 3 WM/WM. Out of the subjects able to perceive AND after OT 16 had the RT/RT GT (57%), 10 RT/WM (36%), 2 WM/WM (7%). Out of the subjects unable to smell AND after OT 8 had RT/RT (67%), 3 RT/WM (25%), 1 WM/WM (8%).

Conclusion: Results from the present study confirm that the ability to smell odors can be improved in healthy subjects. They also confirm previous results indicating a positive relation between the rate of specific anosmia and the molecular weight of the odorant. However, the present results do not support the idea of a significant impact of OR7D4 GT on the ability to improve to smell AND. 

Heyne L, Oleszkiewicz A, Hummel T; Dresden

How many odours do we perceive in our daily life and what does it depend on?

Background: Humans are potentially able to discriminate more than one trillion olfactory stimuli. Little is known about how often we consciously perceive odours during the day.

Methods: We performed a prospective study with a total of 163 participants. Results from 100 healthy subjects (age 47.7±17.8 years, female 64%, male 36%) were compared to 63 outpatients with olfactory disorders (age 59.7 ± 14.0 years, female 42%, male 48%). Participants were asked to count for 2 weeks every perceived odour and to document this as well as their daily activities in a diary. Olfactory function was assessed using the Sniffin’ Sticks before and after the period of counting odours.

Results: The subjects reported an average of 25.9 daily perceived odours. The 94 female subjects counted an average of 30.1 odours per day, while the 65 male subjects counted an average of 20.0 odours per day. The results show a positive correlation between the TI score (Threshold and Identification) obtained at baseline and the average amount of daily perceived odours. Furthermore there was a significant relation between the age of the subjects and the average number of counted odours per day.

Conclusion: The number of perceived odours depends on a variety of different factors like gender, age and olfactory function as well as the daily activity of the participants.

Sara-Lynn Hool¹, Hergen Friedrich², Basile N. Landis³, Marco-Domenico Caversaccio¹, Franca Wagner⁴ and Simona Negoias^1,5

Utility of MRI in the diagnostic of taste disorders

¹Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland

²Department of Otorhinolaryngology, University Children's Hospital Zurich, Switzerland

³Rhinology-Olfactology Unit, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Geneva, Geneva, Switzerland

⁴Department of Neuroradiology, lnselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland

⁵Department of Otorhinolaryngology, Head and Neck Surgery, Basel University Hospital, CH-4051 Basel, Switzerland

Sara-Lynn Hool¹ and Hergen Friedrich^1,2, Basile Landis³, Marco Caversaccio¹ and Simona Negoias^1,4

A retrospective analysis of smell and taste disorders: 10 years experience of the Bernese taste and smell clinic

¹Department of Otolaryngology, Inselspital, University of Bern, Bern, Switzerland

²Division of Otolaryngology, University Children’s Hospital Zurich, Zurich, Switzerland

³Rhinology-Olfactology Unit, Department of Otorhinolaryngology, University Hospital of Geneva, Geneva, Switzerland

⁴Department of Otorhinolaryngology, University of Basel, Basel, Switzerland

David T. Liu^1,2, MD; Maha Sabha¹; Michael Damm³, MD; Carl Philpott^4,5, MD; Anna Oleszkiewicz^1,6, PhD; Antje Hähner¹, MD; Thomas Hummel¹, MD

Parosmia is associated with relevant olfactory recovery after olfactory training

¹Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany

²Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria

³ENT-Medicine Cologne (HNO-Heilkunde Köln) & University Hospitals of Cologne, Cologne, Germany

⁴Norwich Medical School, Chancellor's Drive, University of East Anglia, Norwich, UK. 

⁵The Norfolk Smell & Taste Clinic, Norfolk & Waveney ENT Service, UK

⁶Institute of Psychology, University of Wroclaw, Wroclaw, Poland

Objectives: This study aims to determine the association between parosmia and clinically relevant recovery of olfactory function in patients with postinfectious smell loss receiving olfactory training.

Methods: This was a retrospective cohort study of patients with postinfectious smell loss that received olfactory training. Adult patients with the major complaint of quantitative smell loss were recruited and treated at several ENT clinics in German between 2008 and 2018. The outcome was based on the association between smell-loss related factors (including parosmia and phantosmia) and clinically relevant changes in overall and subdimension olfactory function of threshold, discrimination, and identification using binary logistic regression analysis.

Results: A total of 143 participants with postinfectious smell loss were included. Clinically relevant improvements in overall olfactory function were more likely in those that had lower baseline olfactory function. Relevant improvements in discrimination function were more likely in those that had lower baseline olfactory function and those that had parosmia at initial visit. Similarly, relevant improvements in odor identification were more likely in those that had a lower baseline olfactory function and in those who had parosmia at the first visit. Clinically significant improvements in odor threshold were more likely in those who were older in age.

Conclusion: This study demonstrated that the presence of parosmia is associated with clinically relevant recovery in olfactory discrimination and identification function in patients with postinfectious smell loss receiving olfactory training.

Coralie Mignot¹, Philipp Nahrath¹, Charlotte Sinding², Thomas Hummel¹

Old and young adults experience similar long-term olfactory habituation

¹Smell & Taste Clinic Department of Otorhinolaryngology, TU Dresden, Germany
²Department French National Institute for Agricultural Research, Centre des Sciences du Goût et de l’Alimentation (CSGA),Dijon, France

Olfactory habituation corresponds to a decreased behavioral or perceptual response to an odor after a prolonged exposure to this odor. Our aim was to investigate whether long-term olfactory habituation and its recovery is similar in young (<35 years old) and old adults (>50). Fifty seven participants were recruited for a five week longitudinal study. They were exposed to one of two odors (manzanate, irone alpha) for two weeks at home. Olfactory detection thresholds for both odors were measured before and after exposure. Results showed that the two age groups behaved similarly. The long-term exposure to an odor led to a temporary increase of its detection threshold (lower sensitivity to the odor). Irone alpha thresholds were more sensitive to the duration of exposure with the odor than manzanate thresholds. One week after termination of exposure, participants fully recovered and even became more sensitive to both odors. No cross-habituation was found between the two odors. Our findings highlight that long-term habituation is specific to the odor exposed, behaves the same in young and old adults and is fully reversible in both age groups after one week.

Christian A. Müller, Bernhard Prem

Der Verlust des Geruchssinns als frühes Symptom eines spät diagnostizierten Olfaktoriusmeningeoms – ein Fallbericht

Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien

Wir berichten über eine 28-jährige Patientin, die im Rahmen einer Schwangerschaft über den Verlust des Geruchssinns geklagt hatte. Da die Beschwerden einer Schwangerschafts-induzierten Rhinitis zugeschrieben wurden, erfolgte keine weitere Abklärung. Nach Persistenz der Beschwerden und Auftreten von Kopfschmerzen nach einem Jahr und von Sehstörungen nach zwei Jahren, erfolgte die korrekte Diagnose mittels Magnetresonanz-Tomographie des Kopfes, die ein 7x6x7cm großes Meningeom mit Kompression des N.opticus zeigte.

Bernhard Prem¹, David T. Liu¹, Gerold Besser¹, Bertold Renner^2,3, Christian A. Mueller¹

Six months follow-up of chemosensory function in COVID-19 patients using psychophysical tests: Preliminary data

¹Department of Otorhinolaryngology, Medical University Vienna, Austria

²Institute of Experimental and Clinical Pharmacology and Toxicology, FAU Erlangen-Nürnberg

³Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, TU Dresden

Besides different symptoms (e.g., dyspnea, cough, fever) infection with SARS-CoV-2 may lead to chemosensory dysfunction. Short-term results reveal reconvalescence within four weeks in up to eighty percent of all cases. Yet, data about long-term outcome are rare.

Here, we report about our preliminary data of psychophysical testing of chemosensory function six months after SARS-CoV-2 infection.

Bertold Renner1,2, David T. Liu3, Gerold Besser3, Antje Welge-Lüssen4, Christian A. Müller3

Der Sniffin` Sticks Parosmie Test (SSParoT): erste Daten von Patienten

¹Institut für Experimentelle und Klinische Pharmakologie und Toxikologie, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany

²Institut für Klinische Pharmakologie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

³Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich

⁴Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Universität Basel, Basel, Schweiz

Die Parosmie ist eine häufig vernachlässigte Symptomatik, die sich aber deutlich auf die Lebensqualität der Betroffenen auswirken kann. In den meisten Fällen wird die veränderte Riechwahrnehmung als unangenehm beschrieben, die Intensität ist dabei häufig reduziert. Auf Basis einer etablierten Testmethode wurde daher ein Verfahren zur Bestimmung von qualitativen Riechstörungen entwickelt, der Sniffin` Sticks Parosmie Test (SSParoT). Erste Daten von Patienten mit Parosmie werden berichtet.

Sabiniewicz A, Hummel T; Dresden

The impact of cognitive and non-cognitive factors on odor discrimination performance

This study aimed to investigate which components among a range of cognitive and non-cognitive factors contribute to odor discrimination and to which extent. 160 participants were assessed for olfactory discrimination considering a) the sequence of presentation of the detection target and b) response time taken to perform the discrimination task. Participants were tested with several cognitive tests covering executive functioning, and semantic memory and non-cognitive tests measuring optimism, mindset, general self-efficacy, and self-esteem. Hierarchical regression analyses conducted in classic and Bayesian ways demonstrate a strong impact of semantic memory and age on odor discrimination performance. Conversely, executive functions together with non-cognitive factors and response time were rather weak predictors of odor discrimination performance. Additionally, the positioning of the target odor, when presented last, facilitated the correct choice in odor discrimination. In conclusion, odor discrimination is related to semantic memory, while non-cognitive factors exert only minor influences on odor discrimination scores.

Gunjan Sharma, Gerold Besser, Christian A. Mueller, David T. Liu 

Long-term Recovery of Posttraumatic Smell Loss After 11 Years During Pregnancy: A Case Report and Systematic review

Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien

Only 10-35% of the patients report a spontaneous recovery from head injury induced olfactory dysfunction in the first few years. Head trauma is one of the typical etiologies for smell impairment. Some of the main prognostic factors are a short period of time after trauma, young age and remaining olfactory abilities. We report the case of a 34-year old woman, who has been suffering from olfactory dysfunction since head injury seven years prior to presentation. At first, she achieved low test scores and poor self-assessment in flavor and smell perception. After 4 years, her olfactory abilities spontaneously increased, and she reported of improved smell and flavor in course of her pregnancy.

This case shows significant improvement of olfactory function after 11 years during the course of pregnancy and illustrates potential recovery from post-traumatic anosmia even after a long period of time. 

Steinbach Silke, Marburg

Mechanische Zungenreinigung: Hygienestrategie für besseres Schmeckvermögen?

Hintergrund: Die Fissuren, Krypten und der papilläre Strukturaufbau der Zunge bieten Nischen für Mikroorganismen und Zellüberreste. Der Zungenbelag kann das Binden von Schmeckstoffen an Schmeckrezeptoren erschweren. Ein Bürsten und Schaben des Zungenrückens mit Reduktion des Zungenbelags kann das Schmeckvermögen bessern oder ggf. durch Mikrotraumen durch die mechanische Manipulation verschlechtern. Ziel der vorliegenden Studie ist es daher, zunächst bei Gesunden die Zungenbelagsreduktion, das Schmeckvermögen und potentielle Nebenwirkungen der mechanischen Zungenreinigung zu erfassen.

Material und Methode: Vor und 14 Tage nach 2x täglicher mechanischer Zungenreinigung mittels OraBrush^® wurde bei 50 gesunden Nichtrauchern (44,8 22,7 Jahre) folgendes verifiziert: Zungenbelag mittels Winkel-Index, Schmeckvermögen mittels „taste strips“ und potentielle Nebenwirkungen mittels visueller Analogskala (VAS).

Alle Vergleiche - vor und nach Zungenreinigung - derselben Person wurden mit einem Wilcoxon-Signed-Rank-Test durchgeführt mittels Pratts-Methode (wegen der 0 Werte). Alle Analysen wurden mit der statistischen Analysesoftware R (r-project.org), Version 3.4.0 analysiert. P-Werte <0,05 wurden als statistisch signifikant gewertet.

Ergebnisse: Subjektiv auf einer VAS eingeschätzt besserte sich nach der 14-tägigen mechanischen Zungenreinigung das Schmeckvermögen (p<0,01), der Zungenbelag (p<0,01) als auch der Mundgeruch (p=0,03). Zudem sanken die Zungenbelagswerte gemessen mittels Winkelindex (p<0,01)  und besserten sich die Gesamttestwerte des „taste strip test“ (p<0,01). Alter und Geschlecht wirkten sich nicht auf die Vorher-Nachher-Differenzen der Winkelindexwerte aus; ebenso das Geschlecht nicht auf die Vorher-Nachher-Differenzen der Gesamtschmecktestwerte.  Ältere Nichtraucher (45-91 Jahre) hingegen profitierten mehr als jüngere Nichtraucher (20-44 Jahre) in den Vorher-Nachher-Differenzen der Gesamtschmecktestwerte (p=0,01). Eine Besserung des Gesamtschmecktestwertes zeigte sich vor allem in Nichtrauchern, die vor der mechanischen Zungenreinigung einen niedrigeren Ausgangswert hatten (p<0,01).

Fast alle (n = 48) fanden die Handhabung einfach. Komplikationen wurden auf einer Skala von 0 = keine bis 100 = starke nach 14 Tagen mit 6,5 ± 4,6 eingestuft, dabei wurden z. B. Schleimhautreizungen (n = 5), Zungenbrennen (n = 4) und leichtes Bluten der Zungenoberfläche (n = 2) als Komplikationen genannt.  

Schlussfolgerung: Das zweimal tägliche Anwenden von OraBrush^® reduziert bei wenig genannten Nebenwirkungen den Zungenbelag und bessert das Schmeckvermögen von gesunden Nichtrauchern insbesondere im Alter bzw. bei reduzierten  Ausgangswerten des Schmeckvermögens. Dies ermutigt dazu, das Verfahren als Therapieoption bei Erkrankten zu testen.