文献笔记｜鼻后嗅觉刺激（口腔或者鼻咽腔）retronasal vs 正鼻嗅觉刺激（鼻孔吸入）orthonasal

研究问题

用 freeze-dried gels（冻干凝胶） 鼻后刺激估计嗅觉心理测量函数。

以往研究问题

以往采用鼻孔吸入的实验，存在的不足有：无法对嗅觉功能障碍人群进行测试，而这类障碍可能是某些疾病的临床表现；耗时、嗅觉气味测试环境要求高等。

刺激和流程

鼻后：刺激为七种不同气味的冻干凝胶，每名参与者对鼻后刺激进行两轮识别，记为retronasal test 和 reteat。根据反应调节浓度，识别正确率按下述公式计算

p( c )=a⋅ [Φ(X+b)], where p( c ) is proportion correct, Φ is the normal probability integral, and a and b are the slope and intercept coefficients, respectively.

正鼻：同样的七种嗅觉刺激，采用SST（Sniffin’ Sticks test）。

The test involves removing the cap from one of the odour‐dispensing pens and placing it approximately 2 cm from the external nares for 4‐5 seconds.

最后，鼻后和正鼻实验中都需要对刺激的Pleasantness、Intensity和Familiarity进行五等级评分。

结果和结论

1、鼻后和SST正鼻两种测试方法对参与者的表现无明显差异（表Table 1）。
2、鼻后刺激的优点：dose-response，因为凝胶更好控制，参与者对刺激的嗅觉反应更为灵敏和有针对性。
3、在pleasant方面，和SST正鼻刺激相比，鼻后冻干刺激表现较差，存在显著性差异。

Results: Psychometric functions indicated a dose‐response relationship between aroma concentration and probability of detection. Test‐retest reliability of the retro‐ nasal stimuli was acceptable (r70 = 0.72, P < 0.001), and identification scores were not dependent on testing method (ie, retronasal vs Sniffin’ Sticks).
Stimuli delivered using the Sniffin’ Sticks test were rated more pleasant than their retronasal counterparts.

Conclusions: Freeze‐dried retronasal stimuli offer an easy‐to‐use and rapid means to test olfaction function and are arguably well suited for clinical practice, but require further development and trialing prior to the adoption in the clinical context.

参考文献：
[1] Pal P, Shepherd D, Hamid N等. The use of freeze-dried retronasal stimuli to assess olfactory function[J]. Clinical Otolaryngology, 2019, 44(5): 770–777. DOI:10.1111/coa.13389.