Authors (including presenting author) :
Chu SY(1), Lui NF(1), Mak HK(2)
Affiliation :
(1)Occupational Therapy Department, Queen Elizabeth Hospital (2)Department of Neurosurgery, Queen Elizabeth Hospital
Introduction :
Olfactory dysfunction is one of the common sensory deficits in neurosurgical cases. It affects patient in food enjoyment and difficulty to detect environmental hazards, i.e. chemical, fire and smoke. In 2021, Occupational Therapy department of Queen Elizabeth Hospital introduced olfactory rehabilitation in neurosurgical service. It aims to improve patients’ olfactory sensation and olfactory-related daily activities in order to optimize their daily functioning and enhance Quality of Life (QoL).
Objectives :
This paper reviews a patient who has received olfactory rehabilitation with positive outcome.
Methodology :
A 67 year-old woman diagnosed with traumatic brain injury was referred by neurosurgery department for anosmia assessment and training in April 2021. She was injured in road traffic accident and reported suffering from anosmia afterwards. In the olfactory rehabilitation program, occupational therapist initially evaluated patient’s olfactory performance by the Smell Identification Test (UPSIT). Rehabilitation program included two parts: Home program and olfactory safety education. Home program of olfactory training was educated, which patient was asked to smell 4 different odors, i.e. floral, resinous, fruity and spicy, twice daily. Olfactory related safety precautions and coping skills were advised to promote patient’s awareness and adjustment in daily activities. The olfactory training underwent for 6 months and patient was reviewed at 6-month and 15-month post first assessment.
Result & Outcome :
In the initial occupational therapy assessment, the patient scored 16 out of 40 in UPSIT which classified as total anosmia. In 6-month follow up after rehabilitation, the patient showed mild improvement which she scored 20 out of 40 in UPSIT, which classified as severe microsmia. According to patient’s experience, she subjectively reported she was now able to smell sweet odor which she could not perform before. In 15-month follow up, the effect of olfactory training sustained and patient’s performance in UPSIT was 22 out of 40. The patient expressed no mood problem and no change of appetite after olfactory dysfunction. And she was able to adapt the disorder in daily activities with coping strategies recommended.
Conclusion: The olfactory rehabilitation program demonstrates positive impact in patient with olfactory dysfunction in this case study. More case recruitment on analyzing the rehabilitation outcome will be conducted. Moreover, apart from assessing olfactory function, further investigation on the effect on olfactory-related QoL is needed.
