Electrogustometry: validation of bipolar electrode stimulation.

Electrogustometry (EGM) is a practical way to test taste. It is typically performed using unipolar electrodes, with the anode on the tongue and the cathode on the hand, forearm, or neck. This results in electric current passing through nontaste tissues and adds a level of impracticality to its clinical application. We compared, using a repeated measures counterbalanced design, anodal thresholds from a unipolar electrode to those of a unique bipolar electrode in which the anode and cathode are contiguously located. Both sides of the anterior tongue were assessed in 70 subjects, as were the effects of age and sex. Nonparametric analyses were performed. The median threshold of the bipolar electrode's central disk (2.49 µA) did not differ from that of the unipolar electrode (2.96 µA) (P = 0.84). On average, older persons exhibited higher thresholds. No significant sex or tongue side effects were evident. Interestingly, when the annular (donut-shaped) bipolar electrode served as the anode, the threshold was higher than that of the other electrodes (5.19 µA; Ps < 0.001). This conceivably reflected lessened summation of activity among adjacent afferents and partial sampling of tongue regions with fewer taste buds. Correlations among all EGM thresholds were nominally higher for women than for men, ranging from 0.83 to 0.85 for women and 0.54 to 0.67 for men; all Ps < 0.001. This study validates the use of a bipolar electrode for assessing taste function, averting movement of current through nontaste-related tissues and making such testing safer and more practical.

Postoperative olfaction in chronic sinusitis: smokers versus nonsmokers.

In order to study the efficacy of surgical intervention, as well as the influence of cigarette smoking on olfaction in clinical states, we examined olfactory ability by means of the University of Pennsylvania Smell Identification Test (UPSIT). We enrolled 37 patients 21 to 60 years of age who underwent surgery for chronic sinusitis. Normosmia was defined as an UPSIT score of 30 or more. Among these patients, 31 had a disturbance in their smelling ability in the preoperative stage, and the improvement rate, defined as a rise in score of 4 or more points after surgery, was 64.5%; 11 were well healed. However, all 7 patients who were more than 40 years old at the time of surgery, and currently smoking cigarettes, had a significant deficit in olfaction in the preoperative stage and even in the postoperative stage. This study demonstrated that cigarette smoking has adverse effects on olfactory ability, especially for older patients.