High test-retest reliability of the extended version of the "Sniffin' Sticks" test.

The "Sniffin' Sticks" test kit is a validated and commonly used tool for assessment of olfactory function in subjects with normal sense of smell and in individuals with smell loss. That test incorporates subtests for odor threshold, discrimination, and identification. To gain higher subtest reproducibility, tests on odor discrimination and odor identification were extended using 32 instead of the usually applied 16 single trials each. In developing the extended Sniffin' Sticks test, a number of preliminary experiments were performed in 46 healthy, normosmic individuals 1) to evaluate intensity and familiarity of the additionally selected odors, 2) to select distractors for the discrimination and identification test, and 3) to evaluate the test-retest reliability of each subtest. Furthermore, the extended test was applied to 126 patients with olfactory loss and 71 normosmic individuals. Follow-up investigation could be performed in 69 controls within an average interval of 4 days. Results revealed significant differences between patients and healthy subjects. Estimated intensity and familiarity of the newly selected 16 items of the discrimination test did not differ significantly from the 16 standard items. Test-retest reliability was found to be r = 0.80 (odor discrimination), r = 0.88 (odor identification), and r = 0.92 (odor threshold). In conclusion, the extended test kit allows a precise evaluation of olfactory function, especially when different olfactory tasks are assessed using individual subtests. Furthermore, the high test-retest reliability of both the 16 and the 32-item tests allows the evaluation of even relatively small changes of olfactory function over time by means of either test.

Benign paroxysmal positional vertigo: a series of eight singular neurectomies.

CONCLUSION: The singular neurectomy as described by Gacek in 1974 is an efficient procedure to control symptoms in case of intractable benign paroxysmal positional vertigo (BPPV), with an acceptable risk of postoperative sensorineural hearing loss (SNHL). We postulate that this complication may not be a direct consequence of the surgical procedure but rather may be consecutive to the reactivation of the biological phenomenon that caused the BPPV. We also observed in one patient that BPPV may exist although no nystagmus can be elicited by provocative manoeuvres. OBJECTIVE: To report our experience of the surgery, and to analyse the rate and causes of complications. PATIENTS AND METHODS: The eight patients operated in the department between August 1997 and April 2006 were evaluated in June 2006. One had been operated because he had a typical history of BPPV, but no nystagmus could be elicited by the Hallpike's manoeuvre. RESULTS: All patients were free of vertigo and considered their quality of life improved. The Hallpike's manoeuvre was negative in all cases. A SNHL occurred in two patients, immediately after surgery in one and several months later in the second. The patient with a negative Hallpike's manoeuvre before surgery went back to work 3 weeks after surgery.