Author(s)
Naomi C Wang, BA
Cole Bird, BS
Maria Feucht, MD
Amelia Lawrence, BS
Rahul Alapati, MD
Jennifer Villwock, MD
Hannah Kavookjian, MD
Affiliation(s)
The University of Kansas Medical Center, Kansas City, KS, USA;
Abstract:
Background: This study investigates the relationship between olfactory function and severity of oropharyngeal dysphagia.
Methods: A cross-sectional study was conducted at a tertiary academic medical center, recruiting patients undergoing modified barium swallow (MBS) from 2023-2024. Olfactory testing was performed using the Affordable Rapid Olfactory Measurement Array (AROMA). Participants completed the sinonasal outcomes test (SNOT-22), Questionnaire of Olfactory Disorders (QoD-NS), and EAT-10. MBS data were analyzed, and oropharyngeal dysphagia severity was determined by summing oral and pharyngeal phase Impairment Profile (MBSImP) scores.
Results: Forty-seven participants were included (mean age 67.9 ± 9.7? years). Median composite MBSImP score was 6 [IQR 2-12]. Etiologies of dysphagia included upper GI abnormalities (55%), neurological conditions (30%), head and neck cancer (17%), and functional (15%). The cohort was stratified into 2 groups: no/mild dysphagia (n=23) for MBSImP <6, and moderate/severe dysphagia (n=24) for scores >6. Patients with moderate/severe dysphagia had lower AROMA scores indicating olfactory dysfunction (64.9±12.9 vs. 74.7±14.3, p=0.018), worse to citrus scents (44.8±28.3 vs. 66.3± 2.4, p=0.006). EAT-10 scores were higher in patients with moderate/severe dysphagia (6.0 [2.5-20.0]?vs.14.0 [9.0-26.8]?, p=0.003). No significant differences were found in QoD-NS or SNOT-22. AROMA score was significantly correlated with MBSImP score (r=-0.305, p=0.037) and NOMS dysphagia severity (r=0.347, p=0.017) and trended toward significance for penetration-aspiration score (r=-0.261, p=0.077) and EAT-10 (r=-0.251, p=0.104). ?
Conclusions: Patients with moderate/severe oropharyngeal dysphagia had worse olfaction. Larger studies with stratified cohorts are needed to characterize this association, which may inform targeted approaches in swallow rehabilitation.