Induction of smell through transethmoid electrical stimulation of the olfactory bulb.
BACKGROUND
Anosmia has an estimated prevalence of 5% of the general population. Outside of inflammatory causes, therapeutic options are limited despite research advances. Bypassing peripheral neuronal damage through central stimulation is a potential therapeutic option that has shown success in other sensory systems, most notably with hearing. We performed a pilot study to determine the feasibility of inducing smell through artificial electrical stimulation of the olfactory bulbs in humans.


METHODS
Subjects with a history of sinus surgery, including total ethmoidectomy, with intact ability to smell were enrolled. The ability to smell was confirmed with a 40-item smell identification test. Awake subjects underwent nasal endoscopy and either a monopolar or bipolar electrode was positioned at 3 areas along the lateral lamella of the cribriform plate within the ethmoid sinus cavity. A graded stimulation current of 1-20 mA at 3.17 Hz was administered while cortical evoked potential (CEP) recordings were collected. Subjective responses of perceived smell along with reports of discomfort were recorded. Subjects with artificially induced smell underwent repeat stimulation after medically induced anosmia.


RESULTS
Five subjects (age, 43-72 years) were enrolled. Three subjects reported smell perception smell with electrical stimulation. This was reproducible after inducing anosmia, but CEP recordings could not provide objective support. All subjects tolerated the study with minimal discomfort.


CONCLUSION
This is the first report of induced smell through transethmoid electrical stimulation of the olfactory bulb. These results provide a proof of concept for efforts in development of an olfactory implant system.
['Holbrook|Eric H|EH|0000-0002-7632-2204', 'Puram|Sidharth V|SV|0000-0003-3543-889X', 'See|Reiner B|RB|', 'Tripp|Aaron G|AG|', 'Nair|Dinesh G|DG|']
D000328:Adult D000368:Aged D004599:Electric Stimulation Therapy D004724:Endoscopy D005004:Ethmoid Bone D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009296:Nasal Cavity D000857:Olfaction Disorders D009830:Olfactory Bulb D010865:Pilot Projects D020127:Recovery of Function D012903:Smell
humans endoscopy ethmoid sinus ethmoid bone olfactory perception olfactory receptor neurons