Adaptation of the Pediatric Smell Wheel™ to evaluate olfactory function in Brazilian children

Objective: Olfaction influences nutrition, safety, and the cognitive development of children. Presently there are few olfactory tests for children, and normative reference values are generally lacking. In this study, we validate the Pediatric Smell Wheel (TM) (PSW) to evaluate olfactory function in Brazilian children. Methods: We modified and validated the PSW, a test developed in the United States, for administration in Brazil, and established normative data for Brazilian children. The validation process consisted of five phases. First, we identified odorants familiar to Brazilian children. Second, we established the test-retest reliability of the Brazilian PSW test that employed these odorants. Third, we compared the test scores of healthy children to those microsmic from adenoid hypertrophy. Fourth, we examined the test's ability to detect improvement in olfactory function before and after adenoidectomy. Finally, we determined a normative 10th percentile cut point for defining microsmia in a sample of 169 healthy Brazilian children between 5 and 12 years of age. Results: Eleven odors were identified for inclusion in the test. The test-retest reliability wasmodest (r = 0.54, p < 0.001), although likely attenuated based on the inclusion of only datafrom children with normal function. The test clearly differentiated the olfactory function ofchildren with adenoid hypertrophy from that of healthy children and demonstrated the returnof function after adenoidectomy. An overall score <7 was found useful in defining hyposmia, although additional age-related cut-points were also defined. Conclusion: A Brazilian version of the PSW was developed and validated and found to be efficacious in detecting smell dysfunction in children ranging in age from 5 to 12 years. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

This study validated the Pediatric Smell Wheel (PSW) for evaluating olfactory function in Brazilian children, and established normative data for Brazilian children. The PSW test clearly differentiated the olfactory function of healthy children and children with adenoid hypertrophy, and showed the restoration of function after adenoidectomy.