cAMP (Cyclic Adenosine Monophosphate) Levels in the Nose
cAMP (Cyclic Adenosine Monophosphate) Levels in the Nose
The purpose of this study is to determine the normal distribution of nasal tissue
 cathelicidin antimicrobial peptides (cAMP) levels in subjects with normal smell and subjects
 with smell dysfunction. The investigators will also look at the effect of nasal saline
 irrigation on olfaction and cAMP levels and if nasal irrigation is capable of harvesting
 olfactory cilia. The investigators hypothesize that nasal saline will have no effect on
 olfaction and will be inadequate to harvest olfactory cilia.
The investigators will recruit 40 subjects: 10 with olfactory dysfunction and 30 with normal
 olfaction. The normal olfaction group will be randomized (15-15)to either daily saline nasal
 irrigation for one week or no irrigation. Normal olfaction subjects will be seen for two
 visits, olfactory dysfunction for one. All subjects will complete an UPSIT (smell
 identification test)and a co-morbidity form. All subjects will have a brief nasal exam and
 then have nasal cells collected by means of a curette on one side and a cytobrush on the
 other. All subjects will receive Afrin and lidocaine, to improve visualization and for
 comfort during cell collection. Subjects will then complete a Comfort Scale related to the
 methods of cell collection. Normal olfaction subjects randomized to nasal irrigation will
 receive instructions on how to do it and the irrigation results will be collected for
 analysis along with the nasal cells. At their return visit, normal olfaction subjects will
 repeat the UPSIT and the comfort scale--all normal olfaction subjects will have a repeat cell
 collection. Subjects randomized to nasal irrigation will also complete a transition scale
 which asks if they feel the irrigation made a difference in their sense of smell. Subjects
 are compensated for time with a gift card.
Inclusion Criteria:

 Normal olfactory function cohort:

 -  self-reported normal smell function

 -  age greater than 18 years

 Olfactory dysfunction cohort:

 -  ICD9 diagnostic code for olfactory dysfunction

 -  idiopathic olfactory dysfunction

 -  age greater than 18 years

 Exclusion Criteria:

 -  allergy to lidocaine

 -  active upper respiratory infection

 -  previous nasal or sinus surgery

 -  current tobacco use

 -  unable to give consent due to language barrier, cognitive or medical issues