Abstract
Patients with olfactory disorders are often referred to the otolaryngologist for assessment and treatment. Karely, however, is the otolaryngologist prepared to provide such services. In a previous paper in this journal, we described the basic anatomy and physiology of the olfactory system. Additionally, we listed a standardized nomenclature for classifying olfactory disturbances, and reviewed means for clinically assessing such disorders. In this paper, we provide a more detailed protocol for evaluating patients with loss of smell, incorporating sensory, imaging, and medical approaches employed at the Smell and laste Center of the University of Pennsylvania, USA. Examples of common syndromes encountered in everyday practice are deicribed.
Key words: olfactory assessment, smell identification, anosmia, dysosmia, psychophysics
Full Text
The Full Text of this article is available as a PDF (575.0 KB).
References
- 1.Doty RL, Shaman P, Dann M. Development of the University of Pennsylvania Smell Identification Test: A standardised microencapsulated test of olfactory function. Physiological Behaviour. 1984;32:489–502. doi: 10.1016/0031-9384(84)90269-5. [DOI] [PubMed] [Google Scholar]
- 2.Doty RL. The Smell Identification Test (TM) Administration Mannual. 3rd edition. Haddon Heights, NJ: Sensonics; 1995. [Google Scholar]
- 3.Doty R. L. Odor Threshold Test TM Administration Manual. Haddon Hts., N J: Sensonics~ Inc.; 2000. [Google Scholar]
- 4.Doty RL, Kobal G. Current trends in the measurement of olfactory function. In: Doty RL, editor. Handbook of Olfaction and Gustation. New York: Marcel Dekker; 1995. pp. 191–225. [Google Scholar]
- 5.Lovell MA, Jafek BW, Moran DT. Biopsy of human olfactory mucosa: An instrument and a tecniqtte. Archives of Otolaryngology: Head and Neck surgery. 1982;108:247–9. doi: 10.1001/archotol.1982.00790520047013. [DOI] [PubMed] [Google Scholar]
- 6.Lanza DC, Moran DT, Doty RL. Endoscopic human olfactory biopsy tecnique: A preliminary report. Laryngoscope. 1993;103:815–9. doi: 10.1288/00005537-199307000-00017. [DOI] [PubMed] [Google Scholar]
- 7.Finelli PF, Mair RG. Disturbances of taste and smell. In: Bradley WG, Darrof RB, Fenichel GM, Marsden CD, editors. Neurology in Clinical Practice. Boston: Butterworth Heinemann; 1991. pp. 209–16. [Google Scholar]
- 8.Deems DA, Doty RL, Settle RG. Smell and taste disorders. A study of 750 patients from the University of Pennsylvania Smell and Taste Center. Archives of Otolaryngology: Head and Neck Surgery. 1991;117:519–28. doi: 10.1001/archotol.1991.01870170065015. [DOI] [PubMed] [Google Scholar]
- 9.Yousem DM, Geckle RJ, Bilker W. MR evaluation of patients with congenital hyposmia or anosmia. American Journal of Radiology. 1996;166:439–443. doi: 10.2214/ajr.166.2.8553963. [DOI] [PubMed] [Google Scholar]
- 10.Leopold DA, Schwob JE, Youngentob SL. Successful treatment of Phantosmia with preservation of olfaction. Archives of Otolaryngology: Head and Neck Surgery. 1991;117:1402–6. doi: 10.1001/archotol.1991.01870240094016. [DOI] [PubMed] [Google Scholar]
- 11.Kaufman MD, Lassiter KRL, Shenoy BV. Paroxysmal unilateral dysosmia: A cured patient. Annals of Neurology. 1988;24:450–1. doi: 10.1002/ana.410240315. [DOI] [PubMed] [Google Scholar]
- 12.Henkin RI, Barterr FC. Studies on olfactory thresholds in normal man and patients with adrenal cortical insufficiency: The role of adrenal cortical steroids and of serum sodium concentration. Journal of Clinical Investigation. 1966;45:1631–1639. doi: 10.1172/JCI105470. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Doty RL, Deems DA, Frye R. Olfactory sensitivity, nasal resistance, and autonomic function in the multiple chemical sensitivity (MCS) syndrome. Archives of Otolaryngology: Head and Neck Surgery. 1988;114:1422–7. doi: 10.1001/archotol.1988.01860240072027. [DOI] [PubMed] [Google Scholar]