Diagnostics and treatment of olfactory dysfunction

Abstract

Dysosmia is one of the most common disorders in otorhinolaryngology. However, epidemiological data are lacking and treatment strategies are insufficiently standardized. The aim of this study was to evaluate the frequency of causes of olfactory disorders and the different therapeutic approaches used in ENT departments in German-speaking countries. The results were also compared to findings of the survey in 2000. Furthermore, asystematic review of treatment strategies was conducted. In 2010, atwo-page survey addressing olfactory dysfunction was sent to all ENT departments in German-speaking countries. The literature review included sources such as PubMed, the Cochrane Library, and relevant guidelines. The diagnosis of dysosmia was made less frequently in ENT departments (decrease of 52%). The three most widely used therapeutic approaches were corticosteroids (topical and systemic) and systemic antibiotics. There is evidence in the literature showing asmall to medium effect of topical steroids in sinonasal smell disorders. Since a 50% decrease in the prevalence of olfactory disturbances is unlikely, the lower patient numbers may relate to amore critical diagnosis. The use of olfactory training in clinics has increased significantly (from <6% to up to 23%). The use of topical steroids for sinonasal dysosmia is evidence based. Smell training is asafe and effective treatment strategy, especially in post-infectious and post-traumatic olfactory disorders.