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Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies
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Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (30 December 2022) | Viewed by 15964

Special Issue Editor

Dr. Christian A. Mueller

E-Mail Website
Guest Editor
Department of Otorhinolaryngology, Medical University Vienna, Vienna, Austria
Interests: psychophysics of human olfaction; flavor perception; diagnostic procedures in smell and taste;
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite former beliefs that, compared to the rest of the animal kingdom, humans have relatively poor olfactory function, it has actually been found to be highly sensitive. Olfaction plays a major role in a variety of daily tasks (e.g., perception of food, warning of potential hazards, such as fire, gas or toxins) and it therefore forms an integral part of our quality of life. As a consequence, patients with smell and taste disorders are increasingly seeking medical counsel, and would thus benefit from effective diagnosis and therapy.

Since the onset of the COVID-19 pandemic, clinical research into smell loss has been intensified due to the published observations of the detrimental effects on olfactory function. This heightened interest will hopefully help to improve the understanding of disease pathophysiology, clinical diagnosis and subsequent management of patients with smell and taste disorders.

During the last few years a number of new therapeutic options have been proposed and investigated. Smell training represents an evidence-based option for the treatment of sensorineural olfactory damage and recently, the first few attempts into the development of olfactory implants have been made. However, further research into the technical and clinical implementation of these devices is needed.

Another emerging field in smell loss is the effect of biological therapies on olfactory function. Although beneficial effects on smell acuity have been reported in patients receiving these new monoclonal antibody therapies in sinus diseases such as nasal polyposis, more targeted research on the relationship between olfactory function and biological therapy is required.

The present Special Issue aims to present research regarding established or innovative diagnostic procedures and management strategies of olfactory dysfunction.

Dr. Christian A. Mueller
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Smell
  • Olfaction
  • Flavor
  • Anosmia
  • Hyposmia
  • Parosmia
  • Diagnosis
  • Therapy
  • Smell training
  • Olfactory Implant

Published Papers (6 papers)

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Research

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12 pages, 929 KiB  
Article
The Correlation between the Results of the Sniffin’ Sticks Test, Demographic Data, and Questionnaire of Olfactory Disorders in a Hungarian Population after a SARS-CoV-2 Infection
by András Molnár, Stefani Maihoub, Panayiota Mavrogeni, Magdolna Krasznai, László Tamás and Helga Kraxner
J. Clin. Med. 2023, 12(3), 1041; https://doi.org/10.3390/jcm12031041 - 29 Jan 2023
Cited by 5 | Viewed by 1112
Abstract
Background: After a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, smell disorders frequently occur, significantly affecting patients’ quality of life (QoL). Methods: 110 patients with persistent olfactory disorder after coronavirus infection were enrolled. These patients underwent chemosensory testing using the Sniffin’ Sticks test, [...] Read more.
Background: After a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, smell disorders frequently occur, significantly affecting patients’ quality of life (QoL). Methods: 110 patients with persistent olfactory disorder after coronavirus infection were enrolled. These patients underwent chemosensory testing using the Sniffin’ Sticks test, and completed the Questionnaire of Olfactory Disorders (QOD). Results: 30% of the patients reported anosmia, and 70% reported hyposmia. Upon comparing subjective and chemosensory testing categories, good category matching was observed in 75.3% (i.e., anosmia based on both methods in 10 and hyposmia in 48 cases). Statistical analysis using the Chi-square test revealed a significant result (p = 0.001 *). Between the TDI (i.e., Threshold, Discrimination, Identification) results of the three subjective report groups (i.e., hyposmia, anosmia, and parosmia), no significant differences were observed. When the TDI and QOD results were compared, no consistent significant correlations were found in most TDI and QOD outcomes. Between the TDI and Scale 2 results, a significant, although slight correlation was observed by the Spearman’s (rho = 0.213, p = 0.027 *) and Pearson’s (rho = 0.201, p = 0.037 *) tests. Conclusions: The nonsignificant correlation between objective and subjective methods suggests that these results should be interpreted independently. Moreover, adequate management is essential even in mild cases. Full article
(This article belongs to the Special Issue Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies)
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12 pages, 844 KiB  
Article
Drug-Associated Parosmia: New Perspectives from the WHO Safety Database
by Diane Merino, Alexandre Olivier Gérard, Susanne Thümmler, Nouha Ben Othman, Delphine Viard, Fanny Rocher, Alexandre Destere, Elise Katheryne Van Obberghen and Milou-Daniel Drici
J. Clin. Med. 2022, 11(16), 4641; https://doi.org/10.3390/jcm11164641 - 09 Aug 2022
Cited by 2 | Viewed by 2534
Abstract
Parosmia is a qualitative distortion of smell perception. Resulting from central causes, sinonasal diseases, and infections, parosmia has also been associated with medications. Therefore, we aimed to investigate potential signals for drugs associated with parosmia. VigiBase® (the WHO pharmacovigilance database) was queried [...] Read more.
Parosmia is a qualitative distortion of smell perception. Resulting from central causes, sinonasal diseases, and infections, parosmia has also been associated with medications. Therefore, we aimed to investigate potential signals for drugs associated with parosmia. VigiBase® (the WHO pharmacovigilance database) was queried for all reports of “Parosmia” (MedDRA Preferred Term), registered up to 23 January 2022. Disproportionality analysis relied on the reporting odds ratio and the information component. A signal is detected when the lower end of the 95% confidence interval of the information component is positive. We found 14,032 reports of parosmia, with a median patient age of 53 years. Most reported drugs were antiinfectives, among which COVID-19 vaccines accounted for 27.1% of reports. Antibiotics and corticosteroids were involved in 6.8% and 4.6% of reports. Significant disproportionate reporting was detected for corticosteroids, antibiotics, drugs used in nicotine dependence, COVID-19 and HPV vaccines, serotonin–norepinephrine reuptake inhibitors (SNRI), and incretin mimetics. We suggest potential safety signals involving nicotine replacement therapies and vaccines. We also highlight the potential role of less suspected classes, such as SNRIs and incretin mimetics. An iatrogenic etiology should be evoked when parosmia occurs, especially in the elderly. Full article
(This article belongs to the Special Issue Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies)
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13 pages, 850 KiB  
Article
Olfactory Training in Post-COVID-19 Persistent Olfactory Disorders: Value Normalization for Threshold but Not Identification
by Clair Vandersteen, Magali Payne, Louise-Émilie Dumas, Élisa Cancian, Alexandra Plonka, Grégoire D’Andréa, David Chirio, Élisa Demonchy, Karine Risso, Florence Askenazy-Gittard, Charles Savoldelli, Nicolas Guevara, Philippe Robert, Laurent Castillo, Valeria Manera and Auriane Gros
J. Clin. Med. 2022, 11(12), 3275; https://doi.org/10.3390/jcm11123275 - 08 Jun 2022
Cited by 10 | Viewed by 2941
Abstract
(1) Background: Persistent post-viral olfactory disorders (PPVOD) are estimated at 30% of patients one year after COVID-19 infection. No treatment is, to date, significantly effective on PPVOD with the exception of olfactory training (OT). The main objective of this work was to evaluate [...] Read more.
(1) Background: Persistent post-viral olfactory disorders (PPVOD) are estimated at 30% of patients one year after COVID-19 infection. No treatment is, to date, significantly effective on PPVOD with the exception of olfactory training (OT). The main objective of this work was to evaluate OT efficiency on post-COVID-19 PPVOD. (2) Methods: Consecutive patients consulting to the ENT department with post-COVID-19 PPVOD were included after completing clinical examination, the complete Sniffin’ Stick Test (TDI), the short version of the Questionnaire of olfactory disorders and the SF-36. Patients were trained to practice a self-olfactory training with a dedicated olfactory training kit twice a day for 6 months before returning to undergo the same assessments. (3) Results: Forty-three patients were included and performed 3.5 months of OT in average. We observed a significant TDI score improvement, increasing from 24.7 (±8.9) before the OT to 30.9 (±9.8) (p < 0.001). Based on normative data, a significant increase in the number of normosmic participants was observed only for the threshold values (p < 0.001). Specific and general olfaction-related quality of life improved after the OT. (4) Conclusions: Olfactory function appeared to improve only in peripheral aspects of post-COVID-19 PPVOD after OT. Future controlled studies must be performed to confirm the OT role and justify new therapeutic strategies that may focus on the central aspects of post-COVID-19 PPVOD. Full article
(This article belongs to the Special Issue Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies)
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26 pages, 10123 KiB  
Article
Machine-Learning Points at Endoscopic, Quality of Life, and Olfactory Parameters as Outcome Criteria for Endoscopic Paranasal Sinus Surgery in Chronic Rhinosinusitis
by Jörn Lötsch, Constantin A. Hintschich, Petros Petridis, Jürgen Pade and Thomas Hummel
J. Clin. Med. 2021, 10(18), 4245; https://doi.org/10.3390/jcm10184245 - 18 Sep 2021
Cited by 4 | Viewed by 1767
Abstract
Chronic rhinosinusitis (CRS) is often treated by functional endoscopic paranasal sinus surgery, which improves endoscopic parameters and quality of life, while olfactory function was suggested as a further criterion of treatment success. In a prospective cohort study, 37 parameters from four categories were [...] Read more.
Chronic rhinosinusitis (CRS) is often treated by functional endoscopic paranasal sinus surgery, which improves endoscopic parameters and quality of life, while olfactory function was suggested as a further criterion of treatment success. In a prospective cohort study, 37 parameters from four categories were recorded from 60 men and 98 women before and four months after endoscopic sinus surgery, including endoscopic measures of nasal anatomy/pathology, assessments of olfactory function, quality of life, and socio-demographic or concomitant conditions. Parameters containing relevant information about changes associated with surgery were examined using unsupervised and supervised methods, including machine-learning techniques for feature selection. The analyzed cohort included 52 men and 38 women. Changes in the endoscopic Lildholdt score allowed separation of baseline from postoperative data with a cross-validated accuracy of 85%. Further relevant information included primary nasal symptoms from SNOT-20 assessments, and self-assessments of olfactory function. Overall improvement in these relevant parameters was observed in 95% of patients. A ranked list of criteria was developed as a proposal to assess the outcome of functional endoscopic sinus surgery in CRS patients with nasal polyposis. Three different facets were captured, including the Lildholdt score as an endoscopic measure and, in addition, disease-specific quality of life and subjectively perceived olfactory function. Full article
(This article belongs to the Special Issue Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies)
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8 pages, 234 KiB  
Article
Association of Olfactory and Pulmonary Function in Middle-Aged and Older Adults: The Korea National Health and Nutrition Examination Survey
by Ji-Sun Kim, Jun-Ook Park, Dong-Hyun Lee, Ki-Hong Chang and Byung Guk Kim
J. Clin. Med. 2021, 10(7), 1535; https://doi.org/10.3390/jcm10071535 - 06 Apr 2021
Cited by 4 | Viewed by 1675
Abstract
Objectives: To identify the relationship between pulmonary function and subjective olfactory dysfunction in middle-aged and older adults. Materials and Methods: We used Korea National Health and Nutrition Examination Survey data from 2010 to 2012 to analyze 6191 participants in their 50s or older. [...] Read more.
Objectives: To identify the relationship between pulmonary function and subjective olfactory dysfunction in middle-aged and older adults. Materials and Methods: We used Korea National Health and Nutrition Examination Survey data from 2010 to 2012 to analyze 6191 participants in their 50s or older. Results: The frequency of olfactory dysfunction was 6.8% among the subjects with normal pulmonary function tests, but was significantly more frequent in those diagnosed with restrictive (9.6%) or obstructive (10.1%) pulmonary function. Forced volume vital capacity, forced expiratory volume (FEV)1, FEV6, and peak expiratory flow were significantly lower in the olfactory dysfunction group. The risk of olfactory dysfunction was significantly associated with obstructive pulmonary function (odds ratio (OR) [95% confidence interval (CI)]: 1.449 [1.010–2.081]) after adjusting for confounders (sex, rhinitis, chronic rhinosinusitis, hypertension, dyslipidemia, education level, stress, depressed mood, and suicidal ideation). Conclusion: Middle-aged and older adults with obstructive pulmonary function had a higher incidence of subjective olfactory dysfunction than the normal pulmonary function group. Early olfactory testing may improve the quality of life of patients with obstructive pulmonary function. Full article
(This article belongs to the Special Issue Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies)

Review

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15 pages, 6506 KiB  
Review
Olfactory Evaluation in Clinical Medical Practice
by Květoslav Červený, Karla Janoušková, Kristýna Vaněčková, Šárka Zavázalová, David Funda, Jaromír Astl and Richard Holy
J. Clin. Med. 2022, 11(22), 6628; https://doi.org/10.3390/jcm11226628 - 08 Nov 2022
Cited by 5 | Viewed by 4815
Abstract
The subjective and demanding nature of olfactory testing means that it is often neglected in clinic despite loss of smell leading to significant limitations in everyday life. The list of diseases associated with loss of olfaction far exceeds the field of otorhinolaryngology and [...] Read more.
The subjective and demanding nature of olfactory testing means that it is often neglected in clinic despite loss of smell leading to significant limitations in everyday life. The list of diseases associated with loss of olfaction far exceeds the field of otorhinolaryngology and can also be seen in neurodegenerative disorders. Knowledge of possible clinical testing is essential to determine a proper differential diagnosis for the loss of olfactory sense. Causes of olfactory impairment can be divided into either failure in transferring odour to the organ of perception or damage to the olfactory pathway structure itself. Examination should therefore include methods evaluating cross-sectional area and patency of the nasal cavity as well as subjective or objective assessment of olfactory function. In this report we summarize several articles, studies, and our own experiences to provide a comprehensive review of their current clinical usage including their benefits, limitations, and possible outcomes. We also discuss the mechanism of olfaction step by step to provide a full understanding of the possible errors depending on the localization in the pathway and the methods designed for their detection. We discuss the correlation of the microbiome in nasal polyposis and chronic rhinitis with olfactory impairment using objective olfactometry. The topic of objective olfactometry and the examination of olfactory event-related potentials (OERP) is commented upon in detail. Full article
(This article belongs to the Special Issue Olfactory Dysfunction: Clinical Diagnosis and Current Management Strategies)
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