Position paper on olfactory dysfunction

T Hummel¹, K L Whitcroft¹, P Andrews², A Altundag³, C Cinghi⁴, R M Costanzo⁵, M Damm⁶, J Frasnelli⁷, H Gudziol⁸, N Gupta⁹, A Haehner¹, E Holbrook¹⁰, S C Hong¹¹, D Hornung¹², K B Hüttenbrink¹², R Kamel¹³, M Kobayashi¹⁴, I Konstantinidis¹⁵, B N Landis¹⁶, D A Leopold¹⁷, A Macchi¹⁸, T Miwa¹⁹, R Moesges²⁰, J Mullol²¹, C A Mueller²², G Ottaviano²³, G C Passali²⁴, C Philpott²⁵, J M Pinto²⁶, V J Ramakrishnan²⁷, P Rombaux²⁸, Y Roth²⁹, R A Schlosser³⁰, B Shu³¹, G Soler³², P Stjärne³³, B A Stuck³⁴, J Vodicka³⁵, A Welge-Luessen³⁶

Affiliations

¹ Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
² UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK.
³ Department of Otorhinolaryngoglogy, Istanbul Surgery Hospital, Istanbul, Turkey.
⁴ Department of Otolaryngology; Eskisehir Osmangazi University, Istanbul, Turkey.
⁵ Smell and Taste Disorders Center, Department of Otolaryngology Head and Neck Surgery, VCU School of Medicine, Richmond, VA, USA.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne Medical Center, Cologne, Germany.
⁷ Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, QC, Canada.
⁸ Department of Otorhinolaryngology, University of Jena, Jena, Germany.
⁹ Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India.
¹⁰ Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
¹¹ Department of Otorhinolaryngology, Konkuk University Medical Center, Hwayang-dong, Gwangjin-gu, Seoul, South Korea.
¹² Dept. of Biology, St. Lawrence University, Canton, NY, USA.
¹³ Department of Otorhinolaryngology, Cairo University, Cairo, Egypt.
¹⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan.
¹⁵ Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁶ Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland.
¹⁷ Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, University of Vermont Medical Center, Burlington, Vermont, USA.
¹⁸ ENT Clinic, University of Insubria, ASST, sette laghi, Varese, Italy.
¹⁹ Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan.
²⁰ Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Cologne, Germany.
²¹ Rhinology Unit and Smell Clinic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.
²² Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
²³ Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy.
²⁴ Head and Neck section, Department of Aging, Neurosciences, Head and Neck and Orthopedic; Catholic University of Sacred heart, A. Gemelli Hospital Foundation, Rome, Italy.
²⁵ Norwich Medical School, University of East Anglia, Norwich, UK.
²⁶ Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA.
²⁷ Departments of Otolaryngology and Neurosurgery, University of Colorado, Aurora, CO, USA.
²⁸ Universite Catholique de Louvain, Institute of Neurosciences, Unit of Otorhinolaryngology, Brussels, Belgium.
²⁹ The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel.
³⁰ Department of Otolaryngology, Head and Neck Surgery, Medical Univeristy of South Carolina, Charleston, SC, USA.
³¹ Department of Otolaryngology, Taipei Veterans General Hospital, National Yang Ming University School of Medicine Faculty of Medicine, Taipei, Taiwan.
³² Division of Otorhinolaryngology, Area of Smell and Taste, Hospital de Clinicas, University of Buenos Aires, Buenos Aires City, Argentina.
³³ Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
³⁴ Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Germany.
³⁵ Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic.
³⁶ University Hospital Basel - Otorhinolaryngology, Basel, Switzerland.

PMID: 28623665
DOI: 10.4193/Rhino16.248

Position paper on olfactory dysfunction

T Hummel et al. Rhinology. 2016.

. 2016 Jan 31;56(1):1-30.

doi: 10.4193/Rhino16.248.

Authors

Affiliations

¹ Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
² UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK.
³ Department of Otorhinolaryngoglogy, Istanbul Surgery Hospital, Istanbul, Turkey.
⁴ Department of Otolaryngology; Eskisehir Osmangazi University, Istanbul, Turkey.
⁵ Smell and Taste Disorders Center, Department of Otolaryngology Head and Neck Surgery, VCU School of Medicine, Richmond, VA, USA.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne Medical Center, Cologne, Germany.
⁷ Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, QC, Canada.
⁸ Department of Otorhinolaryngology, University of Jena, Jena, Germany.
⁹ Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India.
¹⁰ Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
¹¹ Department of Otorhinolaryngology, Konkuk University Medical Center, Hwayang-dong, Gwangjin-gu, Seoul, South Korea.
¹² Dept. of Biology, St. Lawrence University, Canton, NY, USA.
¹³ Department of Otorhinolaryngology, Cairo University, Cairo, Egypt.
¹⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan.
¹⁵ Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁶ Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland.
¹⁷ Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, University of Vermont Medical Center, Burlington, Vermont, USA.
¹⁸ ENT Clinic, University of Insubria, ASST, sette laghi, Varese, Italy.
¹⁹ Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan.
²⁰ Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Cologne, Germany.
²¹ Rhinology Unit and Smell Clinic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.
²² Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
²³ Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy.
²⁴ Head and Neck section, Department of Aging, Neurosciences, Head and Neck and Orthopedic; Catholic University of Sacred heart, A. Gemelli Hospital Foundation, Rome, Italy.
²⁵ Norwich Medical School, University of East Anglia, Norwich, UK.
²⁶ Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA.
²⁷ Departments of Otolaryngology and Neurosurgery, University of Colorado, Aurora, CO, USA.
²⁸ Universite Catholique de Louvain, Institute of Neurosciences, Unit of Otorhinolaryngology, Brussels, Belgium.
²⁹ The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel.
³⁰ Department of Otolaryngology, Head and Neck Surgery, Medical Univeristy of South Carolina, Charleston, SC, USA.
³¹ Department of Otolaryngology, Taipei Veterans General Hospital, National Yang Ming University School of Medicine Faculty of Medicine, Taipei, Taiwan.
³² Division of Otorhinolaryngology, Area of Smell and Taste, Hospital de Clinicas, University of Buenos Aires, Buenos Aires City, Argentina.
³³ Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
³⁴ Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Germany.
³⁵ Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic.
³⁶ University Hospital Basel - Otorhinolaryngology, Basel, Switzerland.

PMID: 28623665
DOI: 10.4193/Rhino16.248

Abstract

Background: Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following: - Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy with small diameter endoscopes. - Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability. - Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour threshold, and/or one of odour identification or discrimination. - Comprehensive chemosensory assessment should include gustatory screening. - Smell training can be helpful in patients with olfactory loss of several aetiologies.

Conclusions: We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.

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Position paper on olfactory dysfunction

Affiliations

Position paper on olfactory dysfunction

Authors

Affiliations

Abstract

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