[Diagnostics and treatment of olfactory dysfunction]

Abstract

Background: Dysosmia is one of the most common disorders in otorhinolaryngology. However, epidemiological data are lacking and treatment strategies are insufficiently standardized.

Objective: 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, a systematic review of treatment strategies was conducted.

Materials and methods: In 2010, a two-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.

Results: 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 a small to medium effect of topical steroids in sinonasal smell disorders.

Conclusion: Since a 50% decrease in the prevalence of olfactory disturbances is unlikely, the lower patient numbers may relate to a more 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 a safe and effective treatment strategy, especially in post-infectious and post-traumatic olfactory disorders.

Keywords: Anosmia; Epidemiology; Hyposmia; Sinunasal; Steroids.