xRead - Olfactory Disorders (September 2023)

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INTERNATIONAL CONSENSUS ON OLFACTION

TABLE VII.1 Section evidence summary: Basic underlying mechanisms of sinonasal disease related olfactory loss Study Year LOE Study design Study groups Clinical end point Conclusions Youngentob et al 140 1986 4 Case series 10HCs ∙ Perceived odorant intensity ∙ Perceived sniffing effort Olfactory magnitude

decreases with increased nasal resistance

Seiden

2001 3

Prospective

All-comers with change in

Etiology of olfactory loss may help guide prognosis and response to steroids Alterations in nasal patency do not correlate with OF Decrease in olfaction during allergy season correlated to ECP but notNVF Significantly decreased number of OR cells infiltrate in CRS as respiratory epithelium; inflammatory changes may contribute to olfactory deficit anosmia in 12 of 24 patients; oral but not intranasal steroid sprays improved anosmia in 9 of the 12 remaining patients Use of nasal dilators increases odorant identification and intensity and decreases threshold Surgery resolved and abnormal morphology in anosmic specimens OE has a similar inflammatory

∙ UPSIT R

et al 137

cross-sectional

smell/taste perception (n = 420)

Lane

1996 3

Prospective case series

Pollen-sensitive

∙ Nasal patency ∙ UPSIT R

et al 152

patients (n = 8)

Klimek

1997 2

Prospective

Grass allergy (n = 17), HC(n = 12)

∙ NVF ∙ ECP ∙ CCCRC olfactory test ∙ Map5 ∙ Cellular morphology ∙ T&T olfactometer

et al 153

case-control

Lee

2000 5

Invitro

18 explants from 6 normosmic patients, 45

et al 174

explants from 15 anosmic patients

Kern 175

2000 5

Invitro

120 OE explants (26 patients with CRS, 4HCs)

∙ UPSIT R ∙ Histologic inflammatory changes

Stevens 146

2001 4

Prospective case series

24 patients with CRSwNP with anosmia

∙ UPSIT R

Hornung et al 141

1997 4

Case series

12HCs

∙ Custom odors

Landis

2003 2

Prospective

HCs (n = 56) vs patients with

Retronasal OF is retained over

∙ SS-ID (10 odors) ∙ Odorized powder identification

et al 139

case-control

CRSwNP (n = 42)

orthonasal in the presence of NPs in the anterior portion of the OC

Pfaar

2006 1

RCT

HCs with sponges in OC(n = 20) or

Orthonasal but not retronasal odor indentification is significantly decreased after

∙ SS-ID ∙ Odorized powder identification

et al 138

respiratory epithelium (n = 13)

obstruction of the OC

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