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Current Opinion in Otolaryngology & Head & Neck Surgery:
doi: 10.1097/MOO.0000000000000013
NOSE AND PARANASAL SINUSES: Edited by Samuel S. Becker and Nithin D. Adappa

The optimal evaluation and management of patients with a gradual onset of olfactory loss

Enriquez, Karlaa,b; Lehrer, Eduardoa,c; Mullol, Joaquima,c

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Purpose of review: The aim of this review is to provide an overview of the causes of olfactory dysfunction, their evaluation and management, with a main focus on the gradual/progressive loss of smell.

Recent findings: As the sense of smell gives us essential information about our environment, its loss can cause nutritional and social problems while threatening an individual's safety. Recent surveys have shown quite a substantial prevalence of hyposmia (one out of four people) and anosmia (one out of 200 people) in a variety of populations.

Summary: Nasal inflammatory diseases such as allergic rhinitis and predominantly chronic rhinosinusitis account for the major and common causes of gradual/progressive loss of smell. However, they are also among the most successfully treated forms of olfactory dysfunction. The management of gradual/progressive smell deficit must always address its etiological causes. In most cases, a detailed medical history and nasal examination, smell testing, and imaging will help to establish an appropriate diagnosis. In addition to anti-inflammatory therapy, mainly nasal and systemic corticosteroids, recent investigations on smell training suggest that the controlled exposure to selected odors may increase olfactory performance.

Video abstract available: See the Video Supplementary Digital Content 1 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins


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