Olfactory Disorders

The most important method for evaluating a patient presenting with a complaint of olfactory disorder is taking a detailed medical history and conducting a physical examination.

During the medical history, factors such as the onset time, severity, specific odors triggering the olfactory disturbances, history of trauma, upper respiratory tract infections (URTI), and medication use are investigated.

In the physical examination, “obstructive causes” that might lead to nasal obstruction are assessed, and olfactory tests are conducted for both nostrils.

• Certain imaging techniques, such as CT or MRI, can be used to examine the nasal cavity, paranasal sinuses, and olfactory pathways.
• Olfactory and mucosal biopsies are rarely utilized diagnostic methods.

Causes of Olfactory Disorders

The causes of olfactory disorders include:

• Nasal lesions: structural anomalies, deviated septum, alar cartilage weakness, nasal polyps, allergic rhinitis, vasomotor rhinitis, atrophic rhinitis (ozena), hypertrophic rhinitis, rhinitis medicamentosa, adenoid hypertrophy, Sjögren’s syndrome
• Chronic inflammatory diseases: syphilis, tuberculosis, sarcoidosis, scleroma, leprosy, Wegener’s granulomatosis, midline granuloma
• Infections: influenza, bacterial rhinosinusitis, infected teeth or gums, tonsillitis, bronchiectasis, acute viral hepatitis, etc.
• Metabolic causes
• Tumors
• Neurological causes
• Vascular insufficiencies
• Endocrine causes
• Congenital (present at birth) causes
• Trauma and medication-related causes
• Psychiatric causes
• Physiological causes: menstruation, pregnancy, idiopathic origins.

Treatment of Olfactory Disorders

Treatment methods for olfactory disorders vary depending on the underlying cause.

The primary goal in treating olfactory disorders is to address the root cause.

Potential treatment approaches include:

• Surgical removal of obstructions or infections
• Balancing metabolism and nutrition
• Tumor-targeted therapies
• Correcting endocrine deficiencies
• Treating trauma-related complications
• Discontinuation of inappropriate medications.

Patients are also advised to avoid exposure to strong odors and air pollution and to refrain from smoking or being in smoky environments.