Objective: To report the case of a woman who underwent smell training for post-infectious olfactory dysfunction presumably from COVID-19. Methods: Design: Case Report. Setting: Tertiary Private Training Hospital. Patient: One. Result: A 41-year-old woman who developed olfactory dysfunction attributed to COVID-19 underwent smell training. At baseline, her responses were mostly “no smell,” and those reported as “can smell a bit” were rated as distorted. After three months, she could now smell items that she previously could not smell, but these smells were still distorted. At the time of this writing, she was on her 4th month of smell training. Conclusion Although we cannot rule out spontaneous resolution of anosmia in our patient, we would like to think that smell training contributed to her recovery of smell.
Anosmia ; Anosmia ; Olfactory Bulb ; Olfaction Disorders

Objective: To retrospectively analysely the electrophysiological and imaging features of isolated congenital anosmia (ICA) and to assess the clinical phenotypic characteristics and classification of ICA. Methods: Clinical data of 30 ICA patients in Beijing Anzhen Hospital from 2012 to 2019 was retrospectively reviewed, including 13 males and 17 females, aged (35±19) years. The control group consisted of 30 healthy people from medical examination center, including 13 males and 17 females, aged (39±14) years. The clinical characteristics of ICA were analyzed using Sniffin' Sticks test, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERP) and olfactory pathway MRI. SPSS 17.0 software was used to compare the difference of olfactory function between the two groups. The correlation between olfactory bulb, olfactory sulcus structure and age was observed, and the clinical phenotype characteristics of ICA patients were analyzed. Results: The subjective olfactory function was completely lost in ICA patients. oERP was absent in all of the ICA patients, but showed normal N₁ and P₂ waves in controls. tERP could be evoked in 63.3% (19/30) of ICA patients, and signals in these patients showed higher amplitude in the N₁ ((-10.33±6.93) μV vs (-5.11±2.71) μV, t=-10.113, P<0.01) and P₂ ((+17.25±8.51) μV vs (+7.31±3.46) μV, t=5.443, P<0.01) waves than that of the controls. Olfactory bulbs were aplastic in 80.0% (24/30) of patients and hypoplastic in 20.0% (6/30) of patients. Fifty-six point seven percent (17/30) of patients had bilateral olfactory sulcus deletion while 43.3% (13/30) had dysplasia, and all of the patients exhibited a depth of olfactory sulcus less than 8 mm. Both the structure of olfactory bulbs and olfactory sulcus were not associated with age for ICA patients (r value was -0.174 and 0.325, respectively, all P>0.05). Conclusions: ICA patients show neurophysiologic deficits and some anatomic differences compared with healthy controls. The absence of oERP combining with a depth of olfactory sulcus less than 8 mm is the important indicator for clinical diagnosis of ICA. The structure of olfactory bulb may be a critical factor for clinical classification of ICA.
Adolescent ; Adult ; Anosmia ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Olfaction Disorders/diagnosis* ; Olfactory Bulb/diagnostic imaging* ; Olfactory Pathways ; Retrospective Studies ; Smell ; Young Adult

A 26-year-old female presented to the paediatric clinic at 11 years of age with poor growth. The detection of delayed puberty, anosmia, coloboma and hearing impairment led to a diagnosis of CHARGE syndrome. This was confirmed by a heterogenous de novo pathogenic variant c.6955C >T:p.(Arg2319Cys) detected in the CHD7 gene. Detailed assessment, including olfaction, ophthalmic and auditory examination should be part of the evaluation framework in children with delayed growth and puberty.
Anosmia ; Puberty, Delayed

Background: Olfactory dysfunction (OD) in COVID-19 presents as a sudden onset smell loss commonly seen in mild symptomatic cases with or without rhinitis but can occur as an isolated symptom. The reported prevalence of OD among COVID-19 patients ranged from 5% to 98%. Although numerous studies have been conducted about their association, these were mainly based on self-reported cases and subjective questionnaires. Objective: This study investigates whether there is a significant difference in the prevalence of olfactory dysfunction between self-reported and objective testing using validated objective olfactory tests among RT-PCR confirmed COVID-19 patients. Methods: PubMed (MEDLINE), Cochrane, Web of Science, and Google Scholar were searched for studies investigating the prevalence of OD by using objective olfactory tests among patients who self-reported OD (November 1, 2019 to July 31, 2020). All studies were assessed for quality and bias using the Cochrane bias tool. Patient demographics, type of objective olfactory test, and results of self-reported OD and objective testing were reported. Results: Nine studies encompassing 673 patients met the inclusion criteria. Validated objective olfactory tests used in the included studies were CCCRC, SST and SIT. Overall prevalence of OD among patients who self-reported was higher after objective testing (71% versus 81%). This was also seen in when we performed subgroup analysis based on the objective tests that were used. However, meta-analysis using random effects model showed no significant difference in the overall prevalence of OD (p value=.479, 95% CI 56.6 to 84.0 versus 71.2 to 89.8) as well as in the subgroups. Conclusion To the best of our knowledge, this is the first meta-analysis that statistically reviewed articles that evaluated the difference between self-reported and objective tests done on the same patients. Results showing that self-reporting OD approximates the results of the objective tests among COVID-19 positive patients may imply that self-reporting can be sufficient in contact tracing and triggering swabbing and self quarantine during the time of COVID-19 and objective tests can be used as an adjunct in the diagnosis particularly in research. However, this study was limited by small sample size and articles done in European countries hence, interpretation and application of the results of this study must be approached with care. Further studies documenting the difference between self-reporting and objective test in large scale setting involving different countries may be helpful in establishing a definitive consensus.
Anosmia ; SARS-CoV-2 ; Pandemics

Objective: To determine the association of anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR test results among patients in a tertiary government hospital in Metro Manila. Methods: Design: Cross-Sectional Study. Setting: Tertiary Government Hospital. Participants: Patients aged 18 years old and above who consulted or were admitted with COVID-19 symptoms at the Quezon City General Hospital in the Philippines from July to September 2020 answered an offline version of the American Academy of Otolaryngology-Head and Neck Surgery AAO-HNS COVID-19 Anosmia Reporting Tool prior to undergoing (COVID-19) RT-PCR testing. Results: Out of 172 participants, 63 (36.6%) presented with anosmia. Sixty (95.2%) out of 63 of those with anosmia had a positive COVID-19 RT-PCR test result. Forty-one (65%) participants reported anosmia as the first symptom while the most common associated symptoms were fever (59%), cough (50%), and rhinorrhea (31%). There was a significant association between anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR tests (X2 =33.85, df=1, p<.0001). Conclusion Anosmia was associated with a positive SARS-CoV-2 (COVID-19) RT-PCR test in more than 95% of those who reported the symptom. Anosmia should be considered as a red flag sign which should be included in the screening of persons suspected of being infected with COVID-19 to help mitigate further spread of the virus.
Anosmia ; Coronavirus ; SARS-CoV-2 ; Pandemics ; COVID-19

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) improves olfactory dysfunction due to chronic rhinosinusitis. Cross-Cultural Smell Identification test (CC-SIT) is known to be one of the useful methods to assess the olfactory dysfunction. We assessed the influence of ESS on olfactory function by using symptom scores and CC-SIT, and determined the clinical validity of CC-SIT. MATERIALS AND METHODS: 151 patients with chronic rhinosinusitis who had received ESS were evaluated. Prior to and three months following the surgery, each patient was requested to mark a 5-point scale ranging from normosmia to anosmia. Preoperative and postoperative CC-SITs were performed for 20 patients who complained of olfactory dysfunction. To evaluate the clinical validity of CC-SIT, we assessed the correlations between CC-SIT scores, symptom scores and CT scores using the Lund-Mackay CT scoring system. RESULTS: There were a significant decrease in the symptom scores and an increase in the CC-SIT scores after ESS. However, normosmia was achieved in only 38.5% (25/65) of the patients determined by symptom scores and 23.5% (4/17) by CC-SITs. There were significant correlations between CC-SIT scores, symptom scores and CT scores (r=-0.416, r=-0.357, r=0.510, p<0.05). CONCLUSION: Although the average postoperative olfactory ability after ESS was in the hyposmic range, ESS could improve the olfactory ability in patients with chronic rhinosinusitis. The 5-point scale and the CC-SIT scores reflected well the severity of olfactory dysfunction in patients with chronic rhinosinusitis, and therefore, we recommend them as convenient and practical tools to assess olfactory ability before and after ESS.
Humans ; Olfaction Disorders ; Smell*

The common causes of anosmia include sinonasal disorder, post-upper respiratory infection, trauma and chemicals. Intracranial tumor also frequently cause anosmia, so it is not easy to diagnose an intracranial tumor in patients who present with no definite related symptoms other than anosmia. Therefore, otolaryngologists should focus their attention on these disorders when they see patients with anosmia. We have experienced a case of olfactory groove menigioma presenting with only anosmia. We herein report this case with a brief review of the literature.
Humans ; Meningioma ; Olfaction Disorders

Humans ; Olfaction Disorders/etiology* ; Smell

Kallman syndrome is characterised by hypogonadotrophic hypogonadism and anosmia. T1 weighted MR coronal images show the bilateral absence or hypoplasia of olfactory bulbs, tracts, and sulci. We report the MR findings of Kallmann syndrome and revew the literature.
Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb

BACKGROUND: Anosmia can be frustrating for both the patient and physician, with no clear treatment. We prospectively investigated the effects of stellate ganglion block (SGB) in anosmic patients who were unresponsive to conventional steroid therapy. METHODS: Thirteen patients with anosmia were treated with SGB. To evaluate the improvement in olfactory function, we evaluated both changes in subjective symptoms and the butanol threshold test. The number of SGB required for improvement in olfactory function was counted. RESULTS: Seven patients (54%) showed improvement of olfactory function with SGB. The average number of SGB for the first response was 7.4 +/- 5.9 times. CONCLUSIONS: These results suggest that SGB may be a good treatment modality for patients with anosmia unresponsive to steroid therapy.
Humans ; Olfaction Disorders* ; Prospective Studies ; Stellate Ganglion*