An unmet need: Patients with smell and taste disorders

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Abstract

There are large numbers of patients with olfactory disturbance in the UK and shortfalls in assessment and support amongst mainstream practice in both primary and secondary care leading to significant quality-of-life impairment and potential missed diagnoses. The aim of this study was to determine the key themes which can be identified from the accounts of anosmia sufferers and to identify important areas to target for future research or service development.

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Most cited references 17

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The association between smoking and smell and taste impairment in the general population.

Mechtild Vennemann, Thomas Hummel, Klaus Berger (2008)

The aim of this study was to evaluate the effect of smoking on taste and smell impairment in a large population- based study. Cross-sectional survey in Dortmund, Germany. The population sample was randomly drawn from the city's central registration office. Following a standardized interview, validated taste and smell tests were performed. Descriptive statistics and logistic regression was used in the analysis. Among the 1312 study participants, 3.6 % were functionally anosmic, and 18 % had olfactory dysfunction. Approximately 20 % recognized only three or less of the four tastes when presented at suprathreshold concentrations, indicating signs of taste impairment. Current smoking in general increased the risk for impairment of olfactory function (odds ratio 1.71, 95 % CI 1.19-2.47), but not the risk for taste impairment. Heavy smokers of 20 or more cigarettes/day had significant increased risks for impairment in both senses. Our results reveal that both olfactory and gustatory function are compromised in a significant proportion of the general population. Smoking increases significantly the risk of impairment of olfactory function. Our findings add an important detail to the large body of evidence that describes adverse health effects of smoking.

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A study on the frequency of olfactory dysfunction.

Jacob Landis, T. Hummel, C Konnerth (2004)

Goals of the study were to evaluate the frequency of olfactory dysfunction in a large representative population without sinonasal complaints and to investigate the extent to which general pathological conditions, medications, and aging influence olfaction. Prospective. Results based on an odor identification test ("Sniffin' Sticks") were reported from 1240 subjects. The subjects presented themselves to an otorhinolaryngology outpatient clinic with relatively mild and transitory complaints unrelated to the upper airways. A detailed otorhinolaryngological examination in combination with a standardized interview further ascertained that these patients had no rhinological problems or symptoms relating to sinonasal disease. Apart from the confirmation of the effects of age, gender, and certain otorhinolaryngological diseases on the sense of smell, the study results revealed that certain general diseases (liver diseases, nonotolaryngological cancers) appear to influence olfactory function, whereas other diseases or disorders have little or no impact on olfaction (hypertension, cardiovascular problems). The data in the study revealed that olfactory dysfunction among subjects under 65 years of age is more frequent than previously reported.

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Impact of olfactory impairment on quality of life and disability.

T Tsukatani, M. Furukawa, L DiNardo … (2001)

To determine whether olfactory loss affects patients' quality of life or level of disability. Retrospective survey using questionnaire data and clinic database review. Two university medical center smell and taste clinics. A total of 1407 patients were tested for smell and taste disturbances from 1984 through 1998. Surveys were mailed to 1093 patients who had abnormal test scores; 420 (38.4%) returned completed surveys. Patients were grouped by self-rated ability to smell as "impaired" (those reporting persisting deficits) or "improved" (those reporting no smell problem when surveyed). Response frequencies were compared between the 2 groups for questions regarding ability to perform common activities of daily living and quality-of-life issues. Mean (+/-SD) number of activities of daily living affected by olfactory loss was 4.70 +/- 3.56 for the impaired group and 0.61 +/- 1.58 for the improved group (P < .001). Among specific activities, the most common cited impairments were ability to detect spoiled food (impaired vs improved groups, 75% vs 12%; P < .001), gas leaks (61% vs 8%; P < .001), or smoke (50% vs 1%; P < .001); eating (53% vs 12%; P < .001); and cooking (49% vs 12%; P < .001). Differences in quality-of-life issues were reported primarily in the areas of safety and eating. Overall satisfaction with life was reported by 87% of the improved group but only 50% of the impaired group (P < .001). Patients reporting persistent olfactory impairment after previously documented olfactory loss indicate a higher level of disability and lower quality of life than those with perceived resolution of olfactory compromise.