Objectives Many patients complain about olfactory fluctuation (OF), which is a symptom commonly attributed to sinonasal disease. Data‐based evidence for its association with sinonasal disease is scarce. The aim of the study is to identify explanatory variables associated with OF and to analyze its predictive value regarding sinonasal disease. Study design We performed a retrospective study based on patients with olfactory dysfunction. Methods We analyzed data from 482 patients attending the smell and taste outpatient clinic with full psychophysical workup and structured questions regarding their symptoms. The questionnaire included items on OF and chronic nasal symptoms. Clinical investigators filled out the second part of this questionnaire that included information about nasal endoscopy, psychophysical tests of orthonasal olfaction (Sniffin' Sticks), retronasal olfaction, and putative etiology of olfactory dysfunction. Results OF was more prevalent in sinonasal disease (42.4%) compared to other putative etiologies of olfactory dysfunction such as postinfectious (28%) or posttraumatic (11.7%) (X2 [5, n = 440] = 24.98; P < .0001). OF was strongly associated with Sniffin' Sticks score categories (anosmia, hyposmia, normosmia) (X2 [2, n = 424] = 39.21; P < .0001; Cramer's V = 0.30; P < .0001) and presence of “chronic nasal symptoms” (X2 [1, n = 437] = 22.71; P < .0001; Cramer's V = 0.23; P < .0001). The accuracy in predicting putative sinonasal disease etiology when OF was present depended strongly on the clinical context. Conclusion Olfactory fluctuation is a symptom mostly but not exclusively associated with sinonasal disease, elevated Sniffin' Sticks test scores, and is frequently accompanied by other nasal complaints. Its presence is valuable information for clinicians to be integrated into the clinical context when doing patients' workup. Level of Evidence 4 Laryngoscope, 130:2442–2447, 2020

Purpose of the Review This study aims to summarize the current state of the art of how taste disorders are clinically best managed. Recent Findings Taste disorders are distressing for the concerned patients since eating and drinking become bothersome or impossible. Apart from nutritional problems, quality of life is impaired. Still, diagnosis and treatment of taste disorders are elusive, and general knowledge about taste and its affection is little within the population and the medical community. This review stresses the importance of accurate workup and diagnosis of taste disorders in order to offer an effective treatment. Yet unclear aspects of taste disorders are discussed, and interesting findings regarding the treatment of taste disorders are reviewed. A special focus is given to current pharmacological options on how to treat taste disorders. Summary Despite impressive insights into the gustatory function and molecular logic of taste receptor cells, there is currently poor clinical knowledge on the pathophysiology of taste disorders in humans. Diagnosing, measuring, and treating gustatory disorders remain restricted to a handful of specialized smell and taste centers worldwide. Despite interesting work on potential drugs treating taste disorders, many of the reported medications lack controlled and randomized trials confirming their efficacy in taste dysfunction. Future efforts need to be focused on the treatment of taste disorders.

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BackgroundThe role of chemosensory senses (olfaction, taste, and trigeminal) is crucial, and their dysfunctions profoundly affect the quality of life, potentially impacting eating behaviors. However, it is unclear which chemosensory symptoms could lead to undernutrition. This study aims to investigate which findings in patients’ smell and taste workup are predictors of weight loss.MethodsThis is a retrospective study based on a validated questionnaire consecutively given to adult patients presented in smell and taste consultations during a 10-year period. Psychophysical tests were used to measure chemosensory function (Sniffin’ Sticks, taste powder, and Taste Strips tests).ResultsWe included 554 patients (307 females) with a median age of 51 years (IQR 23). Among them, 76 (13.7%) reported involuntary weight loss due to chemosensory disorders occurred over periods ranging from 3 to 36 months. We found that the odds of losing weight were 2.1 times higher when patients reported changes in aroma perception (p-value=0.012; 95% CI 1.15 - 3.83). Parosmia, but not phantosmia nor smell loss, was a significant predictor of weight loss (OR 2.22; p-value=0.015; 95% CI 1.17 - 4.2). Furthermore, the duration of symptoms for more than two years was protective for weight loss (OR 0.44; p-value=0.014; 95% CI 0.23 - 0.85). Regarding putative etiologies, post-traumatic chemosensory dysfunction was also a significant predictor (OR 2.08; p-value=0.039; 95% CI 1.04 - 4.16). Concerning psychophysical tests, we found that the probability of a patient to present weight loss increased by 8% for every 1-unit reduction in Taste Strips score (p-value=0.006; 95% CI 0.87 - 0.98).ConclusionWe recommend investigating weight loss in smell and taste consultations, especially when patients report changes in aroma perception, parosmia, duration of symptoms for less than two years, head injury, and when low Taste Strips score is measured.