Diagnosis and management of olfactory disorders: survey of UK-based consultants and literature review

McNeill, Emma; Ramakrishnan, Yujay; Carrie, Sean

doi:10.1017/s0022215107006615

Cited by 29 publications

(30 citation statements)

References 50 publications

(56 reference statements)

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“…This study adds to increasing evidence from patients and healthcare professionals that suggest that olfactory disorders are often poorly managed, 14,27 which in itself appears to exacerbate the negative impact upon sufferers. 28 Sufferers describe a lack of acknowledgement of disordered olfaction as a significant problem.…”

Section: Comparison With Existing Literaturementioning

confidence: 86%

“…Olfactory disorders increase in incidence with age, even in an otherwise healthy population, in a similar manner to impaired hearing or sight, but whereas hearing and vision are readily investigated or tested and frequently improved or corrected today; similar management is not undertaken for olfactory problems. This inattention may be due to a lack of appreciation of the impact of loss of olfaction, ignorance regarding management strategies or frustration at a lack of good treatment options …”

Section: Introductionmentioning

confidence: 99%

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An unmet need: Patients with smell and taste disorders

Erskine

Philpott

2019

Clinical Otolaryngology

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Objectives 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. Design Qualitative analysis of written patient accounts from patients corresponding with a tertiary smell and taste clinic in the UK. This qualitative study utilised unstructured written patient accounts from consenting patients experiencing olfactory disturbances received by the smell and taste clinic. Framework analysis was performed using Nvivo 10 software. Setting Tertiary smell and taste clinic. Participants Consenting patients who contacted the smell and taste clinic with accounts of their experiences. Main outcome measures Themes generated by qualitative analysis with Nvivo software. Results Accounts submitted by 71 participants were included in the analysis; age range 31‐80 years, 45 females, 26 males. Themes identified include negative emotional impact, feelings of isolation, impaired relationships and daily functioning, impact on physical health and the difficulty and financial burden of seeking help. Conclusions Olfactory disturbances have a wide‐ranging impact on the lives of sufferers, compounded by a lack of knowledge of the disorder amongst clinicians. There is a role for further support and education both for sufferers and for clinicians, as well as a need to improve our understanding of olfactory disturbance.

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Section: Comparison With Existing Literaturementioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

An unmet need: Patients with smell and taste disorders

Erskine

Philpott

2019

Clinical Otolaryngology

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“…29,30 We have used the English version of the SS-16, which was developed in Germany 7 and the North-American version of the UPSIT-40. 6 These tests are the most widely used smell tests among Ear Nose and Throat (ENT) specialists in the United Kingdom, 38 although neither test was specifically designed for the British population (the commercially available British version of the UPSIT- 40 does not yet have published normative data 10 ). Both smell tests demonstrated good accuracy in distinguishing PD cases who fulfilled the Queen Square Brain Bank diagnostic criteria 5 from controls and the PD probability yielded by both tests was similar, although there were mismatches probably due to imperfect test re-test repeatability of smell tests (0.9 for the UPSIT-40 39 and 0.73 for the SS-16 7 ), variability of cooperation, familiarity with specific odors of each test and also fluctuations in olfactory function due to rhinitis 40 or other upper respiratory tract chronic problems.…”

Section: Fig 2 Pd Probability Rulers For the 40 Item University Of mentioning

confidence: 99%

The use of a color coded probability scale to interpret smell tests in suspected parkinsonism

et al. 2009

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Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT-40) and/or the 16 item SIT from Sniffin Sticks (SS-16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD (''PD probability''). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) ''PD probability'' were: sensitivity 85.0% (78.8-89.7%), specificity 84.6% (77.3-89.9%) for the UPSIT-40; sensitivity 90.4% (83.5-94.7%), specificity 85.5% (76.2-91.7%) for the SS-16.Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123-I]-FP-CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa 5 0.72) the probability ruler predicted the result of the DaTS-CAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging.2009 Movement Disorder Society

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“…Furthermore, with the advent of a dedicated Olfactory and Gustatory Disorders Clinic at the James Paget University Hospital, it became important to ensure that the use of the “Sniffin’ Sticks” test was suitable for our local population. Whilst the importance of the sense of smell has increasingly been recognised outside ENT practice, for example, in terms of the evaluation of neurodegenerative disorders such as early diagnosis of Parkinson’s disease, 3,4 the commitment to assessing olfaction in ENT Clinics in the UK has be shown to be lukewarm at best 5 …”

Section: Introductionmentioning

confidence: 99%

“…Whilst the importance of the sense of smell has increasingly been recognised outside ENT practice, for example, in terms of the evaluation of neurodegenerative disorders such as early diagnosis of Parkinson's disease, 3,4 the commitment to assessing olfaction in ENT Clinics in the UK has be shown to be lukewarm at best. 5 There are number of alternative ways of assessing the nasal chemosensory performance, and the ''Sniffin' Sticks'' test was initially developed and validated on large numbers of patients in Germany. 6,7 Currently, the kit is used by many clinicians around the world and has been validated for various countries and populations (Australia, 8 Greece, 9,10 Taiwan, [11][12][13] Italy, 14 Holland, 15 Sri Lanka, 16 Brazil 17 ).…”

mentioning

confidence: 99%