Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T14:31:42.607Z Has data issue: false hasContentIssue false

Does imaging of the olfactory tract change the clinical management of patients with olfactory disturbance? A case series of 100 consecutive patients

Published online by Cambridge University Press:  27 August 2014

J Powell*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK The Institute of Health and Society, Newcastle University, UK
M Reda Elbadawey
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK Department of Otolaryngology-Head and Neck Surgery, Tanta University, Egypt
I Zammit-Maempel
Affiliation:
Department of Radiology, Freeman Hospital, Newcastle upon Tyne, UK
*
Address for correspondence: Mr Jason Powell, Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK Fax: (+44) 191 223 1246 E-mail: [email protected]

Abstract

Background:

Isolated olfactory dysfunction is a common complaint; the vast majority of cases are benign and untreatable. A common dilemma is whether to image the olfactory tract of affected patients.

Methods:

A case review of 100 consecutive patients who underwent magnetic resonance imaging for the primary complaint of olfactory dysfunction was performed. Patients with a diagnosis of chronic rhinosinusitis, with or without nasal polyps, were excluded.

Results:

Magnetic resonance imaging abnormalities that were considered clinically relevant to the presentation of olfactory dysfunction were found in only seven patients (7 per cent). Of these, only one patient (1 per cent) had an abnormality found that altered their clinical management. A comparison of the findings for children (less than 16 years old, n = 5) with those for adults (equal to or more than 16 years old, n = 95) revealed that 4 per cent of adults scanned had olfactory-related pathology diagnosed, as opposed to 60 per cent of children.

Conclusion:

Cross-sectional imaging may not be necessary in most patients with olfactory dysfunction. Imaging adds little to the patient history and clinical examination findings.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Vennemann, MM, Hummel, T, Berger, K.The association between smoking and smell and taste impairment in the general population. J Neurol 2008;255:1121–6Google Scholar
2Schubert, CR, Cruickshanks, KJ, Fischer, ME, Huang, GH, Klein, BE, Klein, R et al. Olfactory impairment in an adult population: the Beaver Dam Offspring Study. Chem Senses 2012;37:325–34CrossRefGoogle Scholar
3Murphy, C, Schubert, CR, Cruickshanks, KJ, Klein, BE, Klein, R, Nondahl, DM. Prevalence of olfactory impairment in older adults. JAMA 2002;288:2307–12Google Scholar
4Bramerson, A, Johansson, L, Ek, L, Nordin, S, Bende, M. Prevalence of olfactory dysfunction: the Skövde population-based study. Laryngoscope 2004;114:733–7Google Scholar
5Doty, RL, Shaman, P, Applebaum, SL, Giberson, R, Siksorski, L, Rosenberg, L. Smell identification ability: changes with age. Science 1984;226:1441–3Google Scholar
6Miwa, T, Furukawa, M, Tsukatani, T, Costanzo, RM, DiNardo, LJ, Reiter, ER. Impact of olfactory impairment on quality of life and disability. Arch Otolaryngol Head Neck Surg 2001;127:497503CrossRefGoogle ScholarPubMed
7Allis, TJ, Leopold, DA. Smell and taste disorders. Facial Plast Surg Clin North Am 2012;20:93111CrossRefGoogle ScholarPubMed
8Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:112CrossRefGoogle ScholarPubMed
9Broich, G, Pagliari, A, Ottaviani, F. Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924. Anticancer Res 1997;17:2683–706Google ScholarPubMed
10Geyer, M, Nilssen, E. Evidence-based management of a patient with anosmia. Clin Otolaryngol 2008;33:1466–9Google Scholar
11Hong, SC, Holbrook, EH, Leopold, DA, Hummel, T. Distorted olfactory perception: a systematic review. Acta Otolaryngol 2012;132(suppl 1):S27–31CrossRefGoogle ScholarPubMed
12Busaba, NY. Is imaging necessary in the evaluation of the patient with an isolated complaint of anosmia? Ear Nose Throat J 2001;80:892–6CrossRefGoogle ScholarPubMed