Computed tomography scans in the evaluation of patients with olfactory dysfunction

Area of Science:

• Otolaryngology
• Radiology
• Diagnostic Imaging

Background:

• The role of computed tomography (CT) in evaluating olfactory dysfunction remains debated.
• Assessing the necessity of CT scans for diagnosing olfactory loss and guiding treatment decisions is crucial.

Purpose of the Study:

• To investigate the diagnostic significance of CT scans for olfactory loss.
• To determine the impact of CT scans on therapeutic decisions in patients with olfactory dysfunction.

Main Methods:

• Retrospective analysis of 137 patients with olfactory loss.
• Standardized clinical evaluation including history, ENT examination, and olfactory tests.
• Comparison of diagnoses with and without CT scan findings.

Main Results:

• CT scans identified sinonasal disease (SND) in 7/101 patients lacking clinical evidence.
• In 12/36 patients with suspected SND, CT scans revealed no signs of the disease.
• CT findings altered the initial clinical diagnosis in a subset of patients.

Conclusions:

• CT scans are valuable for diagnosing conductive/inflammatory olfactory loss when non-SND is suspected, potentially guiding steroid therapy.
• CT scans offer significant clinical value primarily for surgical treatment planning or in cases where systemic corticosteroids are contraindicated.
• The utility of CT scans must be weighed against treatment costs and potential benefits.