An algorithmic approach to the evaluation and treatment of olfactory disorders

To review the current evidence in diagnosing olfactory disorders and suggest an algorithmic approach to patients with relevant complaints.

New literature suggests that the incidence of olfactory loss increases with age. Age-associated olfactory loss is often multifactorial and requires careful history and physical exam. Psychophysical tests have a role in screening patients at risk for Parkinson's and Alzheimer's disease, but there is lack of evidence regarding timing and patient selection. Prediction of olfactory improvement in patients with chronic rhinosinusitis (CRS) is difficult with variable results from different studies. Olfactory training is suggested to be an emerging modality in patients with postinfectious olfactory loss.

There is no standard treatment for olfactory loss. Each patient must be approached individually based on the suspected cause. Patients with CRS may require medical management and surgical treatment for alleviation of their olfactory dysfunction.