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Retronasal olfactory testing using candies sent by post and for screening purposes: a feasibility study.
G Besser1, D Tianxiang Liu1, B Prem1
1Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Austria.
Rhinology
|March 17, 2020
Summary
A new 7-item Candy Smell Test (CST) is effective for home-based retronasal olfactory testing. This screening tool can quickly identify individuals with smell dysfunction, aiding in broader olfactory research.
Area of Science:
- Olfactory Neuroscience
- Sensory Science
- Clinical Diagnostics
Background:
- The olfactory system processes external and internal odors via orthonasal and retronasal routes, respectively.
- Flavor perception heavily relies on retronasal olfaction, yet related tests are underutilized.
- Retronasal olfactory tests (ROT) are recommended for comprehensive olfactory assessment.
Purpose of the Study:
- To develop and evaluate a user-friendly ROT suitable for home testing and postal distribution.
- To assess the efficacy of a novel screening test for retronasal olfactory function.
Main Methods:
- An initial 111 participants underwent a 27-item Candy Smell Test (CST).
- A subset of 54 participants completed retesting, with 25 performing home-based testing using "candy-chains".
- A 7-item CST was developed based on performance differences between normosmic and anosmic individuals, using a non-forced-choice format.
Main Results:
- The 27-item CST demonstrated high test-retest reliability in both home-testing and clinic groups.
- The 7-item CST successfully differentiated between healthy individuals and those with olfactory dysfunction (n=163).
Conclusions:
- The Candy Smell Test (CST) is validated for convenient home-based and postal administration.
- The 7-item CST serves as an effective tool for rapid identification of anosmia (complete loss of smell).
- Standardization of ROT is advanced, encouraging routine clinical use and facilitating large-scale studies on olfaction, food preference, and nutrition.

