Rapid clinical evaluation of anosmia in children: the Alcohol Sniff Test

Smell impairment affects 1-2% of Americans and leads to frequent physician visits. Olfactory functional testing is available in chemosensory centers, but is frequently omitted in routine cranial nerve examinations. A new smell test, using the standard 70% isopropyl alcohol pad, was developed at the UCSD Nasal Dysfunction Clinic: The Alcohol Sniff Test (AST). The current study examined the reliability of the AST in children, using test-retest measures. A standard 70% isopropyl alcohol pad was moved upward 1 cm per exhalation until the participant reported detection. Test-retest reliability of the AST in children was significant, r = 0.80. The AST predictably classified children as anosmic, hyposmic or normosmic, p < 0.0001. The AST requires only 5 minutes to administer with materials readily available in any physician's office or hospital. The AST is an effective screening tool, even in children, for the average physician who can then refer patients who show less than normal function for further comprehensive testing.