Clinical presentation of qualitative olfactory dysfunction

  • J. Frasnelli
  • B. N. Landis
  • S. Heilmann
  • B. Hauswald
  • K. B. Hüttenbrink
  • J. S. Lacroix
  • D. A. Leopold
  • T. Hummel
Miscellaneous

Abstract

Many patients with olfactory dysfunction not only experience quantitative reduction of olfactory function, but also suffer from distorted olfactory sensations. This qualitative dysfunction is referred to as parosmia (also called “troposmia”) or phantosmia, with the major difference that distorted olfactory sensations are experienced in the presence or absence of an odor, respectively. Our clinical observations corroborate the literature in terms of a general underestimation of the incidence of olfactory distortions. Based on selected cases we try to show that olfactory distortions exhibit a large variance in their clinical appearance. Further, emphasis is placed on the fact that only a detailed and directed history of the patient can provide cues to the correct diagnosis.

Keywords

Parosmia Phantosmia Olfaction 

References

  1. 1.
    Axel R (1995) The molecular logic of smell. Sci Am Oct:130–137Google Scholar
  2. 2.
    Cain WS, Gent JF, Goodspeed RB, Leonard G (1988) Evaluation of olfactory dysfunction in the Connecticut Chemosensory Clinical Research Center (CCCRC). Laryngoscope 98:83–88PubMedGoogle Scholar
  3. 3.
    Deems DA, Doty RL, Settle RG, Moore-Gillon V, Shaman P, Mester AF, Kimmelman CP, Brightman VJ, Snow JBJ (1991) Smell and taste disorders: a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otorhinolaryngol HNS 117:519–528Google Scholar
  4. 4.
    Doty RL, Shaman P, Dann M (1984) Development of the University of Pennsylvania Smell Identification Test: A standardized microencapsulated test of olfactory function (UPSIT). Physiol Behav 32:489–502PubMedGoogle Scholar
  5. 5.
    Duncan HJ, Seiden AM (1995) Long-term follow-up of olfactory loss secondary to head trauma and upper respiratory tract infection. Arch Otolaryngol HNS 121:1183–1187Google Scholar
  6. 6.
    Faulcon P, Portier F, Biacabe B, Bonfils P (1999) Anosmie secondaire à une rhinite aiguë: sémiologie et évolution à propos d’une série de 118 patients. Ann Otolaryngol Chir Cervicofac 116:351–357PubMedGoogle Scholar
  7. 7.
    Hummel T, Kobal G (2001) Olfactory event-related potentials. In: Simon SA, Nicolelis MAL (eds) Methods and frontiers in chemosensory research. CRC Press, Boca Raton, pp 429–464Google Scholar
  8. 8.
    Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) “Sniffin’ sticks”: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22:39–52PubMedGoogle Scholar
  9. 9.
    Hummel T, Heilmann S, Hüttenbrink KB (2002) Lipoic acid in the treatment of smell dysfunction following viral infection of the upper respiratory tract. Laryngoscope 112:2076–2080PubMedGoogle Scholar
  10. 10.
    Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, Seeber H, Pauli E, Hummel T (2000) Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol 257:205–211CrossRefPubMedGoogle Scholar
  11. 11.
    Lämmle H (1931) Über Geruchsstörungen und ihre klinische Bedeutung. Arch Ohr Nas Kehlk Heilk 130:22–42Google Scholar
  12. 12.
    Leopold D (1995) Distorted olfactory perception. In: Doty RL (eds) Handbook of olfaction and gustation. Marcel Dekker, New York, pp 441–454Google Scholar
  13. 13.
    Leopold D (2002) Distortion of olfactory perception: diagnosis and treatment. Chem Senses 27:611–615CrossRefPubMedGoogle Scholar
  14. 14.
    Leopold DA, Schwob JE, Youngentob SL, Hornung DE, Wright HN, Mozell MM (1991) Successful treatment of phantosmia with preservation of olfaction. Arch Otolaryngol HNS 117:1402–1406Google Scholar
  15. 15.
    Leopold DA, Loehrl TA, Schwob JE (2002) Long-term follow-up of surgically treated phantosmia. Arch Otolaryngol HNS 128:642–647Google Scholar
  16. 16.
    Miwa T, Furukawa M, Tsukatani T, Costanzo RM, DiNardo LJ, Reiter ER (2001) Impact of olfactory impairment on quality of life and disability. Arch Otolaryngol HNS 127:497–503Google Scholar
  17. 17.
    Mueller C, Kallert S, Renner B, Stiassny K, Temmel AF, Hummel T, Kobal G (2003) Quantitative assessment of gustatory function in a clinical context using impregnated “taste strips.” Rhinology 41:2–6Google Scholar
  18. 18.
    Nordin S, Murphy C, Davidson TM, Quinonez C, Jalowayski AA, Ellison DW (1996) Prevalence and assessment of qualitative olfactory dysfunction in different age groups. Laryngoscope 106:739–744PubMedGoogle Scholar
  19. 19.
    Pryse-Phillips W (1971) An olfactory reference syndrome. Acta Psychiatr Scand 47:484–509PubMedGoogle Scholar
  20. 20.
    Quint C, Temmel AF, Schickinger B, Pabinger S, Ramberger P, Hummel T (2001) Patterns of non-conductive olfactory disorders in eastern Austria: a study of 120 patients from the Department of Otorhinolaryngology at the University of Vienna. Wien Klin Wochr 113:52–57Google Scholar
  21. 21.
    Stevens JC, Cain WS (1986) Smelling via the mouth: effect of aging. Percept Psychophys 40:142–146PubMedGoogle Scholar
  22. 22.
    Straschill M, Stahl H, Gorkisch K (1983) Effects of electrical stimulation of the human olfactory mucosa. Appl Neurophysiol 46:286–289PubMedGoogle Scholar
  23. 23.
    Tanaka O, Mukaino Y (1999) The effect of auricular acupuncture on olfactory acuity. Am J Chin Med 27:19–24PubMedGoogle Scholar
  24. 24.
    Temmel AF, Quint C, Schickinger-Fischer B, Klimek L, Stoller E, Hummel T (2002) Characteristics of olfactory disorders in relation to major causes of olfactory loss. Arch Otolaryngol Head Neck Surg 128:635–641PubMedGoogle Scholar
  25. 25.
    Wolfensberger M, Hummel T (2002) Anti-inflammatory and surgical therapy of olfactory disorders related to sino-nasal disease. Chem Senses 27:617–622CrossRefPubMedGoogle Scholar
  26. 26.
    Wolfensberger M, Schnieper I, Welge-Lussen A (2000) Sniffin’Sticks: a new olfactory test battery. Acta Otolaryngol 120:303–306CrossRefPubMedGoogle Scholar
  27. 27.
    Wysocki CJ, Gilbert AN (1989) National Geographic Smell Survey: effects of age are heterogenous. Ann NY Acad Sci 561:12–28PubMedGoogle Scholar
  28. 28.
    Zarinko K (1896) Über Kakosmia subjectiva. In: Festschrift zur Feier des 80-jährigen Stiftungsfestes des ärztlichen Vereins zu Hamburg. Langkammer, Leipzig, pp 339–342Google Scholar
  29. 29.
    Zilstorff K (1966) Parosmia. J Laryngol 80:1102–1104Google Scholar

Copyright information

© Springer-Verlag is a part of Springer Science+Business Media 2003

Authors and Affiliations

  • J. Frasnelli
    • 1
  • B. N. Landis
    • 1
    • 2
  • S. Heilmann
    • 1
  • B. Hauswald
    • 1
  • K. B. Hüttenbrink
    • 1
  • J. S. Lacroix
    • 2
  • D. A. Leopold
    • 3
  • T. Hummel
    • 1
  1. 1.Smell and Taste Clinic, Department of OtorhinolaryngologyUniversity of Dresden Medical SchoolDresdenGermany
  2. 2.Unité de Rhinologie-Olfactologie, ENT DepartmentUniversity Hospital of GenevaGenevaSwitzerland
  3. 3.Department of Otolaryngology and Head and Neck SurgeryUniversity of Nebraska Medical CenterOmahaUSA

Personalised recommendations