Elsevier

Auris Nasus Larynx

Volume 46, Issue 5, October 2019, Pages 653-662
Auris Nasus Larynx

Clinical practice guidelines for the management of olfactory dysfunction — Secondary publication

https://doi.org/10.1016/j.anl.2019.04.002Get rights and content
Under a Creative Commons license
open access

Abstract

Objective

To provide an evidence-based recommendation for the management of olfactory dysfunction in accordance with the consensus reached by the Subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction in the Japanese Rhinologic Society.

Methods

Seven clinical questions (CQs) regarding the management of olfactory dysfunction were formulated by the subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction. We searched the literature published between April 1990 and September 2014 using PubMed, the Cochrane Library, and Ichushi Web databases. The main search terms were “smell disorder,” “olfactory dysfunction,” “olfactory loss,” “olfactory disturbance,” “olfactory impairments,” “olfaction disorder,” “smell disorder,” “anosmia,” “cacosmia,” and “dysosmia.” Based on the results of the literature review and the expert opinion of the Subcommittee, 4 levels of recommendation, from A—strongly recommended to D—not recommended, were adopted for the management of olfactory dysfunction.

Results

Both oral and locally administered corticosteroids have been strongly recommended for patients with olfactory dysfunction due to chronic rhinosinusitis. Nasal steroid spray and antihistamine drugs have been moderately recommended for patients with allergic rhinitis. Although no drugs have been deemed to be truly effective for post-viral olfactory dysfunction by randomized-controlled trials (RCTs) or placebo-controlled trials, olfactory training using odorants has been reported to be effective for improving olfactory function. There is considerable evidence that olfactory testing is useful for differential diagnosis, prediction of disease progression, and early detection of cognitive decline in neurodegenerative diseases.

Conclusion

The Clinical Practice Guideline has developed recommendations for the management of various aspects of olfactory dysfunction.

Keywords

Clinical practice guideline
Olfactory dysfunction
Treatment
Corticosteroids
Olfactory training
Neurodegenerative disorders

Cited by (0)

This article is a secondary publication of the Guideline for the management of olfactory dysfunction published by the Japanese Rhinologic Society, which is available at https://doi.org/10.7248/jjrhi.56.487 (Japanese).

1

Authors from K.I.b to K.T.i contributed equally to this work.