Smell and taste: 8 years of experience from a Tertiary Center

Abstract

Introduction: Olfactory dysfunction (OD) affects up to 20% of the population. Despite significant progress in olfactory function testing, the diagnosis and treatment of OD remains a challenge.

Aim: To conduct a descriptive and statistical analysis of patients undergoing follow-up for olfaction and taste dysfunction. 

Methods: Retrospective study including patients evaluated for olfaction and taste dysfunctions at a tertiary hospital between 2016 and 2023. We collected data on demographics, associated comorbidities, initial severity of OD, symptom duration, other sinonasal symptoms, and therapeutic approach. We used the Sniffin’ Stiks®, validated for Portuguese, to assess olfaction and presented the results as the TDI score. A melhoria do olfato após instituição terapêutica foi tida por um aumento mínimo de 5 pontos no TDI score.

Results: 133 patients were included (81 females, mean age of 54.55 years). According to statistical analysis, the most common presumed etiology was sinonasal disease (60%), presenting worse results in the threshold assessment test than in the odour discrimination and identification tests. Post-infectious OD (12%) had satisfactory results in threshold and discrimination and lower results in odour identification. Patients with neurodegenerative pathology (10%) showed a good result in the threshold assessment but a lower result in odour identification and discrimination. Post-traumatic OD (8%) presented an overall low TDI score. Treatment was according to the presumed etiology. Post-infectious was the etiology with better outcome in terms of TDI score improvement. 

Conclusion: Identifying the etiology through the assessment of various presentations and psychophysical patterns of olfaction is essential to develop targeted treatment strategies. However, the correct categorization of etiologies remains a challenge and highlights the need to improve diagnostic strategies.