Evaluation and treatment of smell dysfunction.

We gave 63 patients with symptoms of smell dysfunction a full evaluation by age-adjusted olfactory threshold and odor identification testing, rhinomanometry, nasal cytology, nasal endoscopy, computed tomographic (CT) scan and a trial of medical treatment. CT scans were valuable for identifying ethmoid sinus disease and nasal endoscopy for inspecting olfactory epithelium. A trial of prednisone served as a diagnostic modality to identify correctable causes of smell dysfunction. Given that there are 2 million people in the United States with a smell dysfunction, that the average physician knows little about its diagnosis and treatment and that the psychosocial impact to an afflicted person is great, we urge a greater awareness of smell dysfunction, its diagnosis and its treatment.