DIAGNOSIS

Here are some ideas you can bring to your doctor, so that he can properly diagnose your smell disorder.

Please note that the Anosmia Foundation does not endorse or recommend any of the following. It is for your information only.

• Medical evaluation (complete medical history and physical examination)
• Hematological tests (e.g., hematocrit count, hemoglobin level, white blood cell count, urea nitrogen level, creatinine level, glucose level, erythrocyte sedimentation rate, eosinophil count, and immunoglobulin E level)
• Otolaryngological consultation
• Nasal mucous membranes should be examined for abnormal conditions.
• Trigeminal nerve assessment. Trigeminal nerve endings are important in detecting tactile pressure, pain, and temperature sensations in the areas of the mouth, eyes, and nasal cavity. They can alter the processing of information in olfactory receptors.
• Laboratory tests for impaired smell: Should include a complete blood count, sedimentation rate, blood sugar concentration, and blood urea nitrogen, as well as tests of thyroid function and antinuclear antibody level.
• A biopsy might be necessary if intra-nasal or intra-oral neoplasm is suspected to be the cause of the dysfunction.
  

  • Biopsy of the olfactory mucosa
    
  • Intra-nasal biopsy is also helpful in diagnosing post-upper respiratory infection-induced olfactory loss.
• Nasal endoscopy
• Drug assays, chemical analyses and thyroid function studies might be helpful, since some chemosensory problems are caused by the use of certain medications (e.g., anti-depressants and anti-convulsants, anti-psychotics, anti-hypertensives and cardiac medications, lipid-lowering agents, and anti-Parkinsonian agents), nutritional deficiency (e.g., zinc deficiency), and thyroid disease.
• Neurological consultation: Neuroimaging such as a CT or MRI may be necessary to rule out intra-cranial or peripheral nerve abnormalities.
  

  • Computed tomography is useful in imaging the nasal and sinus cavities, skull base, olfactory cleft, nasopharynx, parotid, oropharynx, neck, and mandible.
    
  • Bone abnormalities and widening of cranial nerve foramina are best observed with CT.
    
  • Magnetic resonance imaging is useful in evaluating the olfactory bulbs, ventricles, other soft tissues in the brain, soft tissues of the tongue, tongue base, blood vessels and nerves in the skull base and neck.
• Patients with a history of seizure disorder should be referred for EEG.
• Otolaryngological, neurological, and psychiatrical consultation may be necessary if the underlying cause of the problem is diagnosed as a condition, which may require further evaluation and treatment by a specialist in such discipline.
  

Please see the list of Smell Tests

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