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Significant Clinical and Self-Assessed Differences Exist Between Patients With and Without Flavor Loss

by Linda Kossoff •

Why do some patients with olfactory disorder (OD) report smell and flavor loss while others report smell loss only?

BOTTOM LINE: Patients with OD reporting smell and flavor loss present significantly different clinical features from those with smell loss only, and they suffer more as a consequence.

BACKGROUND: OD is a common issue that can significantly decrease quality of life. Of the two olfaction pathways, orthonasal and retronasal, the latter is key in multisensory flavor perception. Although some theories exist, it is not yet understood why some patients with OD report smell loss only with intact flavor perception.

STUDY DESIGN: Observational, analytic, cross-sectional study.

SETTING: Smell and Taste Clinic, Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital Dresden, Germany.

SYNOPSIS: Researchers identified 401 patients who presented at a single clinic between January and October 2019 reporting either smell and flavor loss (Group One) or smell loss alone (Group Two). Disease-specific and general clinical details (duration/onset type) of their dysfunction were assessed via medical questionnaire and clinical interview. After thorough clinical examination, diagnoses and probable causes of disorder were identified and sensory testing was administered. The majority of patients did not receive retronasal testing. Following data analysis, no difference in olfactory function or taste function was seen between the groups; however, Group One showed a shorter disease duration, a higher subjective impairment, and a significantly more sudden onset. Disease causes also varied between groups, with Group One most frequently diagnosed with upper respiratory airway infection and Group Two with an idiopathic dysfunction. Study limitations included a lack of big population data to assess and characterize the degree of retronasal dysfunction in patients with smell loss.

CITATION: Negoias S, Meves B, Zang Y, et al. Characteristics of olfactory disorder with and without reported flavor loss. Laryngoscope. 2020;130:2869-2873.