BACKGROUND: Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following: - Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy with small diameter endoscopes. - Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability. - Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour threshold, and/or one of odour identification or discrimination. - Comprehensive chemosensory assessment should include gustatory screening. - Smell training can be helpful in patients with olfactory loss of several aetiologies. CONCLUSIONS: We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.

Department for ENT Head and Neck Surgery Bern University Hospital Bern Switzerland

Department of Neurosciences DNS Otolaryngology Section University Padua Italy

Department of Otolaryngology Head and Neck Surgery Medical Univeristy of South Carolina Charleston SC USA

Department of Otolaryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA USA

Department of Otolaryngology Taipei Veterans General Hospital National Yang Ming University School of Medicine Faculty of Medicine Taipei Taiwan

Department of Otolaryngology; Eskisehir Osmangazi University Istanbul Turkey

Department of Otorhinolaryngoglogy Istanbul Surgery Hospital Istanbul Turkey

Department of Otorhinolaryngology and Head and Neck Surgery Hospital Pardubice Faculty of Health Studies University of Pardubice Pardubice Czech Republic

Department of Otorhinolaryngology Cairo University Cairo Egypt

Department of Otorhinolaryngology Head and Neck Surgery Mie University Graduate School of Medicine Mie Japan

Department of Otorhinolaryngology Head and Neck Surgery University Hospital Essen University Duisburg Essen Germany

Department of Otorhinolaryngology Head and Neck Surgery University of Cologne Medical Center Cologne Germany

Department of Otorhinolaryngology Kanazawa Medical University Uchinada Kahoku Ishikawa Japan

Department of Otorhinolaryngology Konkuk University Medical Center Hwayang dong Gwangjin gu Seoul South Korea

Department of Otorhinolaryngology Medical University of Vienna Vienna Austria

Department of Otorhinolaryngology University College of Medical Sciences and GTB Hospital Delhi India

Department of Otorhinolaryngology University of Jena Jena Germany

Departments of Otolaryngology and Neurosurgery University of Colorado Aurora CO USA

Dept of Biology St Lawrence University Canton NY USA

Division of Otorhinolaryngology Area of Smell and Taste Hospital de Clinicas University of Buenos Aires Buenos Aires City Argentina

Division of Otorhinolaryngology Head and Neck Surgery Department of Surgery University of Vermont Medical Center Burlington Vermont USA

ENT Clinic University of Insubria ASST sette laghi Varese Italy

Head and Neck section Department of Aging Neurosciences Head and Neck and Orthopedic; Catholic University of Sacred heart A Gemelli Hospital Foundation Rome Italy

Institute of Medical Statistics Informatics and Epidemiology University Hospital of Cologne Cologne Germany

Norwich Medical School University of East Anglia Norwich UK

Research Chair in Chemosensory Neuroanatomy Department of Anatomy Universite du Quebec a Trois Rivieres Trois Rivieres QC Canada

Rhinology Unit and Smell Clinic IDIBAPS University of Barcelona Barcelona Catalonia Spain

Section of Otolaryngology Head and Neck Surgery The University of Chicago Medicine and Biological Sciences Chicago IL USA

Section of Rhinology Department of Otorhinolaryngology Karolinska University Hospital and Karolinska Institutet Stockholm Sweden

Smell and Taste Clinic 2nd Academic Otorhinolaryngology Department Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece

Smell and Taste Clinic Department of Otorhinolaryngology TU Dresden Dresden Germany

Smell and Taste Disorders Center Department of Otolaryngology Head and Neck Surgery VCU School of Medicine Richmond VA USA

The Institute for Nose and Sinus Therapy and Clinical Investigations Department of Otolaryngology Head and Neck Surgery Edith Wolfson Medical Center Tel Aviv University Sackler Faculty of Medicine Holon Israel

UCL Ear Institute Faculty of Brain Sciences University College London London UK

Universite Catholique de Louvain Institute of Neurosciences Unit of Otorhinolaryngology Brussels Belgium

University Hospital Basel Otorhinolaryngology Basel Switzerland

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