OBJECTIVES: Olfactory dysfunction (OD) is common and carries significant personal and societal burden. Accurate assessment is necessary for good clinical and research practice but is highly dependent on the assessment technique used. Current practice with regards to UK/international clinical assessment is unknown. We aimed to capture current clinical practice, with reference to contemporaneously available guidelines. We further aimed to compare UK to international practice. DESIGN: Anonymous online questionnaire with cross-sectional non-probability sampling. Subgroup analysis according to subspeciality training in rhinology ('rhinologists' and 'non-rhinologists') was performed, with geographical comparisons only made according to subgroup. PARTICIPANTS: ENT surgeons who assess olfaction. RESULTS: Responses were received from 465 clinicians (217 from UK and 17 countries total). Country-specific response rate varied, with the lowest rate being obtained from Japan (1.4%) and highest from Greece (72.5%). Most UK clinicians do not perform psychophysical smell testing during any of the presented clinical scenarios-though rhinologists did so more often than non-rhinologists. The most frequent barriers to testing related to service provision (e.g., time/funding limitations). Whilst there was variability in practice, in general, international respondents performed psychophysical testing more frequently than those from the UK. Approximately 3/4 of all respondents said they would like to receive training in psychophysical smell testing. Patient reported outcome measures were infrequently used in the UK/internationally. More UK respondents performed diagnostic MRI scanning than international respondents. CONCLUSIONS: To our knowledge, this is the most comprehensive UK-based, and only international survey of clinical practice in the assessment of OD. We present recommendations to improve practice, including increased education and funding for psychophysical smell testing. We hope this will promote accurate and reliable olfactory assessment, as is the accepted standard in other sensory systems.

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

5th Sense London UK

Centre for Olfactory Research Applications IP School of Advanced Study London UK

CIBER of Respiratory diseases Health Institute Carlos 3 Madrid Spain

Department of Clinical Medicine Flavour Institute Aarhus University Aarhus Denmark

Department of Otolaryngology Head and Neck Surgery Biruni University School of Medicine Istanbul Turkey

Department of Otolaryngology Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK

Department of Otorhinolaryngology and Head and Neck Surgery Regional Hospital Pardubice Pardubice Czech Republic

Department of Otorhinolaryngology Flavour Clinic University Clinic for Flavour Balance and Sleep Regional Hospital Gødstrup Herning Denmark

Department of Otorhinolaryngology Jikei University School of Medicine Tokyo Japan

ENT Department Cliniques Universitaires Saint Luc Brussels Belgium

ENT Department Guy's and St Thomas' NHS Trust London UK

ENT Department Pinderfields Hospital Mid Yorkshire Hospitals NHS Trust Wakefield UK

Faculty of Health Studies University of Pardubice Pardubice Czech Republic

Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain

Institute of Neuroscience Université Catholique de Louvain Brussels Belgium

Norwich Medical School Norwich UK

Rhinology Olfactory Unit Department of Otorhinolaryngology Head and Neck Surgery University Hospital of Geneva Medical School Geneva Switzerland

Rhinology Unit and Smell Clinic ENT Department Hospital Clinic University of Barcelona Barcelona Spain

Royal National and ENT Hospital London UK

Skull Base Unit ENT Department Hospital Clinic Barcelona University Barcelona Spain

Smell and Taste Clinic Department of Otolaryngology TU Dresden Dresden Germany

The Norfolk Smell and Taste Clinic Norfolk and Waveney ENT Service James Paget and Norfolk and Norwich University Hospitals Norfolk UK

UCL Ear Institute University College London London UK

Zobrazit více v PubMed

Desiato VM, Levy DA, Byun YJ, Nguyen SA, Soler ZM, Schlosser RJ. The prevalence of olfactory dysfunction in the general population: a systematic review and meta-analysis. Am J Rhinol Allergy. 2021;35(2):195-205.

Mullol J, Alobid I, Mariño-Sánchez F, Quintó L, de Haro J, Bernal-Sprekelsen M, et al. Furthering the understanding of olfaction, prevalence of loss of smell and risk factors: a population-based survey (OLFACAT study). BMJ Open [Internet]. 2012;2:e001256 Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3533119&tool=pmcentrez&rendertype=abstract

Smith B, Hopkins C, Whitcroft K, Kelly C, Burges Watson DL, Deary V. COVID and society: accessing healthcare before, during and after the pandemic [Internet]. London, UK: British Academy for the Humanities and Social Sciences; 2021. p. 1-30 Available from: https://www.thebritishacademy.ac.uk/publications/covid-decade-accessing-healthcare-before-during-after-pandemic/

British Academy for the Humanities and Social Sciences. The COVID decade: understanding the long-term societal impacts of COVID-19 [Internet]. London, UK: British Academy for the Humanities and Social Sciences; 2021 Available from: https://www.thebritishacademy.ac.uk/documents/3238/COVID-decade-understanding-long-term-societal-impacts-COVID-19.pdf

Croy I, Nordin S, Hummel T. Olfactory disorders and quality of life-an updated review. Chem Senses. 2014;39(3):185-194.

Williams GS, Ramachandran K, Nall L, Fong J, Mathews J. Management of post-infectious olfactory dysfunction: a nationwide survey of UK ENT consultants. B-ENT. 2009;5(3):163-167.

Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, et al. Position paper on olfactory dysfunction. Rhinol Suppl [Internet]. 2017;54(26):1-30. Available from: www.rhinologyjournal.com

Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, et al. International consensus statement on allergy and rhinology: olfaction. Int Forum Allergy Rhinol. 2022;12(4):327-680.

Miwa T, Ikeda K, Ishibashi T, Kobayashi M, Kondo K, Matsuwaki Y, et al. Clinical practice guidelines for the management of olfactory dysfunction-secondary publication. Auris Nasus Larynx [Internet]. 2019;46(5):653-662. https://doi.org/10.1016/j.anl.2019.04.002

Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, et al. Position paper on olfactory dysfunction: 2023. Rhinol. 2023; In press. https://doi.org/10.4193/Rhin22.483

Fahmy M, Whitcroft K. Psychophysical testing in chemosensory disorders. Curr Otorhinolaryngol Rep [Internet]. 2022;10:393-404. https://doi.org/10.1007/s40136-022-00429-y

Burns KEA, Duffett M, Kho ME, Meade MO, Adhikari NKJ, Sinuff T, et al. A guide for the design and conduct of self-administered surveys of clinicians. Can Med Assoc J [Internet]. 2008;179(3):245-252. https://doi.org/10.1503/cmaj.080372

Slattery EL, Voelker CCJ, Nussenbaum B, Rich JT, Paniello RC, Neely JG. A practical guide to surveys and questionnaires. Otolaryngol Head Neck Surg. 2011;144(6):831-837.

Hopkins C, Alanin M, Philpott C, Harries P, Whitcroft K, Qureishi A, et al. Management of new onset loss of sense of smell during the COVID-19 pandemic-BRS consensus guidelines. Clin Otolaryngol. 2021;46(1):16-22.

Landis BN, Hummel T, Hugentobler M, Giger R, Lacroix JS. Ratings of overall olfactory function. Chem Senses. 2003;28(8):691-694.

Philpott CM, Wolstenholme CR, Goodenough PC, Clark A, Murty GE. Comparison of subjective perception with objective measurement of olfaction. Otolaryngol Head Neck Surg. 2006;134(3):488-490.

Philpott CM, Rimal D, Tassone P, Prinsley PR, Premachandra DJ. A study of olfactory testing in patients with rhinological pathology in the ENT clinic. Rhinology. 2008;46(1):34-39.

Delank KW, Stoll W. Olfactory function after functional endoscopic sinus surgery for chronic sinusitis. Rhinology. 1998;36:15-19.

Hutson K, Kumaresan K, Johnstone L, Philpott C. The use of MRI in a tertiary smell and taste clinic: lessons learned based on a retrospective analysis. Clin Otolaryngol. 2022;47(6):656-663.

McNeill E, Ramakrishnan Y, Carrie S. Diagnosis and management of olfactory disorders: survey of UK-based consultants and literature review. J Laryngol Otol [Internet]. 2007;121(8):713-720. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-34447618781&partnerID=40&md5=2a614bf26711d9d5370b6a4a9c137745

Palla B, Callahan N, Miloro M. One survey to rule them all. J Oral Maxillofac Surg. 2021;79(2):282-285.

VanGeest J, Beebe T, Johnson T. Surveys of physicians. In: Johnson PT, editor. Handbook of health survey methods [Internet]. Hoboken, NJ, USA: John Wiley & Sons, Inc.; 2014. p. 515-543. https://doi.org/10.1002/9781118594629