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Olfactory loss

BMJ 2007; 334 doi: 10.1136/bmj.39035.624583.68 (Published 22 February 2007)
Cite this as: BMJ 2007;334:423

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  1. E Ofo, specialist registrar in otolaryngology1,
  2. B O'Reilly, ear, nose, and throat consultant1,
  3. A O'Doherty, general practitioner2
  1. 1Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Basildon SS16 5NL
  2. 2Hassengate Medical Centre, Stanford-le-Hope SS17 0PH
  1. Correspondence to: E Ofoeofo{at}hotmail.com

    A 65 year old man presents with loss of smell and altered taste, affecting his appetite and food intake. He had an upper respiratory tract infection before the onset of symptoms nine months ago. Initially, normal odours were distorted, followed by a constant foul smell for three months, and then complete loss of smell.

    What issues you should cover

    Olfactory disorder or true taste complaint— Altered olfaction is common and invariably causes flavour loss, which most patients perceive as taste dysfunction. The ability to taste salt, sour, bitter, and sweet remains intact, as it is a function of the chorda tympani nerve with contribution from the glossopharngeal and vagus nerves.

    Degree of olfactory dysfunction—Anosmia is complete loss of the sense of smell. Most patients have hyposmia (decreased sensitivity to some or all odorants). Cacosmia is the detection of …

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