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Objectives: This study aimed to determine the characteristics of patients with qualitative olfactory dysfunction (qualOD) and whether individuals with parosmia exhibit increased olfactory sensitivity to previously reported odorous triggers of parosmia. Methods: This study included individuals aged ≥18 years, divided into quantitative OD only, parosmia, and phantosmia groups. Data collected included: clinical‐demographic data, "Sniffin' Sticks" scores, questionnaires (depression scale, importance of olfaction), and information about parosmia and phantosmia. A proportion of patients underwent trigger odor threshold testing for 2‐Furfurylthiol [FFT] found in coffee and 2,6‐nonadienal [Nonadienal] found in cucumber. Results: Those with parosmia were typically younger women, with shorter OD duration due to post‐viral OD (PVOD), hyposmic/normosmic, and experienced parosmia more severely. Parosmia was 3.5 times more likely in PVOD. Those with phantosmia were older, with longer OD duration due to idiopathic OD, hyposmic/anosmic, and experienced phantosmia less severely. There were no significant differences between FFT and Nonadienal threshold scores in patients with parosmia, phantosmia, or only quantitative OD, but all groups had significantly increased olfactory sensitivity for trigger odors compared to phenyl ethyl alcohol (PEA). Conclusion: Parosmia and phantosmia patients have distinct characteristics. This may provide clinicians with a better understanding of possible olfactory outcomes in these patients. The higher olfactory sensitivity of all groups to trigger odors compared to PEA raises interesting points about parosmia triggers and odors in the context of warning for danger, in relation to the pathophysiology of parosmia that may be worth exploring in future studies. Level of Evidence: 3 Laryngoscope, 134:3277–3285, 2024 [ABSTRACT FROM AUTHOR]

Introduction: Zinc deficiency may worsen the severity of olfactory dysfunction; however, the relationship between serum zinc levels and therapeutic effects on olfactory dysfunction remains uncertain. This study investigated the relationship between normalising serum zinc levels and the therapeutic effects on olfactory dysfunction. Methods: Forty-two patients diagnosed with post-infectious, post-traumatic, and idiopathic olfactory dysfunction, with serum zinc levels <70 μg/dL, were included in the study. All patients were treated with mecobalamin, tokishakuyakusan, and polaprezinc. The patients were divided into 2 groups: the zinc-normalised (≥70 μg/dL) and zinc-deficient (<70 μg/dL) groups, based on their post-treatment serum zinc levels. Olfactory test results were compared in each of the 2 groups. Results: The patients were treated for a median of 133 days. The zinc-normalised group had significantly better results in all olfactory tests (detection/recognition thresholds of the T&T olfactometer, odour identification test (Open Essence), Visual Analogue Scale for olfactory dysfunction, and self-administered odour questionnaire). In contrast, only the self-administered odour questionnaire showed a significant improvement in the zinc-deficient group, with no significant differences observed in the other olfactory tests. When comparing the changes in the olfactory test scores between the 2 groups, significant differences were observed in the detection/recognition thresholds of the T&T olfactometer test and Open Essence results. Conclusion: These findings suggest that patients with olfactory dysfunction may have difficulty improving their olfactory function if they also have zinc deficiency. Furthermore, normalisation of zinc deficiency may contribute to the improvement of olfactory dysfunction with general treatment. Plain Language Summary: This study examined how zinc levels relate to problems with smelling, which is called olfactory dysfunction. We studied 42 participants who had trouble smelling due to infections, injuries, or unknown reasons and who also had low zinc levels in their blood. After the participants consumed a zinc supplement to treat their low zinc levels, we placed the participants either in the group for those who had their zinc levels go back to normal or in the group for those who remained zinc deficient. We tested the participants' sense of smell in different ways, including using an olfactometer, a card with different scents, and questionnaires. The group with normal zinc levels did much better in all the smell tests; the zinc-deficient group only improved in 1 test, which was the questionnaire. These results suggest that if someone has trouble smelling and they also lack the appropriate level of zinc, it might be difficult for them to get better. However, if they can improve their zinc level and bring it to a normal level, their sense of smell could improve. In summary, this study demonstrated a connection between zinc levels and smelling ability, indicating that repairing zinc deficiency may aid in treating olfactory dysfunction. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]