Is imaging necessary in the evaluation of the patient with an isolated complaint of anosmia?
Imaging studies are often obtained during the evaluation of the patient with an olfactory deficit. The purpose of this article is to describe an investigation that was conducted to assess the effectiveness of imaging studies in determining the etiology of olfactory loss in the patient with an isolated complaint of anosmia and no relevant findings on physical examination, including nasal endoscopy. The author conducted a retrospective review of the records of 20 women and eight men, aged 22 to 71 years (mean: 45), whose duration of anosmia had ranged from 1 month to 2 years (median: 3 mo). Twenty of these patients had undergone contrast-enhanced magnetic resonance imaging of the paranasal sinuses and brain, and the other eight had undergone enhanced computed tomography. The author found that these imaging studies did not add to the information obtained by the clinical history and endoscopic nasal examination and were thus not useful in determining the cause of anosmia. Based on these findings, the author does not recommend that imaging studies be included as part of the evaluation of these patients.
Busaba
N Y
NY
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Division of Otolaryngology, Boston VA Healthcare System, Department of Otology and Laryngology, Harvard Medical School, Boston, USA. nicolas_busaba@meei.harvard.edu
D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed