title: Health-related and specific olfaction-related quality of life in patients with chronic functional anosmia or severe hyposmia.
abstract: OBJECTIVE
  To measure health-related and olfaction-related quality of life (QoL) in patients with permanent, severe hyposmia or functional anosmia.
  
  
  METHODS
  A case study in a university ENT department of patients with severe olfactory dysfunction defined by Sniffin' Sticks olfactory test kit with a score for odor threshold, discrimination, and identification (TDI) < 20 and a dysfunction lasting longer than 6 months.
  
  
  METHODS
  Assessment of QoL by using the SF-36 Health Survey questionnaire and the Questionnaire for Olfactory Dysfunction (QOD).
  
  
  RESULTS
  A total of 958 patients were tested for smell disturbances from 1999 to 2009. Surveys were mailed to 527 patients who fulfilled the inclusion criteria; 280 (53%) returned completed surveys. All SF-36 domains in severely hyposmic and anosmic patients were lower than in the German normal population. Lower SF-36 QoL was found for some domains in female patients, older patients, and hyposmic patients (P < .05 for all groups). Based on the QOD, women showed more parosmia, and anosmic patients had more olfactory-related impairment (P < .05 for both); in general, higher olfactory impairment and higher parosmia score measured by QOD correlated with lower TDI values (all P < .05). Multivariate analysis revealed, for SF-36 domains, the following independent risk factors: female sex was a risk factor for bodily pain; higher age was a risk factor for physical functioning and role, bodily pain, and general health; hyposmia was a risk factor for bodily pain and mental health; QOD QoL was a risk factor for all SF-36 scales; and QOD parosmia was a risk factor for physical role (all P < .05).
  
  
  CONCLUSIONS
  QoL is severely impaired in patients with chronic severe hyposmia or anosmia. The QOD allows a more olfaction-specific assessment of QoL than the SF-36 instrument.
authors.affiliation: Department of Otorhinolaryngology, Friedrich-Schiller-University Jena, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Neuland
authors.forename: Thomas
authors.initials: T
authors.lastname: Bitter
authors.forename: Heike
authors.initials: H
authors.lastname: Marschner
authors.forename: Hilmar
authors.initials: H
authors.lastname: Gudziol
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D000857:Olfaction Disorders / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012803:Sick Role; D011795:Surveys and Questionnaires; D055815:Young Adult