title: Rapidly fluctuating anosmia: A clinical sign for unilateral smell impairment.
abstract: Reports about fluctuating olfactory deficits are rare, as are reports of unilateral olfactory loss. We present a case of unilateral anosmia with contralateral normosmia, presenting as rapidly fluctuating anosmia. The olfactory fluctuation occurred in sync with the average nasal cycle duration. Examination after nasal decongestion, formal smell testing, and imaging revealed unilateral, left-sided anosmia of sinonasal cause, with right-sided normosmia. We hypothesize that the nasal cycle induced transient anosmia when blocking the normosmic side. Fluctuating olfactory deficits might hide a unilateral olfactory loss and require additional unilateral testing and thorough workup.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Bern University Hospital, Bern, Switzerland.
authors.forename: Simona
authors.initials: S
authors.lastname: Negoias
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Bern University Hospital, Bern, Switzerland.
authors.forename: Hergen
authors.initials: H
authors.lastname: Friedrich
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Bern University Hospital, Bern, Switzerland.
authors.forename: Marco D
authors.initials: MD
authors.lastname: Caversaccio
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Bern University Hospital, Bern, Switzerland.|Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland.
authors.forename: Basile N
authors.initials: BN
authors.lastname: Landis
mesh_terms: D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000503:physiopathology; D012008:Recurrence; D012903:Smell / Q000502:physiology*; D014057:Tomography, X-Ray Computed
keywords: Smell disorders; fluctuating olfactory loss; nasal cycle; sinonasal; unilateral anosmia