ALLERGIC RHINITIS AND OLFACTORY LOSS

Background: Allergic rhinitis is associated with reports of olfactory loss, but there are few formal investigations. Patients with diminishe d smell function frequently have nasal polyps or sinusitis, making it difficult to separate the impact of allergic rhinitis from the effects of these other problems. Objective: The goals of this descriptive stu dy were to establish the prevalence of positive skin tests in patients reporting rhinitis and olfactory deficiency, and to assess olfactory function and the results of skin testing in a patient group with chron ic rhinitis but without concomitant sinusitis or nasal polyps. Methods : Sixty-two patients reporting olfactory loss and chronic rhinitis wer e examined by history, physical examination, olfactory testing, skin t esting with perennial and seasonal allergens, endoscopic rhinoscopy, a nd CT scan of the paranasal sinuses. Results: Seventy-one percent of a ll the subjects had at least one positive skin test, 69% to a perennia l allergen, and 58% to mite. Eighty-two percent of the 28 subjects wit h chronic rhinitis but no evidence of polyps or sinusitis had positive tests. The mean olfactory score for this rhinitis group was 4.35, con sistent with moderate hyposmia. The mean olfactory score of 34 subject s with polyps and/or chronic sinusitis was 0.61, consistent with anosm ia, and significantly lower (P < .001). Sixty-two percent of this grou p had positive skin tests. Conclusion: These subjects who experienced olfactory loss and rhinitis appeared to have a high prevalence of alle rgic rhinitis as suggested by the number of positive skin tests. Olfac tory loss was observed in patients without polyps or sinusitis, which suggests that allergic processes may have affected olfactory function.