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SOSI White Paper:
Quality of Life in Olfactory Dysfunction |
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Patient Evaluation
The first step in patient evaluation 46-48 is to take a thorough history. This should include demographics, eating, drinking or smoking habits, listing of major illnesses and injuries, medications taken in relation to symptom onset, history of present illness, endocrine information including questions regarding menstrual status or thyroid function, general nasal health including obstruction, rhinorrhea, and postnasal drip, and finally, changes of the sense of smell. Physical examination typically includes the patient's head and neck; the remainder of the investigation may be directed by the patient's history. Frequently, a detailed neurological examination may become necessary. Specific nasal examination should include at least rhinoscopy, although nasal endoscopy is clearly preferable. Radiological evaluation may be helpful to rule out the presence of olfactory meningeomas, pituitary tumors, frontal lobe gliomas, large aneurysmas, or other cerebral tumors. A CT scan may also be useful in the diagnosis of olfactory loss to be conductive 58. Magnetic resonance tomography may be helpful in the diagnosis of congenital olfactory loss 59. Additional diagnostic tests may include the search for other underlying causes of the olfactory disorders, e.g., diabetes, hypothyroidism, lupus, zinc deficiency, or deficiency of vitamin A or B12. Finally, biopsies of the olfactory epithelium may become helpful in the diagnosis of olfactory disorders 60.
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