Director, The Taste and Smell Clinic, Washington, DC, USAUnited States
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There is a hidden epidemic of hyposmia in the United States. While most otolaryngologists may see one or two patients with hyposmia yearly there are as many as 21 million people in the United States with hyposmia. Most of these patients experienced hyposmia following an influenza-like infection.
OTOLARYNGOLOGY ISSN 2470-4059 http://dx.doi.org/10.17140/OTLOJ-1-e001 Open Journal Editorial The Hidden Epidemic of Smell Loss * *Corresponding author (Hyposmia) in the United States Robert Henkin, MD, PhD Director The Taste and Smell Clinic * Robert Henkin Washington, DC, USA E-mail: doc@tasteandsmell.com Director, The Taste and Smell Clinic, Washington, DC, USA Volume 1 : Issue 1 Article Ref. #: 1000OTLOJ1e001 There is a hidden epidemic of hyposmia in the United States. While most otolaryngol- ogists may see one or two patients with hyposmia yearly there are as many as 21 million people Article History in the United States with hyposmia.1 Most of these patients experienced hyposmia following th Received: October 12th, 2015 an influenza-like infection.2 Data suggest that there are 30 million patients who experience a th Accepted: October 12th, 2015 flu-like illness yearly; our data suggest that about 1% of these patients develop permanent hy- th Published: October 12th, 2015 posmia or about three million people develop and suffer with this symptom on a yearly basis. As many as two million patients who have what can be termed allergic rhinitis suffer with hyposmia on a chronic basis.2 Otolaryngologists do see these patients but if they do not exhibit Citation rhinitis, sinusitis or nasal polyps the patient’s hyposmia may not be paramount in their evalua- Henkin R. The hidden epi- demic of smell loss (hyposmia) tion or treatment. Patients with hyposmia after a traumatic brain injury represent a third major in the United States. Otolaryn- etiology of hyposmia with as many as 500,000 patients exhibiting a persistent hyposmia after gol Open J. 2015; 1(1): e1-e2.
their head injury. Hyposmia associated with aging, head and neck radiation or chemotherapy, doi: 10.17140/OTLOJ-1-e001 Parkinson’s disease or other metabolic or neurological issues constitute a part of this epidemic which is not recognized by otolaryngologists as a major medical problem.
While hyposmia may not be life threatening for most of these patients their lives are inhibited by their inability to obtain flavor from food, enjoy social events around meals or to smell both pleasant and unpleasant or dangerous odors. Most patients are deeply disturbed and can become depressed by this loss and search unsuccessfully for methods to restore their smell function.
The major problems related to this epidemic are lack of understanding of the mecha- nisms responsible for it, how to evaluate it or how to treat it.
Most patients with hyposmia do not have an anatomical or neurological etiology as the cause of their loss. Most patients exhibit hyposmia related to abnormalities of their olfactory receptors which are damaged by the viral RNA associated with their influenza or by an underly- ing immunological pathology associated with their rhinitis.2 Most otolaryngologists do not have the equipment to evaluate quantitatively the sen- sory changes about which the patients complain. We have established specific testing tech- niques to help to evaluate these patients.2 Results of these tests define the roles of the receptors, the brain and the interaction between the receptors and brain play in hyposmia.
Most otolaryngologists are unaware that drugs are available to treat these patients.2 Many studies have demonstrated that treatment with oral theophylline has been successful in restoring smell function in many of these patients.3 And recently, intranasal theophylline has Copyright been even more efficient in helping these patients restore their smell function.4 ©2015 Henkin R. This is an open access article distributed under the It is up to otolaryngologists to understand the extent of this epidemic and to respond Creative Commons Attribution 4.0 International License (CC BY 4.0), to it with the same energy and enthusiasm that they extend to their surgical practice for which which permits unrestricted use, they were well trained. Recognition of this hidden epidemic is the first step in its evaluation. distribution, and reproduction in Understanding the mechanisms which initiated it and its treatment will help otolaryngologists any medium, provided the original deal with this hidden epidemic.
OTOLARYNGOLOGY ISSN 2470-4059 http://dx.doi.org/10.17140/OTLOJ-1-e001 Open Journal