Allergic rhinitis and olfactory loss.

BACKGROUND: Allergic rhinitis is associated with reports of olfactory loss, but there are few formal investigations. Patients with diminished 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 study 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 chronic rhinitis but without concomitant sinusitis or nasal polyps. METHODS: Sixty-two patients reporting olfactory loss and chronic rhinitis were examined by history, physical examination, olfactory testing, skin testing with perennial and seasonal allergens, endoscopic rhinoscopy, and CT scan of the paranasal sinuses. RESULTS: Seventy-one percent of all the subjects had at least one positive skin test, 69% to a perennial allergen, and 58% to mite. Eighty-two percent of the 28 subjects with chronic rhinitis but no evidence of polyps or sinusitis had positive tests. The mean olfactory score for this rhinitis group was 4.35, consistent with moderate hyposmia. The mean olfactory score of 34 subjects with polyps and/or chronic sinusitis was 0.61, consistent with anosmia, and significantly lower (P < .001). Sixty-two percent of this group had positive skin tests. CONCLUSION: These subjects who experienced olfactory loss and rhinitis appeared to have a high prevalence of allergic rhinitis as suggested by the number of positive skin tests. Olfactory loss was observed in patients without polyps or sinusitis, which suggests that allergic processes may have affected olfactory function.