The Unmet Need of Olfactory Testing in Inflammatory Disorders of the Upper Airways—An EAACI Position Paper

Research output: Contribution to journal › Research article › Contributed › peer-review

Contributors

  • L. Klimek - , Center for Rhinology and Allergology Wiesbaden (Author)
  • J. Mullol - , University of Barcelona (Author)
  • Th Hummel - , Department of Otorhinolaryngology, Head and Neck Surgery (Author)
  • S. del Giacco - , University of Cagliari (Author)
  • C. Georgalas - , University of Nicosia (Author)
  • C. Rondon - , Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA) (Author)
  • M. Schiappoli - , Verona Integrated University Hospital (Author)
  • P. Gevaert - , Ghent University (Author)
  • B. Bozkurt - , Selcuk University (Author)
  • A. Chaker - , Technical University of Munich (Author)
  • S. Reitsma - , University of Amsterdam (Author)
  • L. van Gerven - , KU Leuven (Author)
  • J. Maza-Solano - , Hospital Universitario Virgen Macarena, University of Seville (Author)
  • M. Lundberg - , University of Helsinki (Author)
  • S. Becker - , University Hospital Tübingen (Author)
  • F. Bärhold - , Center for Rhinology and Allergology Wiesbaden (Author)
  • A. Karavelia - , General Hopsital of Nafplio (Author)
  • M. Cuevas - , Department of Otorhinolaryngology, Head and Neck Surgery (Author)
  • M. Gröger - , Ludwig Maximilian University of Munich (Author)
  • P. Huber - , Ludwig Maximilian University of Munich (Author)
  • S. Arasi - , IRCCS Ospedale pediatrico Bambino Gesù - Roma (Author)
  • C. Cingi - , Osmangazi University (Author)
  • M. Jesús Rojas-Lechuga - , University of Barcelona, Hospital Clinic of Barcelona, Instituto Nacional de Enfermedades Respiratorias (Author)
  • A. Izquierdo-Domínguez - , Terrassa Health Consortium, Centro Medico Teknon, Clinica Diagonal (Author)
  • I. Agache - , Transilvania University of Brasov (Author)
  • R. Gawlik - (Author)
  • M. Sokolowska - , University of Zurich (Author)
  • I. M. Adcock - , Imperial College London (Author)
  • G. Celik - , Prof.Dr. Gülfem Elif Çelik - Private Practice of Allergy and Immunology, Ankara University (Author)
  • M. Escribese - , CEU San Pablo University (Author)
  • J. Walusiak-Skorupa - , Nofer Institute of Occupational Medicine (Author)
  • C. Betz - , University of Hamburg (Author)
  • O. Palomares - , Complutense University (Author)
  • A. Moreira - , University of Porto, São João Hospital (Author)
  • P. Bonadonna - , Verona Integrated University Hospital (Author)
  • M. Shamji - , Imperial College London (Author)
  • M. J. Torres Jaen - , Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA) (Author)
  • C. Akdis - , University of Zurich (Author)
  • J. Hagemann - , Center for Rhinology and Allergology Wiesbaden, University Medical Center Mainz (Author)
  • V. Hox - , Université catholique de Louvain (Author)
  • S. Toppila-Salmi - , University of Eastern Finland, North Savo Wellbeing Services County, University of Helsinki (Author)

Abstract

The sense of smell, with its extensive evolutionary history, is highly prone to disorders that can have a profound impact on daily life. Anosmia affects approximately 5% of the population, with an additional 15% exhibiting reduced olfactory function. The prevalence of olfactory dysfunction (OD) varies by population and age group, and standardized testing reveals a broad range of impacts. OD includes various causes, most commonly aging, inflammation of the olfactory epithelium, upper respiratory tract infections (URTI), traumatic brain injury, and neurological conditions. The recent COVID-19 pandemic has highlighted the association between viral infections and olfactory dysfunction, with severe hyposmia/anosmia being an early marker of infection. Despite its importance, the assessment of olfactory function remains inconsistent across clinical practices. Psychophysical smell tests, while vital for diagnosis and patient management, are underutilized, especially outside of specialized centers. Standardized testing methods are crucial for objective diagnosis, but significant challenges, including test variability, lack of comparability, and healthcare reimbursement issues, persist. The European Academy of Allergy and Immunology (EAACI) advocates for improvements in the quality and standardization of chemosensory assessments. Future efforts must prioritize education, incentives for better testing, and the integration of digital tools to expand access to olfactory testing and diagnosis in remote or quarantine situations. However, office-based testing remains irreplaceable, even with advancements in telemedicine.

Details

Original languageEnglish
Pages (from-to)2633-2655
Number of pages23
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume81
Issue number8
Publication statusE-pub ahead of print - 2 Feb 2026
Peer-reviewedYes

External IDs

ORCID /0000-0001-9713-0183/work/205992138
ORCID /0009-0007-1117-2210/work/205993017

Keywords

ASJC Scopus subject areas

Keywords

  • chemosensory function, COVID-19, gustation, olfaction, taste, upper airway disease