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Basile Nicolas Landis, MD; Johannes Frasnelli, MD; Jens Reden, MD; Jean Silvain Lacroix, MD, PhD; Thomas Hummel, MD

Arch Otolaryngol Head Neck Surg. 2005;131:977-981.

Objective  To investigate differences between orthonasal and retronasal olfaction in patients with loss of the sense of smell without taste complaints.

Design  Electrophysiological and psychophysical testing of orthonasal and retronasal olfactory functions.

Setting  Outpatient clinics.

Patients  A series of 18 patients who had olfactory loss due to various reasons but no "taste" complaints.

Main Outcome Measures  Orthonasal and retronasal olfactory functions assessed by olfactory event–related potentials and psychophysical smell tests.

Results  Psychophysical testing revealed retronasal olfaction to be normal or slightly altered, whereas orthonasal olfaction was either absent or severely compromised. Findings from nasal endoscopic examinations and computed tomographic scans were within the reference range in all subjects. In response to orthonasal stimulation there were neither detectable olfactory event–related potentials nor any with small amplitudes, whereas olfactory event–related potentials in response to retronasal stimulation were clearly present in some patients.

Conclusion  These clinical observations, together with the psychophysical and electrophysiological findings, suggest that orthonasal and retronasal olfaction might be processed differently.

Author Affiliations: Rhinology-Olfaction Unit, Department of Otorhinolaryngology, University Hospital of Geneva, Geneva, Switzerland (Drs Landis and Lacroix); and Smell and Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany (Drs Frasnelli, Reden, and Hummel).

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