May 2019

Olfactology—the medical science of evaluation and treatment of smell and taste diseases

There are over 21 million people in the United States who suffer the consequences of diseases of smell and taste but there is no medical entity or physician group who specifically addresses this enormous clinical problem. At present patients with these medical complaints consult physicians such as otolaryngologists, neurologists, internists or general physicians who have little experience or knowledge of how to deal with these problem. This leaves the patients with little help for them to obtain medical evaluation or treatment.

I propose that we establish a new medical discipline called OLFACTOLOGY dealing directly with the discipline of diseases of smell and taste. While defining the discipline involves epistimology it also defines a medical discipline directed specifically at the evaluation and treatment of these common but at present poorly publicized medical problems. This discipline may become an independent medical field or an ancillary medical field as a part of another discipline such as otolaryngology or neurology. However, I propose that it should be an independent entity with the physicians dealing with these diseases defined as OLFACTOLOGISTS.

Olfactology is the definition of this newly proposed medical specialty. It is similar in some ways to ophthalmology which is the definition of the medical specialty for evaluation and treatment of eye and vision diseases. I consider myself an olfactologist but other, although not many, physicians can also be described as olfactologists since they also deal with diseases of smell and taste. This definition distinguishes olfactologists from non medical practitioners who can be defined as olfactometrists who simply measure smell and taste function. These latter professionals classified as olfactometrists are similar to those in the ophthalmology field defined as optometrists who evaluate people with disorders of visual acuity and who fit eye glasses for patients with problems of vision acuity. However, systematic evaluation and treatment of eye diseases fall upon the shoulders of olfactologists not olfactometrists.

While presently there are many scientists who practice olfactometry there are few physicians who at present practice the medical role of olfactologist. One of my goals is to identify other physicians who wish to practice olfactology and encourage them so that this aspect of their specialization may become more apparent.

Ophthalmologists use sophisticated measuring techniques to measure and assess sensory aspects of diseases of the eye and vision. Olfactologists can also use sophisticated techniques to measure smell and taste function systematically to evaluate sensory aspects of smell and taste diseases. These techniques are labeled olfactometry and gustometry. These systematic measurement techniques allow for the functional determination of sensory dysfunction of smell and taste diseases. These tests not only define levels of sensory acuity but also the presence of sensory distortions. They determine the function of sensory receptors, sensory nerves, brain function and the interactions among each of these factors which are integrated into the tripartite system of sensory receptors, sensory nerves and brain which are necessary to perform what is considered to be normal of smell and taste function.

Olfactologists also use several biochemical aspects of pathology to diagnosis diseases of smell and taste utilizing saliva and nasal mucus as the substrate. There are also several specific medical treatments by which these diseases can be treated. Understanding these biochemical changes and these treatments offer the olfactologist the tools necessary to evaluate and treat these diseases. There must be controlled clinical trials to determine safety and efficacy of treatment for these diseases and several of these trials are now in the planning process. The National Institutes of Health should be encouraged to help to establish this discipline and to assist in the performance of clinical trials necessary to obtain FDA approval for the various therapies used to treat these diseases.

At present otolaryngologists and neurologists perform some of these tasks. With the definition of olfactology it will be possible to carry out a specific professional role for physicians who deal with the evaluation and treatment of smell and taste diseases.