1481 Is Imaging for the Evaluation of Anosmia Really Necessary?
Abstract Aim Although it is rare for anosmia to be caused by olfactory lesions, it is commonplace for some form of imaging to be undertaken to investigate olfactory loss in patients. This study aimed to identify the pick-up rate of pathology in patients who had an isolated complaint of anosmia. Method We undertook a retrospective study over a 2-year period between 2018 to 2020 in a teaching hospital. The cases were identified using the hospital radiology database for patients referred for CT or MRI of their head or sinuses due to anosmia. Patients referred with symptoms other than olfactory loss were excluded. Results Out of the 132 scans undertaken in this period, 52 were included with 47 being MRI scans. There were 5 (10%) patients who had intracranial pathology identified and these were all on MRI scans. Only 2 (4%) cases had actual olfactory tract-related abnormalities. This included absent olfactory bulbs and a soft tissue lesion within the region of the olfactory apparatus. Conclusions This study suggests a 4% pick up rate of olfactory tract-related pathology which demonstrates some value when investigating anosmia. However, with the large number of scans that do not alter management and the ever-increasing burden on our health system, large scale studies are needed to develop an evidence-based risk stratification approach.