Authors (including presenting author) :
Leung HK(1), Tam MY(1), Wong HK(1), Yeung CY(1), Chow MW(1)(2), Lai CF(1)(2), Li WY(1)(2), Mak WH(1), Yeung CM(1)(2)
Affiliation :
(1)Department of Ear, Nose, and Throat, NTEC, (2)Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong
Keyword 1: :
Smell service
Keyword 2: :
Smell assessment
Keyword 3: :
Smell training
Keyword 4: :
Olfactory function
Introduction :
The sense of smell plays a vital role in flavor perception, safety through hazard detection, and emotional well-being. Olfactory disorders can significantly diminish quality of life and are associated with psychological and neurological conditions like depression and neurodegenerative diseases. Studies have estimated a 13.5% prevalence of smell impairment, yet fewer than 25% of the affected individuals are diagnosed let alone treated. There is currently an absence of dedicated smell services within the Hospital Authority (HA), thereby leaving the olfactory function of many patients unassessed. This gap hinders the identification of dysfunction severity, potential interventions such as smell training—which is evidence-based and cost-effective—and the evaluation of treatment efficacy. Furthermore, pre-existing smell loss is often overlooked to associated Rhinological conditions prior to medical or surgical interventions, highlighting the need for systematic olfactory assessments in clinical practice.
Objectives :
To introduce smell services, including comprehensive smell assessment, smell training and counselling in the New Territories East Cluster (NTEC).
Methodology :
Olfactory function is evaluated using validated orthonasal assessments and structured retronasal assessments conducted by subspecialty‑trained smell nurses specializing in the sense of olfaction. Referrals for olfactory assessments are made by Rhinologists within the NTEC for patients in whom olfactory evaluation is essential to the management of rhinological and sinonasal conditions, including pre‑ and post‑treatment assessment and monitoring of treatment efficacy in the context of nasal surgery, biologic therapy, or other suspected olfactory dysfunctions. Counselling and follow-up reviews are integral to facilitate smell recovery and ensure continuity of care.
In collaboration with The Chinese University of Hong Kong (CUHK), smell training programs are offered to individuals with hyposmia or anosmia, aimed at enhancing their olfactory function.
Result & Outcome :
The smell assessment service was piloted in March 2024. From March 2024 to December 2025, 99 patients with various nasal conditions underwent smell assessments. Seventeen patients were classified as normosmic, 34 (34.3%) as hyposmic, and 48 (48.5%) as anosmic. 12 patients were found post-infective hyposmia or anosmia.
The smell training service commenced in November 2025, with 5 patients receiving education from smell nurse. The implementation of smell assessment provides a more objective evaluation of olfactory abilities, contributing to a more comprehensive understanding of nasal condition to aid Rhinologists in their assessments. It also identifies individuals with post-infective olfactory dysfunction, who are likely to benefit from smell training according to latest available evidence. By integrating systematic evaluations and tailored interventions, we empower patients to participate actively in their recovery, addressing their multifaceted needs and ultimately improving their quality of life.
