How often do we ask about sense of smell in children? Undoubtedly, the olfactory function is seldom formally assessed in the paediatric population, although evidence exists to suggest its potential links with handicap in children’s learning and development. This large multi-centre study, termed OLFAPEDRIAL, involving 1260 children, is novel in assessing the olfactory dysfunction in allergic paediatric population, which can often be underestimated in clinical practice. Using the ARIA classification, the severity of smell dysfunction and disease duration for allergic rhinitis was subjectively assessed in children aged between 6 and 12 years.
From this study, the authors presented two key findings: i) the sense of smell is moderately impacted in children with allergic rhinitis and ii) its prevalence increases with the duration and severity of the disease, where it is more commonly reported in persistent than in intermittent allergic rhinitis.
These results have echoed the findings in the adult allergic rhinitis population, where intranasal steroid remains the mainstay of treatment in improving olfactory impairment. While the impact on the sense of smell in children with allergic rhinitis is yet to be fully established, based on the findings, the authors proposed for the olfactory dysfunction to be considered as a clinical marker for disease severity in allergic rhinitis. Next time, when I meet a child with allergic rhinitis in the clinic, I shall not forget to ask if they can still smell their favourite cookie baking in the oven.