Testing your olfactary nerve

A head-to-toe physical exam includes a neurological assessment and physicians are expected to test the function of the cranial nerves (CN). The olfactary nerve, CN I, is responsible for perceiving smells.

When examining a patient, especially in the outpatient setting, olfactary nerve assessment is skipped because there is a lack of distinct smelling things native to the exam room that the physician can use. This likely means that unless the patient reports a smell-related problem any issues would likely go undetected. With COVID and post-infection syndromes, routine population-level testing of smell may be clinically useful in identifying patients with such conditions.

So, how to test a patient’s olfactory nerve? Hand sanitizer has a distinct smell. Physicians can take some hand sanitizer and hold it up near the patient’s nose and ask them if they can smell it.

Implementing this is a matter of policy at the level of each hospital systmem. There is no logistical considersations because hand sanitizer is already available near all patient rooms in clinics and hospitals.