Short-Course Pentoxifylline Is Not Effective in Post-Traumatic Smell Loss: A Pilot Study

It has been suggested that systemic pentoxifylline may be beneficial in the treatment of olfactory dysfunction. The postulated mechanism of action involves nonselective competitive phosphodiesterase inhibition, leading to increased intracellular cyclic adenosine monophosphate and consequent increased olfactory neuron activity. This should in theory lead to improved olfactory function. We describe a pilot case series from our tertiary referral center of patients treated with oral pentoxifylline for olfactory dysfunction. Six patients with post-traumatic impairment who were treated with systemic pentoxifylline were included. Patients were treated with 200 mg of oral prolonged release pentoxifylline, 3 times a day for 21 days. Olfactory function was tested pre and post-treatment for odor threshold (T), discrimination (D), identification (I) and composite 'TDI' score using a psychophysical test battery, the “Sniffin’ Sticks.” Oral pentoxifylline was well tolerated and all patients completed the treatment period. There was a small improvement in odor threshold and identification scores, but these did not reach statistical or clinical significance. There were deteriorations in discrimination and composite TDI score, which did not reach significance. While our case series was small, systemic pentoxifylline did not appear to be beneficial in the treatment of hyposmia in this patient group.

Download Full-text

4347 Bimodal Visual-Olfactory Training for Post-Surgical or Post-Traumatic Olfactory Dysfunction (VOLT Trial)

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.110 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 23-24

Author(s):

Andrew Michael Peterson ◽

Dorina Kallogjeri ◽

Jay Piccirillo

Keyword(s):

Quality Of Life ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Quality Of Life Questionnaires ◽

Patient Reported ◽

Identification Test ◽

Post Traumatic ◽

Smell Identification ◽

Olfactory Training

OBJECTIVES/GOALS: 1) Assess the patient-reported, perceived change in olfactory function after bimodal visual-olfactory training (OT) 2) Assess change in olfactory function after bimodal visual-olfactory training with a smell identification test 3) Assess which scents are most important to people with olfactory dysfunction (OD) METHODS/STUDY POPULATION: The participants are adults with subjective or clinically diagnosed OD with post-surgical or traumatic etiologies within the last 5 years. At the first of two study visits, participants complete the University of Pennsylvania Smell Identification Test (UPSIT) and complete general health (SF-36) and olfactory-related quality-of-life questionnaires. From a list of 34 scents, participants chose the 4 scents most important to them and smelled the scents twice daily for 3 months. Olfactory testing and the quality-of-life questionnaires were repeated at the final visit. RESULTS/ANTICIPATED RESULTS: 10 participants have enrolled in the study. There was one screen fail and one withdrawal. Six participants are currently undergoing OT and two have completed the study. Seven participants have post-surgical etiology and three have post-traumatic etiology of their OD. Of the two participants who have completed the study, one had an UPSIT score improvement from 25 to 33 out of the 40 questions correct. The minimally clinically important difference on the UPSIT is 4. She reports improvement subjectively. The second participant had a UPSIT score change from 25 to 24 and reports ability to smell is neither better nor worse. DISCUSSION/SIGNIFICANCE OF IMPACT: Traumatic and post-surgical, particularly post-transphenoidal hypophysectomy, are common etiologies of OD and no effective treatments exist. The results from our pilot study will help better inform the best way to undergo OT, how effective it is, and the planning of future studies.

Download Full-text

Differences in Correlation between Subjective and Measured Olfactory and Gustatory Dysfunctions after Initial Ear, Nose and Throat Evaluation

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1722249 ◽

2021 ◽

Author(s):

Hans Jacob Nørgaard ◽

Alexander Wieck Fjaeldstad

Keyword(s):

Case Series ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Clinical Tests ◽

Positive Correlation ◽

Taste Disorder ◽

Strong Indicator ◽

Olfactory Impairment ◽

Chemosensory Function ◽

Nose And Throat

Abstract Introduction Subjective chemosensory function can differ from measured function. Previous studies on olfactory assessment have found a positive correlation between subjective and measured scores. However, information on gustatory correlation between measured and subjective functions is sparse in patients who have undergone an initial ear, nose and throat (ENT) evaluation. Objectives To evaluate the correlation between subjective and measured olfactory and gustatory dysfunctions in a population complaining of taste and/or smell dysfunction after an initial ENT evaluation without chemosensory testing. Furthermore, we aimed to assess the need for chemosensory testing depending on the type of subjective chemosensory dysfunction. Methods A case series in which subjective chemosensory function was assessed through a questionnaire and measured chemosensory function was assessed by validated clinical tests. Results In total, 602 patients with complaints of olfactory and/or gustatory dysfunction were included. We found that 50% of the patients with normal gustatory function and an olfactory impairment classified their olfactory impairment as a subjective taste disorder. Furthermore, 98% of the patients who rated their olfactory function as absent did have a measurable olfactory impairment, but only 64% were anosmic. Conclusion Subjective gustatory dysfunction was poorly correlated with measured gustatory dysfunction, and was often found to reflect olfactory dysfunction. Contrarily, subjective olfactory dysfunction was positively correlated with measurable olfactory dysfunction. Although subjective anosmia was a strong indicator of measured anosmia or hyposmia, the existence of remaining olfactory function was frequently found in these patients. Validated chemosensory testing should be performed in patients with perceived olfactory or gustatory deficits, as this could help ensure increased diagnostic precision and a relevant treatment.

Download Full-text

A Community-Based Study on the Prevalence of Olfactory Dysfunction

American Journal of Rhinology and Allergy ◽

10.1177/1945892420922771 ◽

2020 ◽

Vol 34 (5) ◽

pp. 661-670 ◽

Cited By ~ 3

Author(s):

Rodney J. Schlosser ◽

Vincent M. Desiato ◽

Kristina A. Storck ◽

Shaun A. Nguyen ◽

Jonathan B. Hill ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Linear Regression ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

The United States ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Community Based ◽

Factors Associated ◽

Tdi Score

Background Olfactory dysfunction (OD) is common, affecting an estimated 13 million adults in the United States. Prior studies may underestimate OD prevalence due to use of brief smell identification tests or age-adjusted cutoff values, which concede that it is acceptable for older people to have a decreased sense of smell. Objective To determine OD prevalence in the healthy community when the goal and expectation is ideal olfactory function, rather than age-based population norms. Secondary goals were to explore factors associated with OD. Methods Subjects without otolaryngic complaints were recruited from the community surrounding the Medical University of South Carolina. Olfactory-specific information was collected, and olfactory function was assessed using the Sniffin’ Sticks test (Burghardt, Wedel, Germany) to measure threshold, discrimination, and identification (TDI). OD was defined as a TDI score < 31. Bivariate analysis and linear regression were used to determine factors associated with OD. Results In total, 176 subjects were included with mean age of 52 years (range: 20–93), 111 (63%) female, and 127 (72%) white. Mean TDI score was 28.8 (6.9) and OD was present in 94 (53%) subjects. Multivariate linear regression revealed that TDI decreased an average of 1 point every 5 years. TDI was also associated with Mini-Mental Status Examination (MMSE) score, asthma, and gastroesophageal reflux disease. Threshold was associated with age, heart problems, and gastroesophageal reflux disease. Discrimination was associated with age and MMSE scores. Identification was associated with age, heart problems, and anxiety. Conclusions In a community-based sample, OD affects greater than 50% of subjects. Aging impacts all aspects of olfaction, while the effects of factors such as asthma, MMSE scores, gastroesophageal reflux disease, heart problems, and anxiety may only be evident in specific olfactory subtests.

Download Full-text

Olfactory bulb volume and olfactory function in patients with multiple sclerosis

Rhinology Journal ◽

10.4193/rhino10.136 ◽

2011 ◽

Vol 49 (2) ◽

pp. 221-226

Author(s):

O. Goektas ◽

F. Schmidt ◽

G. Bohner ◽

K. Erb ◽

L. Ludemann ◽

...

Keyword(s):

Multiple Sclerosis ◽

Olfactory Bulb ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Olfactory Bulb Volume ◽

Testing Method ◽

Psychophysical Testing ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Tdi Score

BACKGROUND: Some studies reported olfactory dysfunction in patients with multiple sclerosis (MS). There is no agreement about the most suitable testing method for measuring olfactory function (OF) in MS patients. Recent studies showed that olfactory bulb volume changes with the degree of olfactory dysfunction. We assessed olfactory bulb volume of MS patients with magnetic resonance imaging (MRI) and related it to the OF. MATERIAL AND METHODS: Volumetric measurements of the right and left olfactory bulb (OB) were performed by manual segmentation within 36 MS patients. Psychophysical testing of the orthonasal OF was performed using threshold-discrimination-identification (TDI) score in MS patients. RESULTS: Of all MS patients, 44.4% displayed olfactory dysfunction. The TDI score of all 36 MS patients, especially the score of the Identification subtest correlated strongly with neurological scores typical of MS. In patients with a decreased OB volume, there was a positive correlation between volumetry of the OB and OF. CONCLUSION: OB volumes may provide valuable information about MS patients with olfactory dysfunction. The TDI test and Identification subtest were very sensitive in detecting olfactory dysfunction in MS patients.

Download Full-text

Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center

European Journal of Ophthalmology ◽

10.1177/11206721211023727 ◽

2021 ◽

pp. 112067212110237

Author(s):

Ilkay Kilic Muftuoglu ◽

Ecem Onder Tokuc ◽

V Levent Karabas

Keyword(s):

Optic Disc ◽

Case Series ◽

Internal Limiting Membrane ◽

Maximum Height ◽

Optic Disc Pit ◽

Tertiary Referral Center ◽

Number Of Patients ◽

The Mean ◽

Foveal Center

Purpose: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Methods: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Results: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9–53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80–78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up ( p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery ( p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1–12 months) after the surgery. Conclusion: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

Download Full-text

Postinfectious Olfactory Dysfunction: Oral Steroids and Olfactory Training versus Olfactory Training Alone: Is There any Benefit from Steroids?

ORL ◽

10.1159/000516316 ◽

2021 ◽

pp. 1-8

Author(s):

Sotiria Genetzaki ◽

Evangelia Tsakiropoulou ◽

Vasilios Nikolaidis ◽

Konstantinos Markou ◽

Iordanis Konstantinidis

Keyword(s):

Olfactory Dysfunction ◽

Olfactory Function ◽

Line Treatment ◽

First Line ◽

Olfactory Testing ◽

Significant Difference ◽

Oral Steroids ◽

Group A ◽

Olfactory Training ◽

First Line Treatment

Introduction: There are limited treatment options for postinfectious olfactory dysfunction (PIOD). Olfactory training has recently been used in clinical practice, but no medical treatment is widely accepted. Although there is weak evidence for their value, some physicians use oral corticosteroids as first-line treatment. The aim of this study was to compare combined oral methylprednisolone and olfactory training with olfactory training alone in the management of PIOD. Methods: This prospective cohort study included 131 patients with PIOD over a 2-year period before the COVID-19 pandemic. Seventy-eight patients who were treated with oral methylprednisolone and olfactory training (group A) were compared with 53 patients who were treated with olfactory training only (group B). Olfactory function was evaluated with “Sniffin’ Sticks” at baseline and 2, 8, and 16 weeks after initial assessment. Patients who improved after steroid treatment underwent magnetic resonance imaging of the paranasal sinuses, skin prick tests, lung spirometry, and sputum eosinophil assessment. Results: Oral steroids improved 19.23% of patients (n = 15) of group A. History, clinical evaluation, imaging, and laboratory tests identified an inflammatory background in half of them (n = 8). The remaining 7 had no findings of nasal inflammation, and all had a short history of olfactory dysfunction. Both groups significantly improved in olfactory testing results at the end of the olfactory training scheme without significant difference between them. Conclusions: The percentage of improved patients after oral methylprednisolone was relatively low to suggest it as first-line treatment. Half of the improved patients had an underlying upper airway inflammatory condition not related to the infection that caused the acute loss of olfactory function.

Download Full-text

Transmastoid Hydroxyapatite Resurfacing for Sigmoid Sinus Wall Anomalies Causing Pulsatile Tinnitus

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420987407 ◽

2021 ◽

pp. 000348942098740

Author(s):

Ian Newberry ◽

Julie Highland ◽

Alvin DeTorres ◽

Richard Gurgel

Keyword(s):

Case Series ◽

Sigmoid Sinus ◽

Pulsatile Tinnitus ◽

Retrospective Case ◽

Tertiary Referral Center ◽

Operative Outcomes ◽

Sinus Wall ◽

Objective Tinnitus ◽

Materials Used

Objective: Comprising 4% of tinnitus, pulsatile tinnitus (PT) can be particularly difficult for affected patients as well as surgeons looking to address their symptoms. Often the cause is not identified but can be secondary to turbulent flow in or near the sigmoid sinus, particularly if there is an identifiable sigmoid sinus dehiscence (SSDe) and/or diverticulum (SSDi). These sigmoid sinus wall anomalies (SSWA) may be treated with transmastoid sigmoid sinus resurfacing; however, this intervention remains relatively novel and its technique, materials used, resolution success, and complications need to be continuously reviewed. Methods: A retrospective case series of patients with PT due to SSWA at a tertiary referral center was reviewed. A total of 6 patients (7 ears) treated by transmastoid resurfacing using hydroxyapatite (HA) were retrospectively assessed. Pre-operative demographics and symptoms, pre- and post-operative hearing results, and post-operative outcomes were reviewed. Results: All patients were female with an average BMI of 32.9 (±5.4) and a mean age of 45.5 years (±15.3). Mean follow-up was 648 days. Objective tinnitus was noted in all ears with SSDi (100%); however, no objective tinnitus was noted with purely SSDe. In 100% of ears, PT was diminished with ipsilateral jugular compression and was amplified with contralateral head turn. Pre-operative symptoms of PT resolved in all patients, but delayed recurrence (>1 year) occurred in 1 ear (14%). No patient had pre- or post-operative hearing loss. No major complications were encountered. Conclusions: Transmastoid resurfacing for SSWA with HA bone cement is a safe, reliable intervention in properly identified PT patients.

Download Full-text

Post-traumatic inclusion cysts of the iris: a longterm prospective case series

Acta Ophthalmologica Scandinavica ◽

10.1111/j.1600-0420.2007.00975.x ◽

2007 ◽

Vol 85 (8) ◽

pp. 893-896 ◽

Cited By ~ 21

Author(s):

Viney Gupta ◽

Aparna Rao ◽

Ankur Sinha ◽

Neena Kumar ◽

Ramanjit Sihota

Keyword(s):

Case Series ◽

Post Traumatic ◽

Prospective Case Series

Download Full-text

Sertraline as a treatment for PTSD: a systematic review and meta-analysis

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700008478 ◽

2004 ◽

Vol 21 (3) ◽

pp. 100-103 ◽

Cited By ~ 7

Author(s):

Paul Mooney ◽

Janette Oakley ◽

Michael Ferriter ◽

Raymond Travers

Keyword(s):

Systematic Review ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Meta Analysis ◽

Case Series ◽

Group Differences ◽

Post Traumatic Stress ◽

Relevant Research ◽

Randomised Control Trials ◽

Post Traumatic

AbstractObjective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from ‘talking therapies’ to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD.Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD.Results: Five randomised control trials were identified, along with seven open trials and case series studies.Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on sub-group differences (eg. gender) is required.

Download Full-text