scholarly journals Steroids and Olfactory Training for Postviral Olfactory Dysfunction: A Systematic Review

2021 ◽  
Vol 15 ◽  
Author(s):  
Fan Yuan ◽  
Tianhao Huang ◽  
Yongxiang Wei ◽  
Dawei Wu
Keyword(s):  
Systematic Review ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Cochrane Library ◽  
Topical Steroids ◽  
Olfactory Cleft ◽  
Olfactory Testing ◽  
Nasal Steroid ◽  
Clinically Significant ◽  
Olfactory Training

Background: Postviral olfactory dysfunction (PVOD) is a clinical challenge due to limited therapeutic options and poor prognosis. Both steroids and olfactory training have been proved to be effective for olfactory dysfunction with varied etiologies. We sought to perform a systematic review to summarize the evidence of steroids or olfactory training for patients with PVOD.Methods: A systematic literature review using PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify studies assessing olfactory change in patients with PVOD receiving steroid or olfactory training.Results: Of the initial 273 abstracts reviewed, 20 articles with data from 2,415 patients with PVOD were included. Treatments including topical steroids, systemic steroids, classical olfactory training (COT), modified olfactory training (MOT), and olfactory training with steroid were analyzed. Both psychophysical olfactory testing and subjective symptom scores were utilized to assess the olfactory function. The routine use of nasal steroid spray alone during the management of PVOD seems to have no positive effect on olfactory dysfunction. Direct injection of steroid or nasal steroid spray into the olfactory cleft significantly improved the olfactory function in patients with PVOD. Olfactory improvement is greater than that of the natural course of the disease with short-term COT. Patients with PVOD would benefit more from long-term COT (>12 weeks). Treatment duration, various odorants, olfactory training devices, changing the types of odors periodically, different molecular odorants, and different concentrations of odorants tended to increase the efficiency of MOT. Clinically significant improvement after olfactory training was defined as an increase of threshold, discrimination, and identification (TDI) score ≥6. From week 24 to week 36, both COT and MOT groups reached the maximum therapeutic effect regarding the number of participants achieving clinically significant improvement. A combination of local or oral steroids with olfactory training is more efficient than COT only.Conclusion: Olfactory function in patients with PVOD was effectively improved through direct steroid administration in the olfactory cleft, COT, or modification of COT. The addition of topical steroids to COT therapy showed a tendency for greater olfactory improvement in patients with PVOD.

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

ORL ◽  
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

<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> Oral steroids improved 19.23% of patients (<i>n</i> = 15) of group A. History, clinical evaluation, imaging, and laboratory tests identified an inflammatory background in half of them (<i>n</i> = 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. <b><i>Conclusions:</i></b> 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.

scholarly journals Olfactory Training for Postviral Olfactory Dysfunction: Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982094355 ◽  
Author(s):  
Nrusheel Kattar ◽  
Triet M. Do ◽  
Graham D. Unis ◽  
Matthew R. Migneron ◽  
Andrew J. Thomas ◽  
...  
Keyword(s):  
Web Of Science ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Olfactory Dysfunction ◽  
Upper Respiratory Infection ◽  
Olfactory Loss ◽  
Olfactory Testing ◽  
Clinically Significant ◽  
Olfactory Training ◽  
Existing Data

Objective Olfactory dysfunction is a common problem that is most frequently attributed to upper respiratory infection. Postviral olfactory dysfunction (PVOD) can be prolonged and clinically challenging to treat. Olfactory training (OT) has demonstrated potential benefit for patients with nonspecific olfactory dysfunction. We sought to evaluate the efficacy of OT specifically for PVOD by pooled analysis of the existing evidence. Data Sources PubMed, Embase, and Web of Science. Review Methods Following PRISMA guidelines, PubMed, Embase, and Web of Science databases were queried and abstracts screened independently by 2 investigators. We included studies evaluating the efficacy of OT for PVOD and excluded studies evaluating pharmacologic interventions or olfactory loss from other causes. Results Of the initial 1981 abstracts reviewed, 16 full-text articles were included. Sniffin’ Sticks olfactory testing results were reported in 15 (93%) studies as threshold (T), discrimination (D), and identification (I) subscores and TDI total scores. All studies reported clinically significant results after OT, defined as a score improvement of TDI >5.5. Four studies were included in the meta-analysis, in which pooled estimates revealed that patients with PVOD who received OT had a 2.77 (95% confidence interval, 1.67-4.58) higher odds of achieving a clinically important difference in TDI scores compared to controls. Conclusion Meta-analysis of existing data demonstrates clinically significant improvements in PVOD associated with OT. Variability exists among OT protocols and may benefit from further optimization. Existing data supports the use of OT for the treatment of existing and newly emerging cases of PVOD.

scholarly journals Digital models and orthodontic diagnosis: what degree of reliability?

2021 ◽  
Vol 8 ◽  
Author(s):  
ABDOUL Hafizou RABE ◽  
Fatima SALEK ◽  
Intissar El IDRISSI ◽  
Fatima ZAOUI ◽  
Hicham BENYAHIA
Keyword(s):  
Systematic Review ◽  
Numerical Models ◽  
Meta Analysis ◽  
Physical Models ◽  
Cochrane Library ◽  
Digital Models ◽  
Significant Difference ◽  
Clinically Significant ◽  
Conventional Models ◽  
Plaster Models

Abstract  Background: Our study aims to evaluate, through a systematic review, the reliability of numerical models compared to conventional models on the main parameters of orthodontic diagnosis  Method: four databases were consulted: PubMed; Google Scholar, Cochrane Library, and Ebscohost. The research included published studies since 2010, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies. Results: Among 3811 selected references, only five studies met our inclusion criteria. In the systematic review, there were statistical differences between the digital models and the plaster models. However, this difference is clinically acceptable. On the other hand, there are some limitations, relative to the types of the severity of the congestion, the elapsed time to digitize, and the numerical means. Conclusion: The results of our systematic review have shown that there is no clinically significant difference between the numerical and physical models for the majority of diagnostic parameters.

scholarly journals Exposure to odours improves olfactory function in healthy children

2015 ◽  
Vol 53 (3) ◽  
pp. 221-226
Author(s):  
E. Mori ◽  
W. Petters ◽  
V.A. Schriever ◽  
C. Valder ◽  
T. Hummel
Keyword(s):  
Training Group ◽  
Olfactory Function ◽  
Controlled Study ◽  
Healthy Children ◽  
Olfactory Sensitivity ◽  
Short Term ◽  
Short Term Exposure ◽  
Olfactory Testing ◽  
Test Kit ◽  
Olfactory Training

Background: Short-term exposure to odours, also called "olfactory training" has been shown to improve olfactory function in healthy people but also in people with olfactory loss. Aim of this single center, prospective, controlled study was to investigate the change of olfactory function following twice-daily, short-term exposure to 4 odours over a period of approximately 12 weeks. Material and methods: We compared odour identification abilities and odour thresholds between an olfactory training group (TR group) and a group that did not perform such training (noTR group). Participants exposed themselves twice daily to 4 odours ("rose", "eucalyptus", "lemon", "clove"). Olfactory testing was performed before and after the training period using the "Sniffin' Sticks" test kit (odour identification plus odour thresholds). Results: At baseline the two groups were not significantly different in terms of age and measures of olfactory sensitivity. The TR group performed significantly better for odour thresholds for all 4 odours compared to the noTR group after 12 weeks of olfactory training. Also, with regard to odour identification the TR group outperformed the noTR group. No significant differences were found for diary-based intensity ratings. Conclusion: Repeated exposure to odours seems to improve general olfactory sensitivity in children.

scholarly journals Intranasal sodium citrate solution improves olfaction in post-viral hyposmia

2016 ◽  
Vol 54 (4) ◽  
pp. 368-374
Author(s):  
K.L. Whitcroft ◽  
C. Merkonidis ◽  
M. Cuevas ◽  
A. Haehner ◽  
C. Philpott ◽  
...  
Keyword(s):  
Sodium Citrate ◽  
Feedback Inhibition ◽  
Olfactory Function ◽  
Placebo Control ◽  
Free Calcium ◽  
Citrate Solution ◽  
Trial Methodology ◽  
Olfactory Cleft ◽  
Olfactory Testing ◽  
Before And After

Background: Calcium plays an integral role in olfactory signal transduction, including feedback inhibition. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. We aimed to investigate the utility of intranasal sodium citrate in improving the olfactory function of hyposmic patients, by performing this prospective placebo controlled, single-blind trial. Methodology: Monorhinal olfactory testing for odour identification and threshold was performed in hyposmic patients using Sniffin Sticks, before and after treatment. Treatment consisted of one-off sodium citrate solution application to the olfactory cleft. Sodium chloride solution was applied to the contralateral olfactory cleft, which therefore acted as placebo control. Patients were blinded to the side of sodium citrate application, and side of treatment was randomized between patients. Results: 57 patients participated, aged 22-79. Causes of hyposmia included: post-viral (7); posttraumatic (10); sinonasal disease (30) and idiopathic (10). Compared with placebo, there was significant improvement in the identification scores of participants with post-viral hyposmia, following sodium citrate treatment. No significant change in olfactory function occurred for either identification or threshold in any other aetiological subgroup. Conclusions: Intranasal sodium citrate may be of benefit to patients with post-viral hyposmia.

Adherence and Efficacy of Olfactory Training as a Treatment for Persistent Olfactory Loss

2019 ◽  
Vol 34 (2) ◽  
pp. 238-248 ◽  
Author(s):  
Marco Aurélio Fornazieri ◽  
Ellen Cristine Duarte Garcia ◽  
Natália Medeiros Dias Lopes ◽  
Isabela Naomi Iha Miyazawa ◽  
Gislene dos Santos Silva ◽  
...  
Keyword(s):  
Treatment Success ◽  
Olfactory Function ◽  
University Of Pennsylvania ◽  
Adherence Rate ◽  
Olfactory Loss ◽  
Emerging Therapies ◽  
Spontaneous Improvement ◽  
Clinically Significant ◽  
The University ◽  
Olfactory Training

Background Among emerging therapies, olfactory training (OT) has been proposed as a potential treatment for persistent olfactory loss. This treatment has been suggested to improve olfactory function via sensorineural modulation from repeated odor exposure. However, due to the long treatment period that is required, many patients discontinue the treatment or do not follow the treatment regimen appropriately, potentially biasing estimates of treatment success. Moreover, spontaneous improvement is known to occur without any interventions. Objectives We evaluated both the adherence rates and the efficacy of OT in patients with persistent postinfectious, posttraumatic, or idiopathic olfactory loss. Methods Prospective observational study. Twenty-five patients with persistent olfactory loss underwent OT. Protocol adherence and olfactory function (scores on the University of Pennsylvania Smell Identification Test or UPSIT) were assessed 3 and 6 months after the initiation of treatment. A minimum improvement of 5 UPSIT points was considered clinically significant and adherence throughout the study. Results The adherence rate of the patients after 3 months was 88% and after 6 months was 56%. The corresponding percentages of clinical improvement were 23.5% and 25%. There was no relation of age, sex, time of olfactory loss, race, the degree of olfactory loss, etiology, education, and type of training to the adherence rate or treatment efficacy. Conclusions In this patient population, adherence to training remained high in the first 3 months of OT but declined moderately thereafter. The observed prevalence and degree of improvement were similar to that reported a number of studies, including some studies whose patients did not receive OT.

scholarly journals High prevalence of long-term olfactory dysfunction confirmed by olfactory testing after a community COVID-19 outbreak

HNO ◽  
2021 ◽  
Author(s):  
Hilmar Gudziol ◽  
Timo Kirschstein ◽  
Mathias W. Pletz ◽  
Sebastian Weis ◽  
Orlando Guntinas-Lichius ◽  
...  
Keyword(s):  
Population Based ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Taste Disturbance ◽  
Gustatory Function ◽  
Psychophysical Testing ◽  
Olfactory Testing ◽  
High Prevalence ◽  
Normal Taste

Abstract Purpose The prevalence of long-term olfactory and gustatory dysfunction in participants suffering from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19) is unknown. Furthermore, evaluations of the reliability of participants’ self-reporting of olfactory function (SOF) and gustatory function (SGF) using extended objective psychophysical testing are missing. Methods In this population-based cohort study in a PCR-tested community in Thuringia, Germany, olfactory function was extensively examined 4 months after a COVID-19 outbreak using the “Sniffin Sticks” test battery to determine the TDIa score, i.e., the sum of results obtained for threshold, discrimination, and identification scores averaged for both nasal sides. Gustatory function was assessed using the three-drop test resulting in the gustatory composite score (CSg). The data were compared with SOF and SGF. Results Of 43 adult convalescents (median age: 68 years; 58% female) after SARS-CoV‑2 infection, 18 participants (42%) had olfactory complaints due to SOF, one participant (2%) complained of taste disturbance due to SGF. The TDIa was 22.0 ± 5.9. Normosmia, hyposmia, and anosmia were seen in 17, 18, and eight participants, respectively. TDIa correlated with SOF (rs = −0.434, p = 0.004); CSg was 23.5 ± 2.7. Normogeusia and hypogeusia were objectified in 39 and four participants, respectively. The prevalence of long-term olfactory dysfunction and gustatory dysfunction in the study group was 60.5 and 9.3%, respectively. Conclusion The SOF was reliable, especially for participants who felt a sudden chemosensory dysfunction during the outbreak. At 4 months after SARS-CoV‑2 infection, a high proportion of participants were dysosmic, whereas nearly all of them had normal taste function.

scholarly journals The Effect of Endoscopic Olfactory Cleft Opening on Obstructed Olfactory Cleft Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Rong-San Jiang ◽  
Kai-Li Liang
Keyword(s):  
Local Anesthesia ◽  
Ethyl Alcohol ◽  
Inflammatory Process ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Threshold Levels ◽  
Olfactory Cleft ◽  
Threshold Test ◽  
Before And After ◽  
Phenyl Ethyl Alcohol

Purpose. This study was conducted to evaluate the effect of endoscopic olfactory cleft (OC) opening on olfaction in patients with obstructed OC disease. Materials and Methods. Patients with obstructed OC disease who underwent endoscopic OC opening for treatment were enrolled. The endoscopic olfactory cleft opening was performed under local anesthesia. Under an endoscopy, the middle and superior turbinates were gently lateralized to open the OC using an elevator. The phenyl ethyl alcohol threshold test was performed to evaluate the olfactory function both before and after surgery. Results. An endoscopic OC opening was performed on 42 patients. Amongst them, the etiology of OC obstruction revealed anatomic anomalies in 14 patients, inflammatory process in 14, and anatomic anomalies as well as inflammatory process in 14. The phenyl ethyl alcohol threshold levels improved in 32 (76.2%) of the patients after surgery. The olfactory function was better improved in patients experiencing OC obstructed by inflammatory process than those by anatomic anomalies. Conclusions. This study showed that endoscopic OC opening seemed to be effective in treating olfactory dysfunction in patients with obstructed OC disease caused by inflammatory process.

scholarly journals Characterisation of Prostate Lesions Using Transrectal Shear Wave Elastography (SWE) Ultrasound Imaging: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 122
Author(s):  
Thineskrishna Anbarasan ◽  
Cheng Wei ◽  
Jeffrey C. Bamber ◽  
Richard G. Barr ◽  
Ghulam Nabi
Keyword(s):  
Systematic Review ◽  
Shear Wave ◽  
Sensitivity And Specificity ◽  
Imaging Modality ◽  
Group Analysis ◽  
Shear Wave Elastography ◽  
Cochrane Library ◽  
Reference Standard ◽  
Tissue Stiffness ◽  
Clinically Significant

Background: ultrasound-based shear wave elastography (SWE) can non-invasively assess prostate tissue stiffness. This systematic review aims to evaluate SWE for the detection of prostate cancer (PCa) and compare diagnostic estimates between studies reporting the detection of all PCa and clinically significant PCa (csPCa). Methods: a literature search was performed using the MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov, and CINAHL databases. Studies evaluating SWE for the detection of PCa using histopathology as reference standard were included. Results: 16 studies including 2277 patients were included for review. Nine studies evaluated SWE for the detection of PCa using systematic biopsy as a reference standard at the per-sample level, with a pooled sensitivity and specificity of 0.85 (95% CI = 0.74–0.92) and 0.85 (95% CI = 0.75–0.91), respectively. Five studies evaluated SWE for the detection of PCa using histopathology of radical prostatectomy (RP) specimens as the reference standard, with a pooled sensitivity and specificity of 0.71 (95% CI = 0.55–0.83) and 0.74 (95% CI = 0.42–0.92), respectively. Sub-group analysis revealed a higher pooled sensitivity (0.77 vs. 0.62) and specificity (0.84 vs. 0.53) for detection of csPCa compared to all PCa among studies using RP specimens as the reference standard. Conclusion: SWE is an attractive imaging modality for the detection of PCa.

scholarly journals Orthonasal, but not Retronasal Olfaction Is Specifically Impaired in Parkinson’s Disease

2020 ◽  
Vol 45 (5) ◽  
pp. 401-406 ◽  
Author(s):  
Emilie Aubry-Lafontaine ◽  
Cécilia Tremblay ◽  
Pascali Durand-Martel ◽  
Nicolas Dupré ◽  
Johannes Frasnelli
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Healthy Controls ◽  
Compensatory Mechanisms ◽  
Motor Disturbance ◽  
Flavor Perception ◽  
Olfactory Testing ◽  
Retronasal Olfaction

Abstract Olfactory dysfunction (OD) in Parkinson’s disease (PD) appears several years before the presence of motor disturbance. Olfactory testing has the potential to serve as a tool for early detection of PD, but OD is not specific to PD as it affects up to 20% of the general population. Olfaction includes an orthonasal and a retronasal components; in some forms of OD, retronasal olfactory function is preserved. We aimed to evaluate whether combined testing components allows for discriminating between PD-related OD and non-Parkinsonian OD (NPOD). The objective of this study is to orthonasal and retronasal olfactory function in PD patients and compare them to a NPOD group and to healthy controls. We hypothesized that this combined testing allows to distinguish PD patients from both other groups. We included 32 PD patients, 25 NPOD patients, and 15 healthy controls. Both olfactory components were impaired in PD and NPOD patients, compared with controls; however, NPOD patients had significantly better orthonasal scores than PD patients. Furthermore, the ratio of retronasal/orthonasal score was higher in PD than in both other groups. In the NPOD group, orthonasal and retronasal scores were significantly correlated; no such correlation could be observed in PD patients. In summary, PD patients seem to rely on compensatory mechanisms for flavor perception. Combined orthonasal and retronasal olfactory testing may contribute to differentiate PD patients from patients with NPOD.

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