xRead - Olfactory Disorders (September 2023)

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INTERNATIONAL CONSENSUS ON OLFACTION

TABLE IX-19 Evidence for AR-related olfactory loss management with turbinate surgery Study Year LOE Study design Study groups

Clinical end point

Conclusions

Majority of patients experienced “total improvement”

Degree of smell improvement questionnaire

Hamerschmidt et al 1444

2016

3

Prospective cohort

CRS (AR and non-AR) (n = 57) Inferior turbinoplasty CRS (AR and non-AR) (n = 48) Radiofrequency inferior turbinate reduction CRS (AR and non-AR) (n = 40) RITR Perennial AR refractory tomedical management (n = 50) Radiofrequency volumetric tissue reduction

Assanasen et al 1443

2014 3

Prospective cohort

VAS PEAtest

Significant

improvement in VASbut not T-PEA

Garzaro

SS-TDI

Significant

2011

4

Case series

et al 1441

improvement in SS

Parida

2011

3

Prospective cohort

VAS

Significant

et al 1445

improvement in VAS

VAS

Improvement noted in anosmics

Ikeda

2006 3

Prospective case series

AR(n = 56) Functional inferior

et al 1442

turbinosurgery and resection of posterior nasal nerve

AR = allergic rhinosinusitis; CRS = CRS = chronic rhinosinusitis; LOE = level of evidence; PEA = phenylethyl alcohol; RITR = radiofrequency inferior turbinate reduction; SS = Sniffin’ Sticks; SS-TDI = Sniffin’ Sticks threshold, discrimination, identification combination; VAS = visual analog scale.

TABLE IX-20 Evidence for smell training in intracranial disease–, neurochemistry/neurotransmitter imbalance–, and neurodegenerative disease–related olfactory loss management Study Year LOE Study design Study groups Clinical end point Conclusions Haehner et al 1486 2013 3 Prospective, controlled, nonblinded Patients with PD underwent OT twice daily for 12 weeks with 4 odorants (n = 35) Controls (n = 35) SS-TDI Threshold for 3 other trained odorants The only significant difference was in total SS-TDI (mean increase 2.4) and discrimination scores

20% vs 9% met MCID Independent of age, sex, severity, and duration of disease

Knudsen et al 1483

2015

3

Prospective,

Patients with PD: smell retraining of odors on the test (n = 34) HCs: smell retraining (n = 26) Patients with PD: no training (n = 20) Training consisted of 1 session of two 10-minute exposures to the SS odors with visual and written cues

SS-ID Measured

Improvement in identification

nonblinded, cohort

pretraining and immediately posttraining Retest in 8 after 4 to 8weeks

(increase of 2.2) was noted the same day

Benefit persisted at retest

HC = healthy control; LOE = level of evidence; OT = olfactory training; PD = Parkinson disease; MCID = minimum clinically important difference; SS = Sniffin’ Sticks; SS-ID = Sniffin’ Sticks identification only; SS-TDI = Sniffin’ Sticks threshold, discrimination, identification combination.