xRead - Olfactory Disorders (September 2023)

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PATEL et al.

TABLE IX-27 Systematic review of systemic steroid treatments Author Year LOE Study design Study groups

Clinical end point Conclusions

Studies included only objective psychophysical

Yan,

2019 2

Systematic EBRR Patients with olfactory loss treated with systemic steroids, topical steroids or both

There is weak lower-level evidence only to support use of systemic steroids to treat nonsinonasal inflammatory causes of

et al 1517

test confirmation of smell loss (eg, UPSIT R , SS-TDI)

OD, and their use should be balanced against their known potential side effects and adverse events

Fujii

2002 4

Prospective, single-arm

Population: 27 trauma patients Severity of smell loss: 61% (16) anosmia, 19% (5) severe hyposmia, 11% (3) moderate hyposmia, 8% (2) mild hyposmia Duration of loss: < 2 months to > 120months Treatment: dexamethasone Population: 133 URI patients Severity of smell loss: ≈ 70% severe hyposmia/anosmia Duration of loss: NA Treatment: dexamethasone or betamethasone (5 mg) injection every 2 weeks × 8 to 10 times Population: 9 URI patients Duration of loss: 1 month to 15months Treatment: failed topical beclomethasone, oral prednisolone 40 to 60 mg × 10 to 14 days with taper Population: 116 trauma patients Severity of smell loss: all anosmic Duration of loss: 1 to 264 months Treatment: prednisolone × 15 days starting at 60 mg with taper every 3 days injection 4 mg/0.5 mL septal mucosa every 2 weeks × 8

Follow-up: 4 months T&T olfactometer Alinamin test

35.3% improvement in recognition and 23.5% improvement in detection thresholds by T&T olfactometer Patients treated < 2 months after trauma had higher rates of improved recognition and detection 49.6% improvement in olfaction threshold recognition by at least 1 patient by T&T olfactometer VAS improved from 10.2 to39.5 improvement in olfaction detection or recognition by T&T olfactometer 16.4% (19 of 116 patients) PEA threshold improved Younger patients more likely to improve in olfaction ( P = 0.033) No difference in interval of olfactory loss between patients who showed improvement and those who did not ( P = 0.88) No statistically significant

et al 1533

Fukazawa et al 1534

Follow-up: NA T&T olfactometer, VAS

2005 4

Prospective, single arm

Ikeda

1995 4

Retrospective case series

Follow-up: NA T&T olfactometer

et al 1426

Follow-up: 3 to 21.5 months (mean 5.5

Jiang

2010 4

Prospective, single-arm

et al 1353

months) PEA threshold test

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