xRead - Olfactory Disorders (September 2023)

20426984, 2022, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22929, Wiley Online Library on [04/09/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

593

PATEL et al.

TABLE IX-28 Systematic review of systemic steroid with or versus topical steroid treatment

Clinical end point Follow-up: 21 to 330days SS-TDI

Author

Year LOE Study design Study design

Conclusions

All TDI improved with systematic steroids ( P < 0.0001), both URI ( P = 0.05) and idiopathic ( P = 0.008) Mometasone spray did not improveOF For both topical and systemic steroids, no difference in olfactory improvement based

Heilmann et al 1537

2004 4 Retrospective case series

Population: 55 oral/37 topical URI or idiopathic

Duration of loss: 3 to 360 months Treatment: oral prednisolone 40 mg × 21 day taper 2 Mometasone spray daily × 1 to3 months

on patient age, duration of disease, sex, or parosmia

Ikeda

1995 4 Retrospective case series

Population: 5 oral/12 topical trauma Duration of loss: improved patients mean: 72.3 months Unimproved patients: 22.4 months (no significant difference) Treatment: oral prednisolone 30 to 60mg × 10 to 14 days taper Topical betamethasone twice daily Population: 374 URI, trauma, xerostomia, congenital, or idiopathic Duration of loss: mean 78.4 months Treatment: Oral prednisolone 40 mg × 14days with taper by 5 mg every day Topical Nasonex, 2 sprays in each nostril (total, 200 mg/day) Systemic + topical Population: 28 one arm/43 second armURI Duration of loss: mean 3.4 months Treatment: All taking mometasone NS Prednisolone × 2 weeks tapering from 30 mg daily Prednisolone × 2weeks + ginkgo biloba × 4weeks

Follow-up: 6–12 mo. T&T olfactometer,

3 of 5 patients improved from oral steroid in T&T olfactometer and IV testing, 1 of 12 improved from topical steroid treatment

et al 1352

intravenous olfaction test (thiamine propyl)

Systemic or systemic + topical is better than topical alone in smell threshold and identification and recovery ( P < 0.001) No difference between systemic vs systemic + topical treatment groups ( P = 0.978) With prednisolone + mometasone spray, 32% had improved BTT score ( ≥ 3 points), mean 1.4 points, and 14% had improved B-SIT( ≥ 3 points) mean 0.9 points Both BTT and B-SIT improved P < 0.001 No statistically significant

Follow-up: 1 month Olfactory

Kim

2017 4 Retrospective case series

et al 937

measurement: CCCRC olfactory

test, B-SIT, subjective

“recovery” vs “no recovery”

Seoet al 1536

2009 3

Randomized, nonblinded, parallel group

Follow-up: 4 weeks Olfactory

measurement: BTT, B-SIT

difference between steroids alone and steroids + ginkgo biloba

B-SIT = Brief Smell Identification Test; BTT = Butanol Threshold Test; CCCRC = Connecticut Chemosensory Clinical Research Center; LOE = level of evidence; NS = nasal spray; OF = olfactory function; SS-TDI = Sniffin’ Sticks threshold, discrimination, identification combination; T&T = Toyoda and Takagi; URI = upper respiratory infection.

ment in n-butanol threshold. Last, Qiao et al 1550 found an equivalent recovery in patients with PIOD when COT was compared with using household scents (balm, vine gar, alcohol, and rose perfume) instead, with 41% improv ing above the TDI MCID threshold in both groups. While several studies used an OT duration of 12 to 16 weeks, other studies have found that prolonged duration of OT may have increased incremental benefit. Konstan tinidis et al 1336 demonstrated rapid improvement in both short- and long-term training groups in the first 4 months,

of a single scent (phenylethyl alcohol) versus COT in PTOD for 6 months and found no clinically significant difference in rates of olfactory identification between groups, and that both groups showed a similar improvement in phenylethyl alcohol thresholds. Poletti et al 1549 found little difference in olfactory recovery in patients with both PTOD and PIOD when training was performed with either light-weight or heavy-weight molecules. Langdon et al 1066 used six odors (anise, lemon, rose, vinegar, smoke, and eucalyptus) for OT in patients with PTOD and noted a significant improve