Treatment of post-viral olfactory dysfunction: an evidence-based review with recommendations

Authors

Nanki Hura, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Deborah X. Xie, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Garret W. Choby, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic College of Medicine, Rochester, MN.
Rodney J. Schlosser, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
Cinthia P. Orlov, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Stella M. Seal, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Nicholas R. Rowan, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.

Document Type

Article

Abstract

BACKGROUND: Post-viral olfactory dysfunction (PVOD) is one of the most common causes of olfactory loss. Despite its prevalence, optimal treatment strategies remain unclear. This article provides a comprehensive review of PVOD treatment options and provides evidence-based recommendations for their use. METHODS: A systematic review of the Medline, Embase, Cochrane, Web of Science, Scopus, and Google Scholar databases was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies with defined olfactory outcomes of patients treated for PVOD following medical, surgical, acupuncture, or olfactory training interventions were included. The Clinical Practice Guideline Development Manual and Conference on Guideline Standardization (COGS) instrument recommendations were followed in accordance with a previously described, rigorous, iterative process to create an evidence-based review with recommendations. RESULTS: From 552 initial candidate articles, 36 studies with data for 2183 patients with PVOD were ultimately included. The most common method to assess olfactory outcomes was Sniffin' Sticks. Broad treatment categories included: olfactory training, systemic steroids, topical therapies, a variety of heterogeneous non-steroidal oral medications, and acupuncture. CONCLUSION: Based on the available evidence, olfactory training is a recommendation for the treatment of PVOD. The use of short-term systemic and/or topical steroids is an option in select patients after careful consideration of potential risks of oral steroids. Though some pharmacological investigations offer promising preliminary results for systemic and topical medications alike, a paucity of high-quality studies limits the ability to make meaningful evidence-based recommendations for the use of these therapies for the treatment of PVOD.

Medical Subject Headings

Humans; Olfaction Disorders (etiology, therapy); Research Design; Smell; Steroids

Publication Date

9-1-2020

Publication Title

International forum of allergy & rhinology

E-ISSN

2042-6984

Volume

10

Issue

9

First Page

1065

Last Page

1086

PubMed ID

32567798

Digital Object Identifier (DOI)

10.1002/alr.22624

Recommended Citation

Hura, Nanki; Xie, Deborah X.; Choby, Garret W.; Schlosser, Rodney J.; Orlov, Cinthia P.; Seal, Stella M.; and Rowan, Nicholas R., "Treatment of post-viral olfactory dysfunction: an evidence-based review with recommendations" (2020). ENT and Skull Base Surgery. 46.
https://scholar.barrowneuro.org/ent-and-skull-base-surgery/46