Ae. Mott et al., TOPICAL CORTICOSTEROID TREATMENT OF ANOSMIA ASSOCIATED WITH NASAL ANDSINUS DISEASE, Archives of otolaryngology, head & neck surgery, 123(4), 1997, pp. 367-372
Objective: To establish the efficacy of topical corticosteroid nasal s
pray treatment of severe olfactory loss associated with severe nasal a
nd sinus disease. Design: Efficacy before and after open-label trial o
f topical corticosteroid nasal spray used exclusively in the head-down
-forward position. Setting: Taste and smell clinic of a university tea
ching hospital and research facility. Patients: Taste and smell clinic
patients with anosmia or severe hyposmia associated with paranasal si
nus disease and nasal polyposis including 39 of 45 patients recruited
from 1988 to 1994 who completed the topical corticosteroid treatment c
ourse and returned for subsequent testing. Intervention: At least 8 we
eks of treatment with flunisolide (Nasalide), 2 sprays in each nostril
twice a day, with concurrent antibiotic treatment of any bacterial in
fection. Main Outcome Measures: Subjective olfactory symptoms, objecti
ve olfactory function tests, and otolaryngological evaluation (includi
ng endoscopic examination). Results: Olfactory scores significantly im
proved following treatment (P < .001); signs of nasal and sinus diseas
e significantly decreased (P < .001); and 26 (66%) of the patients rep
orted a subjective improvement in their sense of smell. Conclusion: To
pical corticosteroid nasal spray administered in a head-down-forward p
osition is an effective treatment of severe olfactory loss associated
with severe nasal and sinus disease.