Management of long‐lasting phantosmia: a systematic review

Saltagi, Mohamad Z.; Rabbani, Cyrus C.; Ting, Jonathan Y.; Higgins, Thomas S.

doi:10.1002/alr.22108

Cited by 17 publications

(42 citation statements)

References 31 publications

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“…Even more so than quantitative olfactory loss, qualitative disturbances provide a source of frustration for both the patient and the clinician. Evidence for prescribed treatment for qualitative disorders was limited to 7 studies in a previous systematic review for phantosmia 16 and evidence for self-help measures appears to be very limited. 17 Some patients are so severely affected that consideration has been given to surgical removal of the olfactory epithelium.…”

Section: Introductionmentioning

confidence: 99%

Qualitative Olfactory Disorders: Patient Experiences and Self-Management

Philpott

Dixon²,

Boak³

2021

Allergy�Rhinol (Providence)

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Background Qualitative olfactory disorders in the form of parosmia and phantosmia are very subjective and cannot be measured at present. They pose an unpleasant experience for patients and a therapeutic challenge for clinicians. Objective This study aimed to characterise the specific experiences of patients affected by the qualitative symptoms of parosmia and phantosmia including both triggers for symptoms and self-help measures they have tried. Methods A cross-sectional survey questionnaire was developed with the input of patient experts within the charity Fifth Sense. The survey was then open online for 3 months to charity members complaining of qualitative symptoms. The survey captured the frequency and impact of symptoms and self-management undertaken. Reflective feedback was also captured from a patient workshop. Results There were 100 participants; 61% female, age range 13-88. Common self-reported aetiology included sinonasal disease (17%), idiopathic (33%) and post-viral olfactory loss (26%) and post-traumatic olfactory loss (23%). Parosmia was reported as a daily symptom in 67% compared to 31% for phantosmia; 36% complained of suffering with both symptoms. Only 4% of respondents reported having received any successful treatment for their qualitative symptoms and 58% reported having received no treatment whatsoever. Olfactory training was the most common self-management method reported. Conclusion This study illustrates that qualitative disturbances remain problematic for those who experience them due to the duration of symptoms, the relative lack of experience or knowledge amongst medical professionals and the lack of therapeutic options. In future, consideration needs to be given to adaptation and coping strategies to help patients deal with these symptoms.

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Section: Introductionmentioning

confidence: 99%

Qualitative Olfactory Disorders: Patient Experiences and Self-Management

Philpott

Dixon²,

Boak³

2021

Allergy�Rhinol (Providence)

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“…Phantosmia was classified as a qualitative disturbance of smell function and during the COVID-19 pandemic, this phenomenon was not reported. Phantosmia occurs due to a number of etiologies, including chronic rhinosinusitis, cranial trauma, intracranial hemorrhage, epilepsy, psychiatric conditions, brain radiotherapy, neurologic disorders, iatrogenic causes, and neurologic and neurodegenerative disorders and conductive or sensorineural pathophysiology of this specific symptom is still unclear [1]. The frequency of phantosmia has been reported by up to 25% in patients with odor disorder, and the incidence is higher in the elderly compared to the young population [3].…”

Section: Discussionmentioning

confidence: 99%

“…Phantosmia has been described as a sense of smell without a true stimulating odor and is a subjective olfactory dysfunction. Olfactory hallucinations have been previously associated with migraine typed headaches, endoscopic skull base surgery, intracranial tumors, brain radiotherapy treatment, and head trauma in the literature [1]. As described in the literature, phantosmia can persist for years.…”

Section: Introductionmentioning

confidence: 95%

Phantosmia with COVID-19 Related Olfactory Dysfunction: Report of Nine Case

İşlek

Balci

2021

Indian J Otolaryngol Head Neck Surg

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Phantosmia has been described as a sense of smell without a true stimulating odor and not been reported with COVID-19 disease. Nine patients admitted to Ear Nose Throat (ENT) Clinic with complaints of a phantom smell sense after an average of 33.5 ± 9.5 days after the initial PCR diagnosis. According to the Sniffin 'Sticks test, phantosmia was associated with objective hyposmia in three patients with the persistent phantom smell, and other six patients were detected normosmic. Phantosmia or olfactory hallucinations have not been previously associated with COVID-19 disease. Additionally, COVID-19 related phantosmia showed different characteristics according to described in the literature.

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“…With regard to phantosmia, various modalities have been trialled, including haloperidol, sodium valproate, phenytoin, topiramate, verapamil, nortriptyline, gabapentin, topical cocaine, transcranial magnetic stimulation and surgical excision of the olfactory mucosa. A recent systematic review of the current literature concluded, however, that there was insufficient evidence or consensus to make recommendations on the management of this condition [ 29 ]. Of interest, the successful treatment cases described in this review generally involved longer time periods than the present study (from 18 months to 11 years).…”

Section: Discussionmentioning

confidence: 99%

Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients

Whitcroft

Gunder

Cuevas

et al. 2021

Eur Arch Otorhinolaryngol

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Objectives We have previously shown that treatment with intranasal sodium citrate may be beneficial in post-infectious olfactory dysfunction. Sodium citrate reduces free intranasal calcium and is, therefore, thought to prevent calcium-mediated feedback inhibition at the level of the olfactory receptor. We aimed to determine whether treatment with a 2-week course of intranasal sodium citrate improves quantitative olfactory function in patients with post-infectious impairment. We also aimed to determine whether sodium citrate is beneficial in treating qualitative olfactory dysfunction. Methods We performed a prospective, controlled study. Patients applied intranasal sodium citrate solution to the right nasal cavity for 2 weeks. The left nasal cavity was untreated and, therefore, acted as an internal control. Monorhinal olfactory function was assessed using the “Sniffin’ Sticks” composite ‘TDI’ score, before and after treatment. The presence of parosmia and phantosmia was also assessed. Results Overall, there was a significant increase in TDI after treatment (using the best of right and left sides). Treatment with sodium citrate did not significantly improve quantitative olfactory function, compared to control. The proportion of patients reporting parosmia did not change significantly after treatment. However, there was a significant reduction in the proportion of patients reporting phantosmia, at the end of the study period. Conclusions Treatment with intranasal sodium citrate for a period of 2 weeks does not appear to improve quantitative olfactory function in patients with post-infectious impairment, compared to control. It may, however, be beneficial in treating phantosmia, which should be further addressed in future work.

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Management of long‐lasting phantosmia: a systematic review

Abstract: Despite increasing interest in the treatment of phantosmia and reports of successful therapies, there remains a paucity of data and lack of consensus regarding optimal management of this difficult condition.

Cited by 17 publications

References 31 publications

Qualitative Olfactory Disorders: Patient Experiences and Self-Management

Qualitative Olfactory Disorders: Patient Experiences and Self-Management

Phantosmia with COVID-19 Related Olfactory Dysfunction: Report of Nine Case

Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients

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