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Study Examines Treatment for Olfactory Loss After Viral Infection

CHICAGO -- October 19, 2009 -- Treatment with a glucocorticoid medication, either alone or in combination with Ginkgo biloba, appears to significantly improve the sense of smell in individuals with previous olfactory loss due to upper respiratory infections, according to a study published in the October issue of the Archives of Otolaryngology-Head & Neck Surgery.

Beom Seok Seo, MD, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea, and colleagues studied 71 patients (mean age, 53 years) who were diagnosed as having post-viral olfactory loss from July 2007 to June 2008.

Patients underwent olfactory function tests, including a butanol threshold test (BTT) and the cross-cultural smell identification test (CCSIT). Follow-up tests were performed 4 weeks later. "Anosmia was defined as concentration levels 0 to 3, severe hyposmia as levels 4 to 5, moderate hyposmia as levels 6 to 8, mild hyposmia as levels 9 to 10, and normosmia as levels 11 to 12," the authors noted.

Patients were randomised to treatment with prednisolone for 2 weeks (n = 28) or treatment with prednisolone for 2 weeks plus Ginkgo biloba for 4 weeks (n = 43). All participants also used mometasone nasal spray twice daily for 4 weeks.

"On the basis of the BTT results, 17 patients (24%) had anosmia, 25 patients (35 %) had severe hyposmia, 23 patients (32%) had moderate hyposmia, 5 patients (7%) had mild hyposmia, and 1 patient had normosmia," the authors wrote. "There was no statistically significant difference in the severity of post-viral olfactory loss between the 2 groups."

Both treatment groups' BTT and CCSIT scores increased significantly after treatment. For the group taking prednisolone, the average BTT and CCSIT score changes were 1.4 and 0.9, respectively. For the group taking prednisolone with Ginkgo biloba, the average BTT and CCSIT score changes were 2.2 and 1.9, respectively. Treatment response rates on the BTT (score of >= 3) were 32% in the prednisolone group and 37% in the prednisolone plus Ginkgo biloba group. Treatment response rates on the CCSIT were 14% in the group taking prednisolone and 33% in the combination therapy group.

"Many more patients experience post-viral olfactory loss and seek recovery of their olfactory function than otolaryngologists have previously thought," the authors concluded. "Postviral olfactory loss is caused by neurodegeneration of cells in the olfactory neural system. More clinical trials are required to evaluate drugs shown to be effective against neurodegeneration for the future treatment of olfactory disorder."

SOURCE: Archives of Otolaryngology-Head and Neck Surgery

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