Seoul National University LogoAccording to a latest study, treatment with a glucocorticoid medicine seems to considerably improve the sense of smell in individuals with earlier olfactory loss as a result of upper respiratory infections. Apparently, this glucocorticoid medicine can be either given alone or in combination with Ginkgo biloba.

Olfactory loss i.e. loss of the sense of smell is known to be ordinary. Also, it may perhaps be caused by head trauma, chronic sinonasal inflammation and viral infections of the nose.

Beom Seok Seo said that, “In particular, postviral olfactory loss is a complicated disease.”

Upper respiratory tract viral infections appear to be common and can be caused by various viruses such as rhinovirus, influenza viruses, parainfluenza viruses and respiratory syncytial viruses.

“However, which viruses cause postviral olfactory loss is unknown, as well as who is susceptible to olfactory damage after the common cold,” continues Beom Seok Seo, M.D., of Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea

As a result, olfactory disorder seems to be not clearly understood thereby making treatment for the condition difficult. For the purpose of better understanding this criterion, the study experts were observed to have analysed nearly 71 patients whose average age was 53 and who were diagnosed of suffering from postviral olfactory loss from July 2007 to June 2008.

During the study, the patients were believed to have undergone olfactory function tests, including a butanol threshold test (BTT) and the cross-cultural smell identification test (CCSIT). BTT is known to have examined patients’ ability to distinguish N-butanol from mineral oil with concentrations varying over 13 levels through each nostril. Whereas, CCSIT was noted to have studied odor identification via both nostrils for each patient. Additionally, follow-up tests appear to have been performed four weeks later.

Beom further elucidated that, “Anosmia (absence of the sense of smell) was defined as concentration levels zero to three, severe hyposmia (reduced sensibility to odors) as levels four to five, moderate hyposmia as levels six to eight, mild hyposmia as levels nine to 10 and normosmia (a normal sense of smell) as levels 11 to 12.”

Furthermore, participants were believed to have been randomly assigned to two treatment groups wherein nearly 28 patients were treated with the steroid prednisolone for two weeks and about 43 were treated with prednisolone for two weeks along with Ginkgo biloba for four weeks. All participants also appear to have made use of mometasone nasal spray twice daily for about four weeks. Mometasone is known to be a steroid used to reduce inflammation.

“On the basis of the BTT results, 17 patients (24 percent) had anosmia, 25 patients (35 percent) had severe hyposmia, 23 patients (32 percent) had moderate hyposmia, 5 patients (7 percent) had mild hyposmia and one patient had normosmia. There was no statistically significant difference in the severity of postviral olfactory loss between the two groups,” claims Beom.

The findings of the study revealed that both treatment groups’ BTT and CCSIT scores seemed to have increased considerably after treatment. For the group taking prednisolone, the average BTT and CCSIT score changes were noted to be 1.4 and 0.9, respectively. Besides, the group which took prednisolone with Ginkgo biloba, the average BTT and CCSIT score changes appear to 2.2 and 1.9.

Treatment response rates on the BTT which is defined as a score increase of three or more seemed to have been about 32 percent in the prednisolone group while 37 percent in the prednisolone with Ginkgo biloba group. Moreover, the study authors discovered that treatment response rates on the CCSIT appear to be 14 percent in the group taking prednisolone and 33 percent in the combination therapy group.

Beom stated that several patients seem to have suffered from postviral olfactory loss and seek recovery of their olfactory function than otolaryngologists have in the past thought. Postviral olfactory loss is known to have been caused by neurodegeneration of cells in the olfactory neural system.

Beom further claimed that additional clinical trials appear to be needed in order to evaluate drugs shown to be effective against neurodegeneration for the potential treatment of olfactory disorder.

The findings of the study have been published in the Archives of Otolaryngology- Head and Neck Surgery.