China
Africa
Explore chapters and articles related to this topic
History Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
If sensorineural anosmia (most often of post-viral origin) is diagnosed, explain that there are no curative treatments. Spontaneous recovery is possible, COVID-19 related anosmia typically improves in 7–14 days. In patients without spontaneous improvement there is some evidence that smell training (actively and mindfully sniffing four distinct scents daily) or vitamin A drops are helpful in some patients.
Chemosensation to Enhance Nutritional Intake in Cancer Patients
Published in Alan R. Hirsch, Nutrition and Sensation, 2023
Taste and smell training may also be an effective method to address chemosensory alterations. von Grunderr and colleagues (2019) provided patients with a 60-minute lesson in taste and smell training. The training was provided by a dietitian and included nutrition counseling specific to taste disorders, recommendations to keep the tongue clean, to consume adequate fluids (1.5–2 liters per day), to breathe through the nose as opposed to the mouth, and to smell two odor probes (lemon flavor and clove flavor) twice a day for 15 seconds. Changes in taste were assessed using “Taste Strips,” a validated objective method to assess flavor; and subjectively using the “Taste and Smell Questionnaire.” The intervention group was able to improve their taste scores from baseline (increase of at least 2-points based on Taste Strip) compared to the control group, which only received basic nutrition counseling (p < 0.001). Interestingly, there were no significant changes in self-reported taste changes. Total energy intake and weight changes were not assessed (von Grunderr et al. 2019).
Evaluation of switching or simultaneous use of biologic treatment in patients with severe chronic rhinosinusitis with nasal polyps and severe asthma. Considerations in clinical decision making
Published in Expert Review of Clinical Immunology, 2023
Josje Otten, Rik van der Lans, Eugenio de Corso, kanstantsin Dziadziulia, Bart Hilvering, Els Weersink, Matteo Bonini, Jan Hagemann, Wanrawee Thaitrakool, Claudio Montuori, Ludger Klimek, Sietze Reitsma, Wytske Fokkens
After 6 months of treatment, his asthma control remained excellent without any work impairment and without exacerbations. In addition, he was able to exercise vigorously. Also, his upper airway symptoms strongly improved with improved sense of smell, but infrequent mild pressure on AD persisted. Nasal endoscopy showed minimal polyps on the right side (NPS grade 1) and none on the left (NPS grade 0). Sniffin’s Sticks-12 (olfactory) identification test (SSIT-12: 0–12; 0–6 anosmia, 7–10 hyposmia, 11–12 normosmia) was 6, indicating borderline anosmia. Spirometry results showed FVC = 5,11 L(137,71%); FEV1 = 3,59 L(123,10%); FEV1%M = 70%. Otoscopy showed an unaltered retracted tympanic membrane AD and no abnormalities in AS. We decided to reduce the dose of dupilumab to 300 mg/4 wks. At a recent visit one year after the start of treatment with dupilumab and now 6 months on a dose of 300 mg/4 weeks, he has excellent control of both upper and lower airways. His only remaining complaint is infrequent aural pressure in AD, without conductive hearing loss. Nasal endoscopy showed grade 0 NPS on both sides, and SSIT remained 6. Otoscopy showed a retracted eardrum on the right side, AS normal. The patient indicated that he could perceive all odors during the olfaction identification test, which he was unable to do previously, but he continued to have trouble identifying them. We advised him on smell training. In the end, we decided to further lengthen the dupilumab dosing interval to 300 mg/6 weeks. The patient is continuing on this dose and has well-controlled CRSwNP and asthma.
Anosmia in COVID-19: What Care Providers Need to Know
Published in Issues in Mental Health Nursing, 2021
Pre-COVID literature on smell training does exist, as summarized in a meta-analysis that found a significant, positive effect of smell training, based on studies of participants with post-infectious and post-traumatic olfactory loss and all types of olfactory diseases (Sorokowska et al., 2017). Olfactory training involves asking people to sniff four different odors twice a day for 4-6 months, presumably to increase the growth of olfactory receptor neurons (Sorokowski et al.) The patient selects items representing flowery, spicy, resinous, and fruity categories. Although it is too early to evaluate efficacy of smell training for post-COVID anosmia, there is nothing in the literature to suggest harmful effects of such simple daily exercises.