Takaki Miwa1, Katsuhisa Ikeda2, Takuya Ishibashi3, Masayoshi Kobayashi4, Kenji Kondo5, Yoshinori Matsuwaki6, Takao Ogawa7, Hideaki Shiga8, Motohiko Suzuki9, Kenzo Tsuzuki10, Atsuko Furuta11, Yoshiharu Motoo12, Shigeharu Fujieda13, Yuichi Kurono14. 1. Department of Otorhinolaryngology, Kanazawa Medical University, Japan. Electronic address: miwataka@kanazawa-med.ac.jp. 2. Department of Otorhinolaryngology, Juntendo University, Japan. 3. Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University, Japan. 4. Department of Otorhinolaryngology-Head and Neck Surgery, Mie University, Japan. 5. Department of Otorhinolaryngology, The University of Tokyo, Japan. 6. Matsuwaki Clinic Shinagawa, Japan. 7. Department of Otorhinolaryngology, Shiga University of Medical Science, Japan. 8. Department of Otorhinolaryngology, Kanazawa Medical University, Japan. 9. Department of Otorhinolaryngology, Nagoya City University, Japan. 10. Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Japan. 11. Department of Otorhinolaryngology, Nippon Medical School Tama Nagayama Hospital, Japan. 12. Department of Medical Oncology, Kanazawa Medical University, Japan. 13. Division of Otorhinolaryngology Head and Neck Surgery, Department of Sensory and Locomotor Medicine, University of Fukui, Japan. 14. Department of Otolaryngology, Head and Neck Surgery, Kagoshima University, Japan.
Abstract
OBJECTIVE: To provide an evidence-based recommendation for the management of olfactory dysfunction in accordance with the consensus reached by the Subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction in the Japanese Rhinologic Society. METHODS: Seven clinical questions (CQs) regarding the management of olfactory dysfunction were formulated by the subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction. We searched the literature published between April 1990 and September 2014 using PubMed, the Cochrane Library, and Ichushi Web databases. The main search terms were "smell disorder," "olfactory dysfunction," "olfactory loss," "olfactory disturbance," "olfactory impairments," "olfaction disorder," "smell disorder," "anosmia," "cacosmia," and "dysosmia." Based on the results of the literature review and the expert opinion of the Subcommittee, 4 levels of recommendation, from A-strongly recommended to D-not recommended, were adopted for the management of olfactory dysfunction. RESULTS: Both oral and locally administered corticosteroids have been strongly recommended for patients with olfactory dysfunction due to chronic rhinosinusitis. Nasal steroid spray and antihistamine drugs have been moderately recommended for patients with allergic rhinitis. Although no drugs have been deemed to be truly effective for post-viral olfactory dysfunction by randomized-controlled trials (RCTs) or placebo-controlled trials, olfactory training using odorants has been reported to be effective for improving olfactory function. There is considerable evidence that olfactory testing is useful for differential diagnosis, prediction of disease progression, and early detection of cognitive decline in neurodegenerative diseases. CONCLUSION: The Clinical Practice Guideline has developed recommendations for the management of various aspects of olfactory dysfunction.
OBJECTIVE: To provide an evidence-based recommendation for the management of olfactory dysfunction in accordance with the consensus reached by the Subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction in the Japanese Rhinologic Society. METHODS: Seven clinical questions (CQs) regarding the management of olfactory dysfunction were formulated by the subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction. We searched the literature published between April 1990 and September 2014 using PubMed, the Cochrane Library, and Ichushi Web databases. The main search terms were "smell disorder," "olfactory dysfunction," "olfactory loss," "olfactory disturbance," "olfactory impairments," "olfaction disorder," "smell disorder," "anosmia," "cacosmia," and "dysosmia." Based on the results of the literature review and the expert opinion of the Subcommittee, 4 levels of recommendation, from A-strongly recommended to D-not recommended, were adopted for the management of olfactory dysfunction. RESULTS: Both oral and locally administered corticosteroids have been strongly recommended for patients with olfactory dysfunction due to chronic rhinosinusitis. Nasal steroid spray and antihistamine drugs have been moderately recommended for patients with allergic rhinitis. Although no drugs have been deemed to be truly effective for post-viral olfactory dysfunction by randomized-controlled trials (RCTs) or placebo-controlled trials, olfactory training using odorants has been reported to be effective for improving olfactory function. There is considerable evidence that olfactory testing is useful for differential diagnosis, prediction of disease progression, and early detection of cognitive decline in neurodegenerative diseases. CONCLUSION: The Clinical Practice Guideline has developed recommendations for the management of various aspects of olfactory dysfunction.
Authors: Heike Rebholz; Ralf J Braun; Dennis Ladage; Wolfgang Knoll; Christoph Kleber; Achim W Hassel Journal: Front Neurol Date: 2020-10-26 Impact factor: 4.003