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The treatment of hyposmia with intranasal steroids

Published online by Cambridge University Press:  29 June 2007

David G. Golding-Wood*
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Mats Holmstrom
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Yvonne Darby
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Glenis K. Scadding
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Valerie J. Lund
Affiliation:
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
*
Address for correspondence: Mr D. G. Golding-Wood, F.R.C.S., The Department of ENT and Head and Neck Surgery, Farnborough Hospital, Farnborough Common, Orpington, Kent, BR6 8ND.

Abstract

Hyposmia is a neglected symptom in patients with rhinitis. We studied 25 patients presenting with perennial rhinitis. Fifteen patients expressed hyposmia as a significant symptom. University of Pennsylvania smell identification test (UPSIT) and visual analogue scales (VAS) were used to score the symptoms of hyposmia, nasal obstruction and nasal discharge before and after six weeks treatment with betamethasone sodium phosphate drops. Those patients with initial symptoms of hyposia significantly improved their UPSIT scores (p = 0.00009) and their VAS scores for hyposmia (p = 0.00133). Despite a significant decrease in the sensation of nasal obstruction, the non-hyposmics showed no increase in UPSIT scores after betamethasone therapy. There was no clear correlation between UPSIT results and other symptom scores. The judicious use of betamethasone drops in the treatment of rhinogenic hyposmia can be recommended.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1996

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References

Brown, H. M., Storey, G., Jackson, F. A. (1977) Beclomethasone diproprionate aerosol in treatment of perennial and seasonal rhinitis: A review of five years' experience. British Journal of Clinical Pharmacology 4: 283S286S.Google Scholar
Chalton, R., Mackay, I., Wilson, R., Cole, P. (1985) Double blind, placebo controlled trial of betamethasone nasal drops for nasal polyposis. British Medical Journal 291: 788.CrossRefGoogle ScholarPubMed
Doty, R. L., Shaman, P., Kimmelman, C. P., Dann, M. S. (1984) University of Pennsylvania smell identification test: A rapid quantitative olfactory function test for the clinic. Laryngoscope 94: 176178.CrossRefGoogle Scholar
Doty, R. L., Newhouse, M. G., Azzalina, J. D. (1985) Internal consistency and short-term test-retest reliability of the University of Pennsylvania smell identification test. Chemical Senses 10: 297300.Google Scholar
Fein, B. T., Kamin, P. B., Fein, N. N. (1966) The loss of sense of smell in nasal allergy. Annals of Allergy 24: 278283.Google ScholarPubMed
Flynn, M. D., Beasley, P., Tooke, J. E. (1992) Adrenal suppression with intranasal betamethasone drops. Journal of Laryngology and Otology 106: 827828.CrossRefGoogle ScholarPubMed
Fukushima, Y. (1978) Clinical studies on olfactory disturbance with the adrenocortical hormone nose-drops. (author's translation). Nippon Jibiinkoka Gakkai Kaiho 81: 3644.CrossRefGoogle Scholar
Holopainen, E., Malmberg, H., Binder, F. (1982) Long-term follow-up of intranasal beclomethasone treatment: a clinical and histologic study. Acta Otolaryngologica (suppl) 386: 270273.CrossRefGoogle Scholar
Jafek, B. W., Moran, D. T., Filer, P. M., Rowley, J. C., Jafek, T. B. (1987) Steroid dependent anosmia. Archives of Otolaryngology and Head and Neck Surgery 113: 547549.CrossRefGoogle ScholarPubMed
Lindqvist, N., Holmberg, K., Pipkorn, U. (1989) Intranasally administered budesonide, a glucocorticoid, does not exert its clinical effect through vasoconstriction. Clinical Otolaryngology 14: 519523.CrossRefGoogle Scholar
Mackay, I. (1989) Topical management of allergic conditions of the nose. Part 2. Intranasal steroids. In Rhinitis: Mechanisms and Management. (Mackay, I., ed.), Royal Society of Medicine Services Ltd, London, pp 183204.Google Scholar
McCormack, H. M., Home, D. J., Sheather, S. (1988) Clinical applications of visual analogue scales: a critical review. Psychological Medicine 18: 10071019.CrossRefGoogle ScholarPubMed
Moore-Gillon, V. (1989) Olfactometry and the sense of smell. In Rhinitis: Mechanisms and Management. (Mackay, I., ed). Royal Society of Medicine Services Ltd, London, pp 6979.Google Scholar
Mygind, N., Vesterhauge, S. (1978) Aerosol distribution in the nose. Rhinology 16: 7988.Google ScholarPubMed
Nicolson, A. N. (1978) Visual analogue scales and drug effects in man. British Journal of Clinical Pharmacology 6: 34.CrossRefGoogle Scholar
Stanley, P. J., Griffin, W. M., Wilson, R., Greenstone, M. A., Mackay, I. S., Cole, P. J. (1985) Effect of betamethasone and betamethasone with neomycin nasal drops on human nasal mucociliary clearance and ciliary beat frequency. Thorax 40: 607–12.CrossRefGoogle ScholarPubMed
Stevens, D. J. (1988) Cushing's syndrome due to the abuse of betamethasone nasal drops. Journal of Laryngology and Otology 102: 219221.CrossRefGoogle Scholar
Whittet, H. B., Shinkwin, C., Freeland, A. P. (1991) Anosmia due to nasal administration of corticosteroid (letter). British Medical Journal 303: 651.CrossRefGoogle Scholar
Zealley, A. K., Aitken, R. C. B. (1969) Measurement of mood. Proceedings of the Royal Society of Medicine 62: 993996.CrossRefGoogle ScholarPubMed
Zusho, H., Asaka, H., Okamoto, M. (1981) Diagnosis of olfactory disturbance. Auris-Nasus-Larynx (Tokyo) 8: 1926.CrossRefGoogle ScholarPubMed