Treatment of posttraumatic olfactory dysfunction with corticosteroids and olfactory training

Background:Few have investigated long-term effect of treatment of posttraumatic olfactory dysfunction (OD). Aims/objectives:To explore if sequential treatment with corticosteroids and olfactory training (OT) improved smell in patients with OD after moderate and severe traumatic brain injury (TBI). Material and methods:Twenty-two patients with persistent OD, mean 62 months after trauma, completed an open uncontrolled intervention study of treatment for 10 d with oral corticosteroids and thereafter for 3 months with OT twice daily. Olfaction was assessed by Sniffin' Sticks. They were tested at four-time points, with the last assessment 12 months after baseline measurements. Results:Mean age at trauma was 45 (SD 14) years. Mean threshold, discrimination and identification (TDI) score at baseline was 14.4 (SD 7.3) and increased to mean 20.8 (SD 7.4) after 1 year (minimum -3.0; maximum 19.5,pvalue <.001). Analysed separately, each TDI component increased significantly after 1 year. Half of the patients (11/22) experienced a clinically significant improvement of >= 6.0 TDI points. Improvement was not associated with any sociodemographic or trauma-related characteristics or with olfactory function at baseline. Conclusions and significance:Treatment with corticosteroids and OT was promising in persistent OD after TBI and should be further studied.