title: Topical corticosteroid treatment of anosmia associated with nasal and sinus disease.
abstract: OBJECTIVE
  To establish the efficacy of topical corticosteroid nasal spray treatment of severe olfactory loss associated with severe nasal and sinus disease.
  
  
  METHODS
  Efficacy before and after open-label trial of topical corticosteroid nasal spray used exclusively in the head-down-forward position.
  
  
  METHODS
  Taste and smell clinic of a university teaching hospital and research facility.
  
  
  METHODS
  Taste and smell clinic patients with anosmia or severe hyposmia associated with paranasal sinus disease and nasal polyposis including 39 of 45 patients recruited from 1988 to 1994 who completed the topical corticosteroid treatment course and returned for subsequent testing.
  
  
  METHODS
  At least 8 weeks of treatment with flunisolide (Nasalide), 2 sprays in each nostril twice a day, with concurrent antibiotic treatment of any bacterial infection.
  
  
  METHODS
  Subjective olfactory symptoms, objective olfactory function tests, and otolaryngological evaluation (including endoscopic examination).
  
  
  RESULTS
  Olfactory scores significantly improved following treatment (P < .001); signs of nasal and sinus disease significantly decreased (P < .001); and 26 (66%) of the patients reported a subjective improvement in their sense of smell.
  
  
  CONCLUSIONS
  Topical corticosteroid nasal spray administered in a head-down-forward position is an effective treatment of severe olfactory loss associated with severe nasal and sinus disease.
authors.affiliation: Department of Medicine, School of Dental Medicine, University of Connecticut Health Center, Farmington, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Mott
authors.forename: W S
authors.initials: WS
authors.lastname: Cain
authors.forename: D
authors.initials: D
authors.lastname: Lafreniere
authors.forename: G
authors.initials: G
authors.lastname: Leonard
authors.forename: J F
authors.initials: JF
authors.lastname: Gent
authors.forename: M E
authors.initials: ME
authors.lastname: Frank
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005260:Female; D005446:Fluocinolone Acetonide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications*; D000857:Olfaction Disorders / Q000150:complications / Q000188:drug therapy*; D010254:Paranasal Sinus Diseases / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D005446:Fluocinolone Acetonide; C007734:flunisolide