Steroid-dependent anosmia.
OBJECTIVE
To document the response to steroids in patients remaining anosmic following endoscopic nasal and sinus polypectomy.


METHODS
A prospective study of 24 patients with nasal and sinus polyps who were anosmic prior to endoscopic nasal and sinus surgery. Those who remained anosmic after surgery were treated with steroids. Most patients had asthma, allergic rhinitis, or both. A few had aspirin sensitivity.


METHODS
All 24 patients had testing of their sense of smell before and after surgery. Those who remained anosmic postoperatively were first treated with topical nasal and then oral steroids and then tested again.


RESULTS
Twelve of the 24 remained anosmic after surgery and were found to be unresponsive to nasal steroids, but oral steroids were found to restore the sense of smell to normal in most patients. Few patients continued to take the medication for long periods of time mainly because of a fear of side effects. Recent studies have suggested the role of systemic steroids in olfactory secretion, which may explain the mechanism for this response.


CONCLUSIONS
Patients who remain anosmic after the removal of nasal and sinus polyps can be treated with oral steroids resulting in improvement of their sense of smell. Further research is needed on a molecular level to determine the reason for this and also why oral but not nasal steroids are helpful in these patients.
Stevens
M H
MH
University of Utah School of Medicine, Salt Lake City 84106, USA.
D000281:Administration, Intranasal; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery*; D000857:Olfaction Disorders / Q000188:drug therapy*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D012903:Smell / Q000187:drug effects; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones