title: Olfactory cocainization is not an effective long-term treatment for phantosmia.
abstract: Phantosmia, the perception of an odor when there are no odorants in the environment, can be a very debilitating symptom. In the 1960s, Zilstorff reported olfactory distortions could be treated by the topical application of a cocaine solution to the olfactory epithelium. In evaluating this treatment, we observed no long-term benefit using cocaine on 6 patients with phantosmia. Based on our observations, the patient's olfactory ability was not a determining factor in the initiation or quality of their phantosmia. Following topical cocainization, we observed a remarkable delay of hours to days in the return of olfactory ability, and when cocaine was applied to only 1 nostril, there was a decreased olfactory ability on the noncocainized side. These results may suggest the possibility that phantosmia is related to a central processing problem.
authors.affiliation: Department of Surgery ENT division, University of Vermont, Burlington, VT 05401, USA. donald.leopold@vtmednet.org.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Leopold
authors.forename: David E
authors.initials: DE
authors.lastname: Hornung
mesh_terms: D000328:Adult; D000368:Aged; D003042:Cocaine / Q000494:pharmacology* / Q000627:therapeutic use*; D018765:Dopamine Uptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000188:drug therapy*; D009831:Olfactory Mucosa / Q000187:drug effects* / Q000503:physiopathology; D012903:Smell / Q000502:physiology; D013997:Time Factors
chemical_list: D018765:Dopamine Uptake Inhibitors; D003042:Cocaine
keywords: cocaine; nasal airflow; olfactory cleft; olfactory neuron; smell distortion