title: Efficacy of olfactory training in patients with olfactory loss: a systematic review and meta-analysis.
abstract: BACKGROUND
  Olfactory loss is a challenging clinical problem with few proven therapeutic options. Early experimental results with olfactory training suggest that this novel therapy may be an effective intervention for olfactory dysfunction of multiple etiologies. The aim of this study was to systematically review currently available studies that assess the efficacy and outcomes of olfactory training in patients with olfactory loss.
  
  
  METHODS
  A comprehensive systematic literature review was performed with the assistance of a reference librarian using the PubMed, PsycInfo, Google Scholar, EMBASE, and Proquest databases. Eligible studies were extracted based on defined inclusion criteria and the effect of olfactory training on objective olfactory function was evaluated qualitatively and by meta-analysis.
  
  
  RESULTS
  A total of 10 studies with 639 patients were identified and systematically reviewed. Sufficient data for meta-analysis was available for 3 studies. Patients receiving olfactory training experienced a statistically significant improvement in the Threshold, Discrimination, Identification (TDI) score compared to control patients (mean difference [MD] 3.77; 95% confidence interval [CI], 2.28 to 5.26). Improvement in olfactory function was observed in discrimination (MD 1.92; 95% CI, 1.13 to 2.71) and identification (MD 1.61; 95% CI, 0.55 to 2.68), but not in olfactory thresholds (MD -0.01; 95% CI, -0.42 to 0.39).
  
  
  CONCLUSIONS
  Olfactory training is a promising modality for the treatment of olfactory dysfunction. Results of this systematic review and meta-analysis suggest that it may be an effective treatment for olfactory dysfunction due to multiple etiologies. Additional high-quality studies are needed to define indications, outcomes, and duration of therapy for this novel therapy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Kelly
authors.initials: K
authors.lastname: Pekala
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Chandra
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Justin H
authors.initials: JH
authors.lastname: Turner
mesh_terms: D006801:Humans; D000857:Olfaction Disorders / Q000453:epidemiology*; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: anosmia; essential oils; hyposmia; olfactory dysfunction; recovery; rehabilitation; smell training; treatment