I had a patient who was referred to me 3 month after she became anosmic and cacosmic after a bout of cold. Her PNS-CT and Brain MRI were normal, and also her PHX was okay. What can I do to reduce her cacosmic suffering?
dear Dr. Shaheen,
your patient needs endoscopic evaluation of nasal cavity especially the olfactory cleft. If there is any conductive pathology they have to be addressed. if its a sensorinueral loss (ex. post viral), she can be strated on intranasal steroids with guarded prognosis. stem cell therapy is on its way but have not yet been freely available.
Dear dr. Manoharan, thanks for your answer, there was no intranasal anatomical abnormality, also the mucosal layer was excellent, olfactory cleft was clear and open.
Dear Dr shah in,
The patient also needs a saccharin transit time and nasal brush cytology to look for acquired ciliary abnormality for corroborative evidence of postinfluenza anosmia.
If she has a sensory loss , then she can be on follow up to allow for multipotent stem cells in olfactory cleft to regenerate.
Dear Shahin Bastaninejad,
cacosmia after influenza is quite typical symptom. You can try to put patient on steroid therapy as soon as possible (e.g. Prednison 60mg orally with decreasing the dose), if there is no contraindication (diabetes, gastric ulcer...). Further, olfactory training is also recommended and can be helpful.
In some books cacosmia is considered as a healing process or destructive process of olfactory epithelium.
Dear dr. Manoharan, would you please write me a resource for stem cell transfer in anosmic patients. I'm seriously eager to conduct a research in this regard, also we have Stem Cell bank here in Tehran and it seems to be a real opportunity to test this way for patients suffering from this problem. I appreciate your recommendation in this regard.
Hi, I am looking experience of cacosmia after COVID-19. A pediatrician who had PCR SARS--CoV-2 + after 60 days has cacosmia for 5 days. The neurologist had seen 3 patients more, I wonder could be similar to influenza
Vitamin B complex and Zinc
Nasal corticosteroid spray twice per day
oral prednisone for 3 weeks
doctor,
Pl assess if here is any peripheral neurological sign like trembling fingers, anesthesia at palm, fingers, toes and feet. you may feel for tenderness in nerves like radial, ulnar etc.where they are superficial.
I have got good rsult in treating anosmia when sign symptoms of NTM infection is detected.in such patients. Kindly refer ''A clinical study on NTM (non tubercular mycobacterial infection), published in Research Gate, Germany July 2019''.
- Badges
- Science topic
- Similar topics
- Social Psychology
- Attitude