Treatment of posttraumatic olfactory dysfunction with corticosteroids and olfactory training.

Few have investigated long-term effect of treatment of posttraumatic olfactory dysfunction (OD). To explore if sequential treatment with corticosteroids and olfactory training (OT) improved smell in patients with OD after moderate and severe traumatic brain injury (TBI). Twenty-two patients with persistent OD, mean 62 months after trauma, completed an open uncontrolled intervention study of treatment for 10 d with oral corticosteroids and thereafter for 3 months with OT twice daily. Olfaction was assessed by Sniffin' Sticks. They were tested at four-time points, with the last assessment 12 months after baseline measurements. Mean age at trauma was 45 (SD 14) years. Mean threshold, discrimination and identification (TDI) score at baseline was 14.4 (SD 7.3) and increased to mean 20.8 (SD 7.4) after 1 year (minimum -3.0; maximum 19.5, value <.001). Analysed separately, each TDI component increased significantly after 1 year. Half of the patients (11/22) experienced a clinically significant improvement of ≥6.0 TDI points. Improvement was not associated with any sociodemographic or trauma-related characteristics or with olfactory function at baseline. Treatment with corticosteroids and OT was promising in persistent OD after TBI and should be further studied.