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Management of long‐lasting phantosmia: a systematic review
Author(s) -
Saltagi Mohamad Z.,
Rabbani Cyrus C.,
Ting Jonathan Y.,
Higgins Thomas S.
Publication year - 2018
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22108
Subject(s) - medicine , medline , cochrane library , english language , data extraction , intensive care medicine , randomized controlled trial , surgery , linguistics , philosophy , political science , law
Background Interest in the pathophysiology and management of phantom smells has increased rapidly over the last decade. A PubMed search for the term “phantosmia” demonstrated a near‐doubling of articles published on phantosmia within the past 7 years. We aimed to systematically review the literature on the management of phantosmia. Methods The PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990, using terms combined with pertinent Boolean search operators. We included articles evaluating management of phantosmia written in the English language, with original data and a minimum of 6 months of follow‐up, on at least 2 patients and with well‐defined and measurable outcomes. Results A total of 2151 unique titles were returned upon the initial search. Of these, 146 abstracts were examined, yielding 7 articles meeting the inclusion criteria. All articles were predominantly level 4 evidence. One prospective level 3 study was included. The studies included a total of 96 patients, with follow‐up ranging from 6 months to 11 years. Endpoints were primarily based on subjective patient responses. Management options included observation and medical and surgical therapy. Olfactory mucosa excision was the only surgical intervention studied, with short‐term symptomatic improvement in 10 of 11 patients. Forty‐one patients were treated medically, which included antipsychotic, antimigraine, and antiseizure medications, transcranial stimulation, and topical cocaine application. Conclusion Despite increasing interest in the treatment of phantosmia and reports of successful therapies, there remains a paucity of data and lack of consensus regarding optimal management of this difficult condition.