Safety and Usefulness of the Long-term Intranasal Topical Treatment with Steroids for Olfactory Dysfunction

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  • Kobayashi Masayoshi
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Imanishi Yoshinori
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Ishikawa Masako
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Nishida Kohei
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Adachi Mitsuo
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Oishi Maaya
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Nakamura Satoshi
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Sakaida Hiroshi
    Department of Otorhinolaryngology, Mie University School of Medicine
  • Majima Yuichi
    Department of Otorhinolaryngology, Mie University School of Medicine

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Other Title
  • きゅう覚障害に対するステロイド薬の長期点鼻療法の安全性と有用性の検討
  • キュウカク ショウガイ ニ タイスル ステロイドヤク ノ チョウキテン ビ リョウホウ ノ アンゼンセイ ト ユウヨウセイ ノ ケントウ

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Abstract

Intranasal topical steroids are commonly used for the treatment of olfactory dysfunction. Although the side effects are considered to be minimal, these have not been studied in detail. We examined the side effects of intranasal topical treatment with steroids in patients with olfactory dysfunction. We treated 62 patients with intranasal topical application of 0.1% betamethasone sodium phosphate (Rinderone_??_) administered to the olfactory clefts. After treatment for 1 or 2 months. serum ACTH or cortisol was reduced in 42 (68% of total) patients, however, no clinical symptoms associated with steroid side effects were observed. The treatment was discontinued in 8 of these patients, who elected to withdraw from the treatment. In these patients, the serum ACTH or cortisol returned to normal a month after stopping the treatment. In the remaining 34 patients, the topical treatment was continued and in only 4 of these patients, minor steroid-as-sociated side effects such as the sensation of facial swelling and facial hair thickening, appeared 2-5 months after beginning the treatment. These side effects disappeared within a month after stopping the treatment. Regarding the therapeutic efficacy, in 18 (78%) of the 23 patients who continued treatment for an average period of 5 months, steroid treatment significantly improved their olfactory dysfunction. In conclusion, although it is important to consider the potential side effects of long-term intranasal topical treatment with steroids for olfactory dysfunction, this treatment is a highly effective method against olfactory dysfunction with minimal side effects.

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