1. Effect of Olfactory Training in the Treatment of Traumatic Anosmia
江榮山 涂智文 梁凱莉
台中榮民總醫院 醫學研究部/耳鼻喉頭頸部

2. Olfactory Training
Olfactory training is considered as an effective intervention method that has been used to treat olfactory dysfunction caused by various etiologies.

3. Olfactory Training

4. Olfactory Training

5. Olfactory Training
Pekala K, Chandra RK, and Turner JH. Efficacy of olfactory training in patients with olfactory loss: A systematic review and meta-analysis. Int Forum Allergy Rhinol 6: , 2016.

6. Olfactory Training
Olfactory training may be beneficial to patients with olfactory loss.
Additional randomized controlled trials that include patients with olfactory dysfunction due to multiple etiologies will ultimately be needed to confirm therapeutic effect and protocols.

7. Olfactory Training
The odor identification score in Sniffin’ Sticks test significantly increased after trainings and the odor discrimination score had a trend for significant increase, but the odor threshold score was not significantly different.

8. PEA Threshold Test

9. PEA Olfactory Training
Jiang RS, Twu CW, Liang KL. The effect of olfactory training on the odor threshold in patients with traumatic anosmia. Am J Rhinol Allergy 31: , 2017.

10. PEA Olfactory Training
Jiang RS, Twu CW, Liang KL. The effect of olfactory training on the odor threshold in patients with traumatic anosmia. Am J Rhinol Allergy 31: , 2017.

11. Purpose of the Study
To investigate the effect of olfactory training on the odor identification in patients with traumatic anosmia with traditional 4 odorants.

12. Materials and Methods
A clear history of loss of smell after experiencing a head injury
Birhinal odor detection thresholds: -1, using the PEA odor detection threshold test
Failed steroid and zinc treatment with birhinal and unirhinal PEA thresholds remaining -1

13. Materials and Methods Patients were randomly divided into 2 groups.
Traditional group: a bottle of Eucalyptus oil, Clove oil, Lemon oil, PEA.
PEA group: a bottle of PEA.
To sniff the liquid in each bottle for 10 seconds, twice a day for 6 months.

14. Olfactory Training

15. Evaluation
Evaluated by the birhinal and unirhinal PEA threshold test and traditional Chinese version of UPSIT before and after olfactory training
MRI performed to measure the volume of Olfactory Bulbs (OB)

16. Olfactory Improvement
Birhinal or unirhinal PEA threshold < –1.0
UPSIT-TC score increased 4 or more points

17. Results

18. Results

19. Results Traditional group:
improved threshold: 6/30 (20%), improved identification ability: 12/30 (40%)
PEA group:
improved threshold: 7/33 (21.2%), improved identification ability: 14/33 (42.4%)

20. Discussion The mechanism of olfactory training remains unclear.
Repeated exposure to an odorant might modulate the regeneration of the olfactory mucosa in patients with post-infectious olfactory dysfunction.

21. Discussion
Olfactory training mainly improved the abilities to identify and differentiate odors.
In our previous study, olfactory training improved odor threshold.
In this study, traditional 4 odorant training did not improve the odor identification ability in patients with traumatic anosmia.

22. Conclusion
Olfactory training can improve odor threshold levels in patients with traumatic anosmia.
Whether olfactory training improve the abilities to identify and differentiate odors needs further investigation.