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Intranasal vitamin A is beneficial in post-infectious olfactory loss

  • Rhinology
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Abstract

Vitamin A plays a decisive role in the regeneration of olfactory receptor neurons. In this retrospective study we investigated the effectiveness of topical vitamin A in patients with post-infectious and posttraumatic smell disorders. Retrospective cohort. A total of 170 patients (age range 18–70 years, mean age 52 years) participated. Forty-six patients were treated with smell training only. The remaining 124 patients received smell training and topical vitamin A. Olfactory function was assessed using the Sniffin’ Sticks test kit, a validated technique to measure odor thresholds, discrimination and identification. The duration of olfactory training was 12 weeks. In patients receiving vitamin A, this was applied topically (head back position) at a dose of 10,000 IU/day for 8 weeks. Follow-up testing was performed approximately 10 months after the first assessment. Thirty-seven per cent of all post-infectious patients treated with vitamin A exhibited clinical improvement, whereas only 23% improved in controls. Using a Chi-square test, this was a significant result (χ 2 = 7.06, df = 2, p = 0.03). In addition, when comparing change in score after treatment, olfactory training + vitamin A produced significantly greater improvement compared with training alone, in discrimination score for all patients (1.4 points, p = 0.008), and in threshold and discrimination in the post-infectious group (1.6 points, p = 0.01 and 1.4 points, p = 0.04, respectively). Intranasal vitamin A at a dose of 10,000 IU per day for 2 months may be useful in the treatment of post-infectious olfactory loss. Further work with prospective, placebo-controlled studies is required to confirm these findings.

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Acknowledgements

We are indebted to Dr. Bettina Hauswald for her help with the clinical examination of the patients.

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Author notes

  1. Thomas Hummel, Katherine L. Whitcroft and Gina Rueter contributed equally.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Interdisciplinary Center for Smell and Taste, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany

    Thomas Hummel, Katherine L. Whitcroft, Gina Rueter & Antje Haehner

  2. UCL Ear Institute, London, UK

    Katherine L. Whitcroft

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  1. Thomas Hummel
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  2. Katherine L. Whitcroft
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Correspondence to Thomas Hummel.

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Financial disclosure

Thomas Hummel was supported by a grant from the Deutsche Forschungsgemeinschaft (DFG HU441/18-1).

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The author(s) declare that they have no competing interests.

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Hummel, T., Whitcroft, K.L., Rueter, G. et al. Intranasal vitamin A is beneficial in post-infectious olfactory loss. Eur Arch Otorhinolaryngol 274, 2819–2825 (2017). https://doi.org/10.1007/s00405-017-4576-x

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  • DOI: https://doi.org/10.1007/s00405-017-4576-x

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