Skip to main content

Therapie von Riechstörungen

Treatment of olfactory disorders

Zusammenfassung

Derzeit sind eine Reihe prognostischer Faktoren bekannt, mit denen die Remissionswahrscheinlichkeit bei Riechstörungen auf individueller Ebene vorausgesagt werden kann. Anders verhält es sich bei der Therapie von Riechstörungen. Bei sinunasal bedingten Riechstörungen haben sich medikamentöse und operative Verfahren als effizient erwiesen. Dabei werden v. a. Glukokortikoide topisch und systemisch eingesetzt. Bei schweren mechanischen Behinderungen der Riechfunktion sowie bei fortgeschritteneren Stadien der nasalen Polyposis hat sich die funktionelle endoskopische Nasennebenhöhlenchirurgie bewährt. Hinsichtlich der Therapie posttraumatischer und postviraler Riechstörungen existieren derzeit lediglich nichtmedikamentöse Ansätze, wie das „Riechtraining“.

Abstract

A number of prognostic factors regarding the individual prognosis of untreated olfactory disorders are available. Nevertheless, individual prognostic factors regarding the effects of therapeutic interventions are lacking. Surgical and pharmaceutical interventions have been proven to be effective in the treatment of olfactory disorders due to sinonasal disease. At present, treatment with topical or systemic corticosteroids is most widespread in the management of those disorders. In severe mechanical alterations of nasal airflow and in cases of significant nasal polyposis, functional endoscopic sinus surgery may be helpful. With regard to post-traumatic or postviral olfactory disorders, treatment is currently limited to non-pharmacological intervention such as olfactory training.

This is a preview of subscription content, access via your institution.

Literatur

  1. Blomqvist EH, Lundblad L, Bergstedt H, Stjarne P (2003) Placebo-controlled, randomized, double-blind study evaluating the efficacy of fluticasone propionate nasal spray for the treatment of patients with hyposmia/anosmia. Acta Otolaryngol 123:862–868

    Article  CAS  PubMed  Google Scholar 

  2. Brämerson A, Johansson L, Ek L et al (2004) Prevalence of olfactory dysfunction: the skövde population-based study. Laryngoscope 114:733–737

    Article  PubMed  Google Scholar 

  3. Damm M, Jungehülsing M, Eckel HE et al (1999) Effects of systemic steroid treatment in chronic polypoid rhinosinusitis evaluated with magnetic resonance imaging. Otolaryngol Head Neck Surg 120:517–523

    Article  CAS  PubMed  Google Scholar 

  4. Damm M, Temmel A, Welge-Lüssen A et al (2004) Riechstörungen. Epidemiologie und Therapie in Deutschland, Österreich und der Schweiz. HNO 52:112–120

    Article  CAS  PubMed  Google Scholar 

  5. Damm M, Vent J, Schmidt M et al (2002) Intranasal volume and olfactory function. Chem Senses 27:831–839

    Article  CAS  PubMed  Google Scholar 

  6. Delank KW, Stoll W (1998) Olfactory function after functional endoscopic sinus surgery for chronic sinusitis. Rhinology 36:15–19

    CAS  PubMed  Google Scholar 

  7. Downey LL, Jacobs JB, Lebowitz RA (1996) Anosmia and chronic sinus disease. Otolaryngol Head Neck Surg 115:24–28

    Article  CAS  PubMed  Google Scholar 

  8. El Naggar M, Kale S, Aldren C, Martin FJ (1995) Effect of Beconase nasal spray on olfactory function in post-nasal polypectomy patients: a prospective controlled trial. J Otolaryngol 109:941–944

    Google Scholar 

  9. Fein BT, Kamin PB, Fein NN (1966) The loss of sense of smell in nasal allergy. Ann Allergy 24:278–283

    CAS  PubMed  Google Scholar 

  10. Golding-Wood DG, Holmstrom M, Darby Y et al (1996) The treatment of hyposmia with intranasal steroids. J Laryngol Otol 110:132–135

    Article  CAS  PubMed  Google Scholar 

  11. Graziadei PPC, Monti-Gradiadei GA (1978) Continuous nerve cell renewal in the olfactory system. In: Jacobson M (ed) Handbook of sensory physiology, vol IX. Springer, New York

  12. Gudziol V, Buschhüter D, Abolmaali N et al (2009) Increasing olfactory bulb volume due to treatment of chronic rhinosinusitis–a longitudinal study. Brain 132:3096–3101

    Article  CAS  PubMed  Google Scholar 

  13. Haehner A, Welge-Luessen A (2010) Riechstörungen bei neurodegenerativen Erkrankungen. HNO 58, doi 10.1007/s00106-010-2122-x

  14. Heckmann SM, Hujoel P, Habiger S et al (2005) Zinc gluconate in the treatment of dysgeusia–a randomized clinical trial. J Dent Res 84:35–38

    Article  CAS  PubMed  Google Scholar 

  15. Henkin RI, Schecter PJ, Friedewald WT et al (1976) A double blind study of the effects of zinc sulfate on taste and smell dysfunction. Am J Med Sci 272:285–299

    Article  CAS  PubMed  Google Scholar 

  16. Hosemann W, Görtzen W, Wohlleben R et al (1993) Olfaction after endoscopic endonasal ethmoidectomy. Am J Rhinol 7:11–15

    Article  Google Scholar 

  17. Hotchkiss WT (1956) Influence of prednisone on nasal polyposis with anosmia. Arch Otolaryngol 64:478–479

    CAS  Google Scholar 

  18. Hughes LF, McCasey ME, Donathan CL et al (2002) Effects of hormone replacement therapy on olfactory sensitivity: cross-sectional and longitudinal studies. Climacteric 5:140–150

    CAS  PubMed  Google Scholar 

  19. Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the „Sniffin‘ Sticks“ including tests of odor identification, odor discrimination and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 264:237–243

    Article  CAS  PubMed  Google Scholar 

  20. Hummel T, Rissom K, Reden J et al (2009) Effects of olfactory training in patients with olfactory loss. Laryngoscope 119:496–499

    Article  PubMed  Google Scholar 

  21. Hummel T, Welge-Lüssen A (2008) Erfassung des Riech- und Schmeckvermögens. In: Hummel T, Welge-Lüssen A (Hrsg) Riech- und Schmeckstörungen, Thieme, Stuttgart, S 43–60

  22. Klimek L, Eggers G (1997) Olfactory dysfunction in allergic rhinitis is related to nasal eosinophilc inflammation. J Allergy Clin Immunol 100:159–164

    Article  Google Scholar 

  23. Kobal G, Hummel T, Sekinger B et al (1996) Sniffin‘ Sticks: Screening of olfactory performance. Rhinology 34:222–226

    CAS  PubMed  Google Scholar 

  24. Landis BN, Hummel T, Hugentobler M et al (2003) Ratings of overall olfactory function. Chem Senses 28:691–694

    Article  CAS  PubMed  Google Scholar 

  25. Landis BN, Konnerth CG, Hummel T (2004) A study on the frequency of olfactory dysfunction. Laryngoscope 114:1764–1769

    Article  CAS  PubMed  Google Scholar 

  26. Lildholdt T, Rundcrantz H, Lindqvist N (1995) Efficacy of topical corticosteroid powder for nasal polyps: a double-blind, placebo-controlled study of budesonide. Clin Otolaryngol 20:26–30

    Article  CAS  PubMed  Google Scholar 

  27. Lill K, Reden J, Müller A et al (2006) Olfactory function in patients with post-infectious and post-traumatic smell disorders before and after treatment with vitamin A: a double-blind, placebo-controlled, randomized clincial trial. Chem Senses 31:A33

    Google Scholar 

  28. Livermore A, Hummel T (2004) The influence of training on chemosensory event-related potentials and interactions between the olfactory and trigeminal systems. Chem Senses 29:41–51

    Article  PubMed  Google Scholar 

  29. Meltzer EO, Jalowayski AA, Orgel A, Harris AG (1998) Subjecive and objective assessments in patients with seasonal allergic rhinitis: effects of therapy with mometasone furoate nasal spray. J Allergy Clin Immunol 102:39–49

    Article  CAS  PubMed  Google Scholar 

  30. Michael W (2003) Anosmia treated with acupuncture. Acupunct Med 21:153–154

    Article  PubMed  Google Scholar 

  31. Minovi A, Hummel T, Ural A et al (2008) Predictors of the outcome of nasal surgery in terms of olfactory function. Eur Arch Otorhinolaryngol 265:57–61

    Article  CAS  PubMed  Google Scholar 

  32. Mott AE, Cain WS, Lafreniere D et al (1997) Topical corticosteroid treatment of anosmia associated with nasal and sinus disease. Arch Otolaryngol Head Neck Surg 123:367–372

    CAS  PubMed  Google Scholar 

  33. Murphy C, Schubert CR, Cruickshanks KJ et al (2002) Prevalence of olfactory impairment in older adults. JAMA 288:2307–2312

    Article  PubMed  Google Scholar 

  34. Nordin S, Brämerson A, Bende M (2004) Prevalence of self-reported poor odor detection sensitivity: the Skövde population-based study. Acta Otolaryngol 24:1171–1173

    Article  Google Scholar 

  35. Nordin S, Brämerson A, Millqvist E, Bende M (2007) Prevalence of parosmia: the Skövde population-based studies. Rhinology 45:50–53

    PubMed  Google Scholar 

  36. Nordin S, Monsch AU, Murphy C (1995) Unawareness of smell loss in normal aging and Alzheimer’s disease: discrepancy between self-reported and diagnosed smell sensitivity. J Gerontol B Psychol Sci Soc Sci 50:187–192

    Google Scholar 

  37. Pade J, Hummel T (2008) Olfactory function following nasal surgery. Laryngoscope 118:1260–1264

    Article  PubMed  Google Scholar 

  38. Quint C, Temmel AF, Hummel T, Ehrenberger K (2002) The quinoxaline derivative caroverine in the treatment of sensorineural smell disorders: a proof-of-concept study. Acta Otolaryngol 122:877–881

    Article  CAS  PubMed  Google Scholar 

  39. Reden J, Herting B, Kern RC, Lill K (2007) Treatment of post-infectious olfactory disorders with minocycline: A double-blind, placebo-controlled study. Chem Senses 32:A29

    Google Scholar 

  40. Seiden AM, Duncan HJ (2001) The diagnosis of a conductive olfactory loss. Laryngoscope 111:9–14

    Article  CAS  PubMed  Google Scholar 

  41. Stuck BA, Blum A, Hagner AE et al (2003) Mometasone furoate nasal spray improves olfactory performance in seasonal allergic rhinitis. Allergy 58:1195

    Article  CAS  PubMed  Google Scholar 

  42. Toft A, Wihl JA, Toxman J, Mygind N (1982) Double-blind comparison between beclomethasone dipropionate as aerosol and as powder in patients with nasal polyposis. Clin Allergy 12:391–401

    Article  CAS  PubMed  Google Scholar 

  43. Camp C van, Clement PA (1994) Results of oral steroid treatment in nasal polyposis. Rhinology 32:5–9

    PubMed  Google Scholar 

  44. Vennemann MM, Hummel T, Berger K (2008) The association between smoking and smell and taste impairment in the general population. J Neurol 255:1121–1126

    Article  PubMed  Google Scholar 

  45. Vent J, Wang DW, Damm M (2010) Effects of traditional Chinese acupuncture in post-viral olfactory dysfunction. Otolaryngol Head Neck Surg 142:505–509

    Article  PubMed  Google Scholar 

  46. Yang J, Zhang Q (1999) Twenty-three cases of atrophic rhinitis treated by deep puncture at three points in the nasal region. J Tradit Chin Med 19:115–117

    CAS  PubMed  Google Scholar 

  47. Zhang WP, Ishida T (2006) An ageusia and dysosmia patient treated by acupuncture. Chin J Integr Med 12:66–67

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Die Autoren geben an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B.A. Stuck.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hummel, T., Stuck, B. Therapie von Riechstörungen. HNO 58, 656–660 (2010). https://doi.org/10.1007/s00106-010-2137-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-010-2137-3

Schlüsselwörter

  • Riechen
  • Entzündung
  • Hyposmie
  • Anosmie
  • Riechstörung

Keywords

  • Olfaction
  • Inflammation
  • Hyposmia
  • Anosmia
  • Smell disorders