Surgery usually used to correct a blocked nasal passage may help patients who lose their sense of smell after contracting a COVID infection.
This is according to early-stage research in the UK.
Clinicians at NHS Foundation Trust, University College London Hospitals, demonstrated in 2019 that functional septorhinoplasty (fSRP) could restore the sense of smell following a viral infection or trauma.
They have now found that it could be an option for long-term COVID patients with an impaired sense of smell (persistent olfactory dysfunction of more than two years) if other treatments—smell training and oral/topical corticosteroids—fail.
fSRP aims to improve nasal blockage by correcting a bent or narrow nose, which increases nasal airflow into the olfactory region.
This improves the sense of smell by optimising the delivery of odorants to the olfactory cleft. The working theory is that ‘increased odorant delivery’ ‘kick starts’ recovery.
The research was conducted at the Royal National ENT and Eastman Dental Hospitals at UCLH between October 2022 and May 2023.
Professor Peter Andrews (pictured), a senior consultant surgeon in rhinology and facial plastic surgery, and Alfonso Luca Pendolino, a senior rhinology fellow at UCLH, led the research. Both are affiliated with the UCL Ear Institute.
The team compared two groups of Long COVID patients with similar impaired sense of smell and comparable baseline characteristics. Twelve patients underwent fSRP, while a control group of 13 continued smell training for the study.
The sense of smell was evaluated throughout the study using the Sniffin’ Sticks test, a widely utilised method in clinical practice that assesses olfaction through pen-like odour-dispensing devices.
The study’s results, published in the journal Facial Plastic Surgery, revealed a significant benefit regarding increased nasal airflow and an enhanced sense of smell in the group of patients who underwent fSRP. The sense of smell improved for all the patients who had the procedure. In contrast, the patients who did not receive fSRP saw no improvement in their sense of smell, which decreased by 40%.
The procedure was particularly effective at enhancing odour sensitivity by lowering the odour threshold – the minimal concentration of an odour that a person can detect, which is especially noted in Long COVID patients with a reduced sense of smell.
