Long Covid patients who lost sense of smell can be helped with surgery : University College London Hospitals NHS Foundation Trust

[bobbler]

UCLH research finds that Long Covid patients who lost sense of smell can be helped with surgery : University College London Hospitals NHS Foundation Trust

This one was in a GUardian article that the MEA fb linked to as well


Is it also interesting in perhaps providing any clues it could provide regarding long covid and maybe ME/CFS?

Basically the surgery involved widening the nose passage.

The theories they note in the article are:

fSRP aims to improve nasal blockage by correcting a bent or narrow nose which, as a result, also increases the nasal airflow into the olfactory region. It is thought this improves sense of smell by optimising delivery of odorants to the roof of the nose (called the olfactory cleft), where sense of smell is located. The working theory is that ‘increased odorant delivery’ to the olfactory cleft ‘kick starts’ recovery.

As part of their study, the researchers are now looking at the brain changes that happen following fSRP which could explain the long-term olfactory benefits achieved following the surgery.

 

[forestglip]

Here's the study:

The Effectiveness of Functional Septorhinoplasty in Improving COVID-19-related Olfactory Dysfunction

Alfonso Luca Pendolino, Bruno Scarpa, Peter J. Andrews 

[Line breaks added]

Abstract
Long-Term COVID-19-related olfactory dysfunction (C19OD) remains a significant challenge with no established treatment providing meaningful improvement. This study aimed to assess the efficacy of functional septorhinoplasty (fSRP) in improving olfactory dysfunction in patients with persistent C19OD compared to a control group undergoing olfactory training (OT).

In this prospective study patients with persistent C19OD undergoing fSRP were enrolled while those declining surgery continued with OT as the control group. Patients were followed for six months with olfactory function assessed using Sniffin' Sticks (S'S) and nasal airflow evaluated through peak nasal inspiratory flow (PNIF) and acoustic rhinometry (AR). Among the participants 12 underwent fSRP while 13 were in the control group.

Significant improvements (p < 0.05) in all S'S scores were observed in the fSRP group but not in the control group. TDI scores improved above the minimal clinically important difference only in the fSRP group. Strong correlations were found between olfactory scores and nasal measurements. Comparison of olfactory threshold gains between groups revealed a statistically significant benefit in the fSRP group.

These findings suggest that fSRP can significantly improve persistent C19OD providing a notable olfactory threshold gain compared to OT.

Link | PDF (Facial Plastic Surgery) [Open Access]

 

[Hutan]

Interesting, but I don't think it's very relevant to ME/CFS.

It sounds as though delivering more of the odour particles to the now less sensitive sensors made people more likely to detect the smell (in the same way that turning up the volume helps for someone with some kinds of partial hearing loss).

I don't think we have any evidence that people with ME/CFS aren't receiving enough of an identified external stimulus, let alone any idea of what surgery could be done to essentially 'turn up the volume' of that stimulus.

Could ME/CFS be nerve damage though? Maybe (although reports of temporary improvement are hard to reconcile with that).

 

[Midnattsol]

Could ME/CFS be nerve damage though? Maybe (although reports of temporary improvement are hard to reconcile with that).

Compensatory mechanisms that turn out to not function over time could still be an option?

 

[Jonathan Edwards]

Looking at the data I don't see much evidence of a 'kick start' to recovery. There was a very marginal improvement in the surgery group -perhaps not surprisingly if the airway was enlarged. I presume the normal airway architecture has some protective functions and those will be permanently lost whether ornate there is eventual nerve recovery.

 

[Hutan]

Self-assessment of olfaction was performed using a visual analogue scale for smell (sVAS—0 represents “sense of smell absent” and 10 “sense of smell not affected”)[2] whereas sinonasal symptoms were evaluated using the 22-item Sino-Nasal Outcome Test (SNOT-22).

Only quoting that for the acronym. Now that is a good one.

Edit - and there's more:

The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to subjectively assess nasal obstruction.[38]