To evaluate the therapeutic efficacy of combined olfactory training and pharmacotherapy for post-traumatic olfactory dysfunction.

Fifty-one patients with post-traumatic olfactory dysfunction treated at Mie University Hospital (2003–2022) were retrospectively analysed. Patients received either medication only (n = 33) or medication plus olfactory training (n = 18). Olfactory function was assessed using T&T olfactometry. Pharmacotherapy consisted of tokishakuyakusan (7.5 g/day), zinc (150 mg/day) and methylcobalamin (1500 µg/day).

The cure rate was significantly higher in the combination group (50 percent) than in the medication-only group (21 percent) (p = 0.037). The mean time to improvement was shorter with combination therapy (6 ± 3 vs 14 ± 7 months, p = 0.031). Among patients aged less than or equal to 35 years, the cure rate reached 100 percent.

Olfactory training enhances the therapeutic effect of pharmacotherapy in post-traumatic olfactory dysfunction, especially in younger patients. This simple and safe combination therapy may serve as a practical treatment option for post-traumatic olfactory dysfunction.

To investigate the clinical features, therapeutic efficacy and symptom time course of post-coronavirus disease 2019 parosmia.

A 22-item online questionnaire was distributed to AbScent research group and Facebook coronavirus disease 2019 anosmia group adult members to assess clinical features, interventions and their subjective efficacy for parosmia.

A total of 209 participants (86 per cent females) reported: smell loss on average 3 days after coronavirus symptoms, recovery 4 weeks later, and first parosmia symptoms 12 weeks post infection. Respondents reported 10 per cent body weight loss, and listed onion and garlic as significant parosmia triggers. Regarding quality of life, depression was the most cited item (54 per cent). Smell training was trialled by 74 per cent of participants, followed by nasal corticosteroid spray (49 per cent). Stellate ganglion block, trialled by 16 per cent of respondents, had the highest reported improvement (45 per cent), with 21 per cent reporting a sustained benefit – the highest rate amongst registered treatment options.

Post-coronavirus parosmia has a significant impact and remains challenging to treat. Stellate ganglion block appears to be successful relative to other reported treatments. Further research into the pathophysiology, efficacy and mechanism of stellate ganglion block effect is warranted.