Adult patients (> 18 years) with PIOD were recruited from the Smell and Taste Clinic at the Department for Otorhinolarnygology, TU Dresden. After treatment, 12 reported parosmia, 1 phantosmia. Authors: K.L. Results: This medication can also prevent and treat certain metabolic problems (acidosis) caused by kidney disease.Citric acid and citrate salts (which contain potassium and sodium) belong to a class of drugs known as urinary alkalinizers. Pharmaceutics. This concentration was shown to be effective in our previous studies. Further studies should be performed to systematically investigate the utility of this treatment in qualitative dysfunction of varying cause. - 138.201.62.8. This site needs JavaScript to work properly. Chem Senses 39(8):711–718, Whitcroft KL, Merkonidis C, Cuevas M, Haehner A, Philpott C, Hummel T (2016) Intranasal sodium citrate solution improves olfaction in post-viral hyposmia. Second, whilst calcium is involved in downstream feedback inhibition of the olfactory receptor response, its role is not limited to inhibition, and is instead more neurobiologically complex. We speculated that lack of treatment effect might have been due to the age profile of our patient cohort. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Laryngoscope 114(4):733–737, Croy I, Nordin S, Hummel T (2014) Olfactory disorders and quality of life-an updated review. The application was with a glass pipette (‘dropper’). In our current study, overall mean TDI score (taken as best of two monorhinal scores) improved (ΔTDI = 2.08 ± 3.82, p < 0.0001) following 2 weeks of daily use. Sodium Citrate is the sodium salt of citrate with alkalinizing activity. Glucose, Chlorure de sodium, Erythrosine, Glycine, Citrate de sodium, Citrate de potassium, Dihydrogénophosphate de potassium Forme pharmaceutique : Poudre. The effect of intranasal sodium citrate on olfaction in post-infectious loss: results from a prospective, placebo-controlled trial in 49 patients Further basic and clinical work is required to fully delineate the effect of intranasal sodium citrate in the treatment of post-infectious olfactory loss. Indeed, rising intracellular concentrations of Ca2+ leads to activation of calcium-gated chloride channels and subsequent efflux of Cl−. Eur Arch Otorhinolaryngol (2021). Author(s): Allen Loyd V Jr. Issue: Jan/Feb 2018 - Volume 22, Number 1 View All Articles in Issue. In the study, a group of people with anosmia or hyposmia were treated with a sodium citrate nasal spray, alongside a control group whose spray contained water. No significant change in olfactory function occurred for either identification or threshold in any other aetiological subgroup. First, intranasal sodium citrate may cause short-term, temporary effects on olfactory function, that do not lead to sustained improvements in function demonstrable at the end of a treatment period, as in our study. We did, however, demonstrate a significant reduction in proportion of patients reporting phantosmia at the end of the study period. The reduction in proportion of patients with phantosmia after treatment was statistically significant (p = 0.001). Int Forum Allergy Rhinol 8(7):790–796, Leopold DA, Loehrl TA, Schwob JE (2002) Long-term follow-up of surgically treated phantosmia. Background: Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients. We aimed to determine whether treatment with a 2-week course of intranasal sodium citrate improves quantitative olfactory function in patients with post-infectious impairment. In both of these studies, treatment-related improvements in olfactory test scores reached statistical, but not clinical significance. Rhinol J 54(4):368–374, Whitcroft KL, Ezzat M, Cuevas M, Andrews P, Hummel T (2016) The effect of intranasal sodium citrate on olfaction in post-infectious loss: results from a prospective, placebo-controlled trial in 49 patients. Google Scholar, Whitcroft KL, Merkonidis C, Cuevas M, Haehner A, Philpott CM, Hummel T (2016) Intranasal sodium citrate improves olfaction in post-viral hyposmia. The authors have no conflicts of interest to declare. Thirty patients (96.8%) improved their scores in less than an hour period of time. Sodium citrate reduces free intranasal calcium and is, therefore, thought to prevent calcium-mediated feedback inhibition at the level of the olfactory receptor. Classement du médicament en matière de délivrance : Médicament à usage vétérinaire. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Article  K. L. Whitcroft and N. Gunder contributed equally. PubMed  Furthermore, we did not find a significant improvement in monorhinal olfactory function following treatment, compared to control. Chem Senses 22(1):39–52, 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’. Medicine and Health Sciences Politics, Philosophy, Language and Communication Studies. However, there was a significant reduction in the proportion of patients reporting phantosmia, at the end of the study period. No side effects were sufficiently severe to necessitate discontinuation of therapy. Number of times cited according to CrossRef: 6. Google Scholar, Betchen SA, Doty RL (1998) Bilateral detection thresholds in dextrals and sinistrals reflect the more sensitive side of the nose, which is not lateralized. Eur Arch Oto-Rhino-Laryngology 264(3):237–243, Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T (2006) Clinical significance of results from olfactory testing. Ciofalo A, de Vincentiis M, Zambetti G, Altissimi G, Fusconi M, Greco A, Ottaviano G, Magliulo G. Eur Arch Otorhinolaryngol. Graduate School. (d) pharmacokinetic profile after intranasal administration of 100 μM insulin in 10 mM sodium citrate buffer at pH 4.4 with PTD1 or PTD4 to rats. During this prospective trial of intranasal sodium citrate therapy, we found no significant effect of treatment on quantitative olfactory function, compared to control. Rhinol Suppl. Biochemistry 270(37):21480–21486, CAS  Clin Otolaryngol. Of interest, the successful treatment cases described in this review generally involved longer time periods than the present study (from 18 months to 11 years). Statistical analysis was performed using GraphPad Prism (vGraphPad Software, LaJolla). 2017 Dec;42(6):1295-1302. doi: 10.1111/coa.12878. Patients with psychiatric, neurodegenerative or other conditions affecting olfaction were excluded. Within the anosmic subgroup, 5 reported parosmia and 5 phantosmia at baseline. Furthermore, Ca2+ forms a significant proportion of the cation influx through CNG channels following olfactory receptor activation, and is therefore again involved in cell depolarisation [26]. Previous work from Leopold and colleagues suggested that the pathogenesis of phantosmia may be related to peripheral dysfunction, at the level of the olfactory neuroepithelium [30]. Across all patients, there was a significant improvement in TDI score after treatment (comparing best pre- with best post-treatment TDI of right and left monorhinal scores; improvement of 2.08 ± 3.82 points, p < 0.0001, see Fig. Google Scholar, Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G, Hummel T (1997) ‘Sniffin’ sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. A recent systematic review of the current literature concluded, however, that there was insufficient evidence or consensus to make recommendations on the management of this condition [29]. Neuron 15:169–179, Whitcroft KL, Cuevas M, Haehner A, Hummel T (2017) Patterns of olfactory impairment reflect underlying disease etiology. Br J Hosp Med (Lond). Optical observation of insulin (e) at pH 4.4, 4.8, 5.2, and 5.6 and (f) at pH 4.4, 6.4, and 7.6 with PTD1 or PTD4. However, rising intracellular calcium concentration also initiates downstream pathways involved in receptor feedback inhibition. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. They were instructed to maintain this Position for 1–2 min multifactorial assessment and patient olfactory training may the... Patients experiencing parosmia or phantosmia before and after treatment [ 25 ] citrate did not significantly improve olfactory... Depolarisation [ 25 ] ” composite ‘ TDI ’ score, before and after treatment, in the proportion patients! Cavity for 2 weeks acide citrique on qualitative olfactory dysfunction is diagnosed and monitored to take advantage of the is. 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