Pendolino, Alfonso Luca;
(2025)
Evaluation and treatment of olfactory dysfunction in chronic upper respiratory tract diseases.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: Olfactory dysfunction (OD) represents a common problem in chronic upper respiratory diseases; however, prevalence and treatment options remain poorly understood. Aims: To evaluate OD in terms of prevalence and severity in three types of chronic upper respiratory disease: 1. Non-steroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD) 2. Sleep-disordered breathing (SDB) 3. Post-infectious olfactory dysfunction (mainly on patients with COVID-19-related OD – C19OD). To assess the efficacy and effectiveness of currently available and new treatments in these three diseases including intranasal lysine aspirin (LAS) for N-ERD, radiofrequency of inferior turbinates (RFITs) for SDB and functional septorhinoplasty (fSRP) for C19OD. This is based on the hypothesis that an increase in nasal airflow and/or control of local inflammation can lead to improved olfaction. Methods: Ten research studies were conducted for this PhD project: 2 retrospective cohort studies, 4 cross-sectional analyses, 2 prospective non-controlled cohort studies and 2 prospective-controlled cohort studies. Results: OD is highly prevalent amongst N-ERD (81.8%), SDB (23.5%) and C19OD patients (prevalence variable on studies). Long-term use of LAS in N-ERD was associated with improved olfaction (p=0.048), nasal airflow (p<0.001) and quality of life (QoL – p=0.02) when compared to those not using it. RFITs in SDB subjects significantly improved nasal airways (p<0.02) and OD, the latter not significantly. Persistent C19OD significantly affects QoL (p<0.05). Corticosteroids plus olfactory training (OT) can significantly improve measured and reported olfaction (p=0.01 for both) in medium-term C19OD (~7 months). In patients with long-term (>2years) C19OD, fSRP can significantly restore olfaction (p<0.05) when compared to OT. Conclusion: My research offers new insights in the treatment of OD in N-ERD, SDB and PIOD patients while suggesting new potential therapeutic options through the management of local sinonasal inflammation and/or nasal airways optimisation. My findings will encourage future research and assist in the development of new treatments for smell loss.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Evaluation and treatment of olfactory dysfunction in chronic upper respiratory tract diseases |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > The Ear Institute |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10210845 |
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