Doctors in London have successfully restored a sense of smell and taste in patients who lost it due to long Covid with pioneering surgery that expands their nasal airways to kickstart their recovery.
Most patients diagnosed with Covid-19 recover fully. But the infectious disease can lead to serious long-term effects. About six in every 100 people who get Covid develop long Covid, with millions of people affected globally, according to the World Health Organization.
Losing a sense of smell and taste are among more than 200 different symptoms reported by people with long Covid.
Now surgeons at University College London Hospitals NHS Foundation Trust (UCLH) have cured a dozen patients, each of whom had suffered a profound loss of smell after a Covid infection. All had experienced the problem for more than two years and other treatments, such as smell training and corticosteroids, had failed.
In a study aiming to find new ways to resolve the issue, surgeons tried a technique called functional septorhinoplasty (fSRP), which is typically used to correct any deviation of the nasal septum, increasing the size of nasal passageways.
This boosts airflow into the olfactory region, at the roof of the nasal cavity, which controls smell. Doctors said the surgery enabled an increased amount of odorants – chemical compounds that have a smell – to reach the roof of the nose, where sense of smell is located.
They believe that increasing the delivery of odorants to this area “kickstarts” smell recovery in patients who have lost their sense of smell to long Covid.
Prof Peter Andrews, a senior consultant surgeon in rhinology and facial plastic surgery who led the research, said surgery increased the airway by about 30%, so airflow also increased by about 30%.
“This study has shown impressive results – if we apply the principle of increasing the nasal or olfactory airway, we’re getting a reactivation of the sense of smell and then an improvement of the sense of smell.
“With long Covid anosmia you’ve got patients, fundamentally, who can’t smell or smell very poorly, so we need to somehow wake them up. And this operation sort of does that.
“It sort of wakes up the olfactory mucosa and then it builds on it through the increased nasal airway – hitting that area, more odorants hitting that area – and we’re getting this impressive recovery in the majority of the patients. All patients we operated on improved.”
In the trial, 12 patients had fSRP and a control group of 13 patients continued with smell training – sniffing the same scents repeatedly.
All patients who had fSRP reported an improved sense of smell compared with none of the patients in the sniff test group, where 40% actually reported a worsening sense of smell. The results were published in the journal Facial Plastic Surgery.
One of the patients, Penelope Newman, 27, from south London, said her taste and smell had “almost returned to normal” after the operation.
“Before I had the surgery on my nose, I had begun to accept that I would probably never be able to smell or taste things the way I used to.
“Since the surgery, I have begun to enjoy food and smells the same way I used to. I can now cook and eat garlic and onions and people can cook for me too. I can go out to eat with my friends and family.”
Source: www.theguardian.com