Objectives: Treatment for olfactory dysfunction is challenging
due to limited therapeutic options. Olfactory training has shown
improvement in smell identification, discrimination, and threshold for
odor detection. The primary objective is to assess the effect of
olfactory training in patients with olfactory dysfunction after
pituitary surgery, using functional Magnetic Resonance Imaging (fMRI).
Design: This study was designed as a two-arm pilot clinical trial.
Setting: Chilean tertiary hospital providing endoscopic pituitary
surgery and olfactory evaluation and treatment. Participants: We
included two cohorts of subjects: healthy subjects, and patients with
post-surgical olfactory dysfunction. Healthy patients were recruited
voluntarily at the ENT clinic to assess fMRI testing paradigms and as a
control group for the olfactory dysfunction group. Main outcome
measures: The main outcome measures were functional activation analysis
obtained by fMRI. Olfactory test assessment scores were also obtained
during each testing session. Results: 119 patients that underwent an
endoscopic transsphenoidal approach were contacted and surveyed for
olfactory dysfunction. Twelve patients met inclusion criteria, but six
of them declined to participate. Six patients were randomized using
computer-generated random numbers. The patients in the trained group
showed a significant improvement in the olfactory test results after
olfactory training compared to the no-training group (P <
0.05). The group that underwent olfactory training showed more areas of
activation after training than in baseline analysis (P <
0.05). Conclusion: Patients that underwent olfactory training showed
significant improvement in olfactory testing. fMRI results showed more
activated areas in the olfactory training group, which could be
compatible with neuroplasticity.