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Chem Senses. 2013 Nov;38(9):803-6. doi: 10.1093/chemse/bjt047. Epub 2013 Oct 11.

Olfactory cocainization is not an effective long-term treatment for phantosmia.

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Department of Surgery ENT division, University of Vermont, Burlington, VT 05401, USA.


Phantosmia, the perception of an odor when there are no odorants in the environment, can be a very debilitating symptom. In the 1960s, Zilstorff reported olfactory distortions could be treated by the topical application of a cocaine solution to the olfactory epithelium. In evaluating this treatment, we observed no long-term benefit using cocaine on 6 patients with phantosmia. Based on our observations, the patient's olfactory ability was not a determining factor in the initiation or quality of their phantosmia. Following topical cocainization, we observed a remarkable delay of hours to days in the return of olfactory ability, and when cocaine was applied to only 1 nostril, there was a decreased olfactory ability on the noncocainized side. These results may suggest the possibility that phantosmia is related to a central processing problem.


cocaine; nasal airflow; olfactory cleft; olfactory neuron; smell distortion

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