The patient with post-viral anosmia will always want to know how long they must wait to reach a plateau. This study from South Korea of a comparatively small group (20 controls and 63 patients) tells us that favourable prognostic indicators were female sex and long follow-up. This was a retrospective case note study, which detracts somewhat from the conclusions, although many patients had threshold testing and the setting was a dedicated smell and taste clinic. Over 80% showed some recovery (subjectively) after a year. The occasions where a scientific article makes me laugh out loud (for good rather than bad reasons) are few and far between, but when this occurs it is a pleasant change from the weeping that is often the appropriate emotional response. On this occasion, the authors had a theory as to why female gender was a favourable prognostic factor (and the theory could be true, from what we know about the human capacity for olfactory training and regeneration): ‘most female participants in our study were housewives and continuous olfactory stimulation during cooking might have accelerated regeneration of olfactory neurons.’ I would not be brave enough to advocate support for this theory at the British Rhinological Society meeting (even if I think it is correct)! 

Prognosis of postviral olfactory loss: follow-up for longer than one year.
Lee DY, Lee WH, Wee JH, Kim J-W.
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Edward W Fisher

MA DM FRCS, University Hospitals Birmingham NHS Trust (Heartlands and Good Hope Hospitals); Editor, Journal of Laryngology and Otology.

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