Osteopathic Manipulative Treatment to Treat Patients with Long-Haul COVID Loss of Smell and Taste: A Report of Four Cases

Four cases of patients with Long COVID symptoms of loss of the sense of smell and sense of taste are presented. They differ from the findings in the published case record of anosmia and loss of taste in Magoun. Osteopathic examination revealed flexion and extension of the occiput. No flexion or extension motion of the sphenoid was appreciated. A novel application of the underlying concepts of Osteopathic Cranial Manipulative Medicine is described. This approach resulted in a rapid resolution of the symptoms of loss of the senses of smell and taste, which have persisted for more than a year. An hypothesis for a possible mechanism of the pathophysiology is advanced. The olfactory nerve (CN I) lies on the cribriform plate of the ethmoid bone. When the inflamed sphenoid flexes, becoming stuck down forward on the cribriform plate of an inflamed ethmoid. This may have resulted in impingement of CN I, which then resulted further in anosmia (loss of smell) and concomitant loss of taste.