Part 3: Perspectives on Olfactory and Gustatory Dysfunction Pathophysiology, Management and Relevance to COVID-19: Rationale for Auricular Cranial Nerve Stimulation.

The rapid global emergence of distortions of the senses of smell and taste consequential to COVID-19 has provoked an unprecedented demand for investigation into treatments capable of addressing such medical phenomena. While the pandemic's principal focus rests on interventions intended to prevent the infection and its spread, much attention must be devoted to amelioration of these common symptomatic sequelae of it. The medical historical record reveals a shocking paucity of serious consideration of olfactory and gustatory dysfunction (OGD), hardly exclusive to SARS-CoV-2 infection (as discussed in Part 1 of this article series). To date, no treatment approach has ever delivered noteworthy clinical results for chronic cases. Numerous studies and reviews have addressed the epidemiology and hypotheses of OGD pathophysiology. Past and recent studies have produced vague findings and conclusions devoid of practical clinical applications for patients who continue to experience chronic sensory distortions and deficits. It is urgent that focused exploration be aggressively pursued for therapeutic and restorative modalities to ameliorate OGD across all medical disciplines, with no bias towards any one approach. It is imperative that approaches outside the pharmacological realm are studied; no effective medication of any merit exists. Thus, innovative and new approaches potentially capable of supporting natural self-regulation and restoration of healthy neurophysiology must be investigated, post-haste. Specifically, stimulation of cranial nerves via their auricular branches, by means of various modalities, may hold promise. A vast body of evidence exists to support its investigation. Its inclusion as an extremely safe and inexpensive approach to endeavor to resolve chronic OGD (not merely for post-COVID19 infection) is warranted. The 3-phase auricular acupuncture microsystem may be the most precise form of targeting and positively influencing specific neurological structures affected by COVID-19.