Smell - impaired

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Loss of smell; Anosmia

Treatment of underlying disorders may correct loss of the sense of smell. This can include antihistamines (if the condition is related to allergy), surgical correction of physical blockages, treatment of other disorders, changes in medication, and so on. Avoid excessive use of nasal decongestants, which can lead to recurring nasal congestion.

If loss of the sense of smell is permanent, dietary counseling may include use of highly seasoned foods and stimulation of taste sensations that remain.

Caution should be taken to ensure safety around the home with smoke detectors and use of electric appliances rather than gas appliances or technologies that detect the presence of gas fumes in the home.

For loss of smell due to aging, there is no treatment.

For loss of smell caused by a recent viral upper respiratory infection, be patient. The symptoms return to normal without treatment. Sometimes zinc supplements are recommended.

Note: Loss of the sense of smell may be temporary, and ability to smell may return spontaneously, especially after colds or viral infections.

If the loss of smell is persistent, is getting worse, or is accompanied by other unexplained symptoms, call your health care provider.

The doctor will perform a physical exam and ask questions about your medical history and current symptoms. Questions may include:

• Time pattern
  • When did this problem develop?
  • Have you always had problems with your sense of smell?
  • Is the problem getting worse?
• Quality
  • Are all odors affected or only certain types?
  • Can you taste food?
• Aggravating factors
  • Do you have a cold or other upper respiratory infection?
  • Do you have allergies?
  • Do you have chronic sinusitis?
  • What medications do you take?
• Other
  • What other symptoms do you have?

The doctor will look at your nose and surrounding structures. Tests that may be performed include:

• CT scan
• Olfactory nerve testing
• Nasal endoscopy
• X-rays of the skull
• MRI scan

In some cases, surgery (biopsy) to remove a piece of the olfactory epithelium (cells responsible for smell) may be needed to make a diagnosis.

TREATMENT

If the loss of sense of smell is caused by a stuffy nose (nasal congestion), decongestants or antihistamines may be prescribed.

A vaporizer or humidifier may be recommended to prevent mucosal drying and improve nasal discharge.

Steroid nasal sprays or pills may be recommended.

Vitamin A may be given by mouth or with a shot (injection).

Review Date: 04/28/2006
Reviewed By: Alden J. Pearl M.D., Clinical Assistant Professor, Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, Brooklyn, NY. Review provided by VeriMed Healthcare Network.