Houston Advanced Nose & Sinus | ANOSMIA (SMELL LOSS)
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ANOSMIA (SMELL LOSS)

ANOSMIA (SMELL LOSS)

Hyposmia is a decrease in the ability to smell, and anosmia is a total loss of smell. Smell loss is often associated with taste loss because in order to taste we must also be able to smell. The causes of hyposmia and anosmia are diverse ranging from a simple viral cold all the way to an intracranial skull base tumor that has damaged the nerve responsible for smell. The complexity of smell loss is exactly why you need a nose and sinus specialist at Houston Advanced Nose & Sinus. Dr. Kuperan is one of the few fellowship certified Rhinologists in all of Texas with specialized expertise, experience, and skills in treating patients with all causes of smell loss.

UNDERSTANDING THE CAUSES OF ANOSMIA (SMELL LOSS)

The two major types of smell loss are conductive smell loss and neural smell loss. In general, conductive smell loss is easier to treat because usually there is blockage of odors getting to the normally functioning olfactory nerve that transmits smell input to the brain. For example nasal polyps or other causes of nasal obstruction that block the passage of air odor molecules into the nose can cause smell loss. These conductive causes of smell loss are easier to treat because once the cause of the nasal obstruction is removed the smell returns. Neural causes of smell loss are more challenging to treat because they cause direct damage to the olfactory nerve that is responsible for smell. The most common cause of sudden smell loss is a viral upper respiratory tract infection (common cold) that directly damages the olfactory nerve. Other causes of neuralsmell loss that can damage the olfactory nerve include use of topical nasal sprays with zinc, sinus infections, and sinus and skull base tumors.

TREATMENT OF ANOSMIA (SMELL LOSS)

If the symptoms of anosmia or hyposmia are present it is always essential to consult a Rhinologist immediately for an accurate diagnosis and treatment plan. Nasal endoscopy (looking inside the nose with a small camera) is essential to better assess the problem and determine whether it is a conductive or neural cause of smell loss. If a viral cold is the cause of smell loss the most important thing is to start high dose oral steroids immediately. A longer delay in starting treatment means a lower chance that the smell will return. Olfactory training is like physical therapy for smell loss and has shown promising results in patients with sudden smell loss that has not responded to oral steroids. Conductive causes of anosmia like nasal polyps or nasal obstruction may require medical treatment and if this fails may require endoscopic sinus surgery. For neural causes of smell loss like sinus infections medical treatment such as oral antibiotics and steroids is the primary treatment followed by a CT scan (x-ray) to determine if there is a persistent sinus infection. If the infection persists either balloon sinuplasy or endoscopic sinus surgery may be necessary to improve smell. For more severe neural causes of smell loss like sinus and skull base tumors more advanced endoscopic sinus surgery or anterior skull base tumor resection may be necessary. The key is choosing an approach tailored to the severity and cause(s) of your smell loss. There is not one single solution that is correct for every patient, and that’s why Houston Advanced Nose & Sinus is unique. We don’t promote a “cookie-cutter” approach to treatment like some other practices. Dr. Kuperan’s super specialized expertise and experience as a Rhinologist will make sure you get the best treatment so you can smell again.