What is your sense of smell?
The medical name for your sense of smell is olfaction. Specialised olfactory cells sit in the roof of your nose. Chemicals, known as odorants, are released from everything that has an odour, such as perfume or food that you like. Odorants stimulate the nerve fibres in your nose to produce your sense of smell.
What can go wrong with your sense of smell?
There are many things that can go wrong. Odorants may not be able to reach the nerve cells in your nose or, there may be damage to the nerve fibres themselves. Often, something as simple as a common cold may cause you to lose your sense of smell. This may be temporary or, unfortunately, permanent. Other causes are related to swelling of the lining of your nose. This may be due to allergy or polyps in your nose. Nerve cells may be damaged if you injure your head, such as in a fall or accident. You may also lose your sense of smell after nasal or sinus surgery. Tumours may also cause you to lose your sense of smell.
Hyposmia - decreased ability to smell.
Parosmia - things smell worse than they should.
Cacosmia - things smell like faeces.
Dysosmia - things smell different than they should.
Anosmia - inability to smell.
Hyperosmi - an abnormally acute sense of smell.
Phantosmia - 'hallucinated smell', often unpleasant in nature.
What can be done if I am worried about my sense of smell?
Your sense of smell is vital to your sense of wellbeing and quality of life. Particularly because your taste may also be affected. Your ENT surgeon will take a thorough history from you to establish possible causes and severity of your problem. He will examine your nose. He should perform a smell test to objectively quantify the severity of your problem. Additional investigations, such as an allergy test or a CT scan of your sinuses, may provide more information for your surgeon. Occasionally, a more detailed MRI scan may reveal diseases related to your smell (olfactory) nerve, particularly if your surgeon is worried that a tumour is responsible for your symptoms.
Can your smell disturbance be treated?
Treatment depends on cause. If your loss of smell is related to swelling in your nose, this can be treated with medication. If you have sinusitis or polyps, these can be treated with surgery and medication. Tumours can also usually be treated, depending on type and how early it is found. Where the nerve fibres are injured after trauma, this type of smell loss is often permanent. The longer your sense of smell is absent, regardless of cause, the less likely it is to come back to normal. This is a discussion your surgeon will have with you.
What should you do next?