Smell - impaired

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 medical history will be obtained and a physical examination performed.

Medical history questions documenting impaired sense of smell in detail may include:

• Time pattern
  • When did this problem develop?
  • Have you always had problems with your sense of smell?
  • Is it 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 are being taken?
• Other
  • What other symptoms are also present?

The physical examination will include a physical examination of nasal structures.

Diagnostic tests that may be performed include:

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

Intervention:

If possible, the cause will be treated. If the loss of sense of smell is caused by nasal congestion, local decongestants or antihistamines may be prescribed. A vaporizer or humidifier may be recommended to prevent mucosal drying and improve nasal discharge.

Vitamin A may be given orally or by injection. In some cases, a biopsy of the olfactory epithelium (cells responsible for smell) may be required to make a diagnosis.

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