Question: I have been suffering from anosmia since approximately July 2012. I had no illness around that time (have not had the flu since 2002), and had no injury of any kind. I do have strong hay fever allergies, but those have been present all my life. I have had an MRI done, and no one has ever identified anything wrong with it, nor has looking up my nose with an endoscope revealed anything. The reason for my email is this: All the doctors I have seen so far, once they are up to speed on the above information, have given up surprisingly quickly on the idea of trying anything. Are there any anosmia treatment options available?
Answer:
The loss of the sense of smell can be quite debilitating. The sense of smell is important for our day to day safety (to determine if food has gone bad or if there is a gas leak), for our enjoyment of life in general, and can be a precursor or indicator of other neurologic problems.
Evaluation includes a thorough history, quantification by smell testing, ear nose, and throat evaluation and nasal endoscopy, and imaging studies such as an MRI.
Many times, but not always, the loss of smell can be reversed or improved. Obstructing polyps can be shrunken or removed, inflammation- such as after a viral infection may be treated with steroids, orally or in the nose. Infection can be treated with appropriate antibiotics if needed.
More recently, several studies have shown that in those people whose loss of smell persists, other newer therapies may be helpful.
Theophylline has been used orally and often can be of help.
Smell therapy- also has been shown to be a benefit in many people as well.
Unfortunately, oral theophylline has many side effects. We have been using a topical nasal spray with theophylline for such patients. The study results have been promising.
We’d be happy to see you at the NY Sinus Center to review your previous studies and treatments to see if we could suggest other therapies- such as intranasal theophylline or smell therapy- and to make sure that no other treatable cause has been missed.
Robert Pincus MD Associate Professor Otolaryngology
Co-Director NY Sinus Center
