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
Frequently Asked Questions
Anosmia can result from various factors including nasal polyps, chronic inflammation, infections, or allergies like hay fever, even if no recent illness or injury has occurred. Sometimes the cause may not be immediately apparent without detailed evaluation.
Evaluation typically includes a thorough medical history, smell testing to quantify loss, an ear, nose, and throat examination including nasal endoscopy, and imaging studies such as an MRI to identify potential causes.
Yes, treatment depends on the underlying cause. Polyps can be removed or reduced, inflammation can be treated with steroids, infections with antibiotics, and newer therapies like theophylline and smell therapy have shown benefits in persistent cases.
Smell therapy involves systematically exposing patients to various odors to stimulate the olfactory system and promote recovery. Studies have shown it can improve smell function in many people with persistent anosmia.
Theophylline can be used orally or as a topical nasal spray to help restore smell function. Oral theophylline often has many side effects, so topical nasal formulations are preferred and have shown promising results with fewer adverse effects.
Some doctors may deprioritize anosmia treatment if the cause is unclear or persistent. Patients should seek specialized centers like the NY Sinus Center for comprehensive evaluation and access to newer therapies that might not be widely offered.
Yes, anosmia can sometimes be an early sign or indicator of neurological conditions, which is why thorough evaluation is important to rule out related issues and ensure appropriate management.
