Question: Hi, I had sinus surgery on all four sinuses along with septoplasty and turbinectomy about a month ago. I completely lost all sense of smell and taste. Maybe once or twice a day I will get it back but very slightly and it only lasts a couple of minutes. My surgeon said it should come back in around 2 weeks and I cannot get an appointment to see him for another 6 weeks. It has now been a month and I am starting to worry. Is this normal?
Answer:
Permanent loss of smell is an uncommon risk from any nasal or sinus surgery. Taste is actually not really involved, but since so much of “flavor” is determined by smell we feel that we have lost taste as well.
It is not unusual for there to be a temporarily diminished sense of smell after sinus surgery as the nasal airways can be congested and there are frequently crusts that keep the flow of air away from the smell fibers, at the roof of the nose. It is likely that is what you have as there are times when the sense of smell returns. Loss of smell from obstruction should resolve and in fact many patients who have diminished smell before surgery will note improvement in their abilitiy to smell afterwards. The much less common loss of smell from nerve damage is best treated earlier, rather than later.
However, most sinus specialists, including us at the NY Sinus Center believe that comprehensive post operative care (including cleanings) is an important part of successful sinus surgery- and will help insure the best results.
I hope this clears things up.
Robert L. Pincus MD
Co-Director NY Sinus Center
Question: I fell and I hit head on radiator, blacked out, hospital was vague and unhelpful, found that I have loss of smell and taste from trauma. Can you help? I have some taste of salt. It depresses me. Nobody seems to know anything about this, have any serious ideas. Everybody wants to meet me and charge for consultations. Stupid I am not. But tired of USA doctors. In other countries they will at least say “nothing known about cures for this” but here I get “buy this, eat that” – trivia, as if it were a minor issue.
Answer: Loss of the sense of smell (anosmia) is a major problem, as you well know. It is important for our safety (spoiled foods, smoke, gas) and for our enjoyment of every day life. Loss of smell can be a predictor of neurologic diseases, such as Parkison’s and early dementia.
We at the NY Sinus Center, take the loss of smell as a serious problem and are working to help people like you with the loss of smell and taste.
It is important to find the cause of one’s loss of smell- in this case it seems likely to be the head trauma.
Recent research has shown that early treatment may be beneficial. Studies have shown that in some cases, treatment of sinus disease may help and prednisone early in the loss may be effective. Some newer therapies that we are using include theophylline nasal sprays and smell therapy. They may be effective in later stages, but as time goes on, any treatment is less likely to help.
I wish we could say that a particular therapy will be effective in any individual- specifically in your problem.
I am attaching a power point of a recent continuing medical education lecture I gave to Ear Nose and Throat specialists on this problem.
I hope this clears things up.
Robert Pincus MD
Co-Director NY Sinus Center.
Question: A month ago I had oral surgery, I had a frenectomy, tooth extraction, bone graft, and an implant. My jaw bone was shaved and I was not prescribed the standard pre & post-op antibiotics, so, unfortunately, I developed a jaw bone infection. I had severe facial & neck swelling from the infection and was in the hospital for five days. I thought my decreased sense of smell & taste was due to all the medications but now I am off all of them and no smell or taste has returned. I can only taste or smell a little bit of bitter. I can’t even taste salt. Is this nerve damage from all the facial swelling? Do you think my lost sense of smell after oral surgery will ever return? It is absolutely devastating not being able to smell and taste. I had been a person with a hypersensitive sense of smell, I would get headaches if smells were too strong and avoided perfumes and the soap aisle in stores. I can’t imagine living the rest of my life like this.
Thank you.
Answer: I just posted a response to a question about the loss of smell on our web site- www.nyogmd.com – under ask the doctors- and I won’t repeat the whole answer…
Your issue is certainly more specific- We don’t always know what causes the loss of taste and lost sense of smell after oral surgery. Smell makes up much of the sense of taste-
The smell fibers are at the top of the nose and we can lose the sense of smell because of nasal congestion (think a bad cold)- or from nerve damage- which can occur after trauma, infection, surgery, or from an unknown reason.
You should be evaluated to make sure you don’t still have a sinus infection which can be causing the former loss- certainly, that can be improved-
Nerve losses are more difficult to treat. The nerve can re-grow over up to about a year. So there certainly is a good chance your smell and taste will return after an acute loss such as yours. We have been suggesting alpha lipoic acid to help with this process.
You might also consider the use of topical theophylline nasal spray. You would have to be in a study at this point, though, such as at the NY Sinus Center, as it is not yet commercially available.
R Pincus MD
NY Sinus Center
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