Brief Answer:
Rule out chronic rhinosinusitis.

Detailed Answer:
Hi,

Thank you for your query.

1. If you smell smoke in your nose, it may be due to a pungent by-product of a mild bacterial or fungal infection in the nose or para nasal sinuses. This may also account for your ear surgery.

2. Diabetes makes you more prone for such infections.

3. Oral infections, inflammation including gum and dental (any recent root canal or dental extraction?), foreign bodies, nasal polyps, tumors, tonsilloliths may also cause a smell in the nose. Conditions like atrophic rhinitis, post nasal drip, acid reflux, liver disorders, degenerative brain disorders such as Parkinson's and Alzheimer's may also co-exist. Do you smoke or have alcohol? Have you undergone any blood tests?

4. Due to their unique design, the ventilation of the para nasal sinuses occurs sparingly and passively. This may explain why you get the smell often.

5. If no cause is found, it may be a an olfactory hallucination. This a commonly seen with damage to the olfactory mucosa or olfactory bulb and tract, esp. some years after a head injury. This will show up on imaging such as CT/MRI. Do you have any occupational exposure to extreme cold, constant air conditioning or chemicals?

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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Brief Answer:
Nasal endoscopy, Steam Inhalation.

Detailed Answer:
Hi,

Thank you for writing back.

1. You should seek professional advice as soon as possible. Your blood sugar levels must be reviewed.

2. Your doctor can examine the nose, do a nasal endoscopy, get a nasal swab for culture and a Sinus CT done.

3. Based on the results of these examinations and tests, antibiotics, nasal sprays or endoscopic surgery (including Balloon Sinuplasty) may be prescribed.

4. Home remedies will include steam inhalation and alkaline nasal washes.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.

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