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Dr. Andrew Rynne

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Had cold and sinus infection. Cannot smell anything. Acute sinusitis?

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Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2386 Questions

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Posted on Fri, 18 Jan 2013 in Ear, Nose and Throat Problems
Question: I had a bad cold that turned into a sinus infection. When I had the cold I lost my sense of smell and taste for 6 days. I have regained some sense of smell and a diminished sense of taste/ During the day my sense varies. I noticed that when I drink hot tea, I taste it better than when I eat food. However the first few bites of food I can taste, but then the taste goes away as I eat. I can smell some odors from far away, and certainly can smell everything when it is up close. This began the beginning of December and now we are about a month into this episode. Do you think I may have permament nerve damage, or maybe there is still inflammation from my acute sinusitis, and polyps in my sinus cavity. The sense comes and go at different degrees of taste and smell during the course of the day.
doctor
Answered by Dr. Naveen Kumar 34 minutes later
Hi

Thanks for the query

After going through your description I do feel you are suffering from acute sinusitis.

During an nose gets congested, because of which there will be blockage of the sinus opening leading to stagnation of the secretions in the sinus and increased viscosity. Stagnation of the secretions gives rise to headache and nasal infection. Also, the stagnated secretions along with the nasal congestion blocks the air from reaching the roof of the nose where the area of olfaction is present. The alternate perception of the smell happens when the congestion reduces and bounces back.

Secondly, the possiblity of nasal septal deviation or presence of polyps has to be ruled out after getting the nose examined through endoscopy.

Meanwhile you can try the following:
1. Drink plenty of warm water – this helps in improving the blood circulation, keeping the mucosa moist and relief from pain
2. Use saline nasal spray followed by steam inhalation 3-4 times a day - this helps in removing the thick secretions from the sinuses and thus reduces the nasal block.
3. You can also try using a steroid nasal spray such as fluticasone or momentasone to reduce the nasal congestion and increase the perception of smell.
4. A mucolytic such as bromhexine or ambroxol will be beneficial in reducing the consistency of the sinus secretions and effective clearing of the sinuses.
5. If the symptoms do not improve, request your doctor for a nasal endoscopy and CT scan of the paranasal sinuses.
6. Also, avoid smoking/chilled food & beverages/alcohol/coffee till you recover.

Hope I have answered your queries; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naveen Kumar 22 minutes later
Thank you for your quick response. I have been diagnosed with a Deviated Septum and some Polyps. When I had the infection earlier in December, I was on Biaxin for 10 days, and the congestion went away, however, I still have a decreased sense of smell and taste, although it was better than before. In the morning my taste and smell is not as good as later on in the day. Any reason for that? I cannot taste grapefruit, but I an taste a kiwi and a chocoloate pop. I can taste my hot tea as well, maybe not as well as before, but enough to enjoy it.

Can this lack of smell be due to continued inflammation from the infection. Because the loss of smell and taste occurred when I had this bad cold/ infection, not when I was feeling okay. Or do you think that this could be permament nerve damage of the Olfactory, or perhaps, these nerves can regenerate over the long term, and i should improve. What time frame to improve. It has been a month already.

Should my ENT prescribe a steroid spray and see if that helps me out.

Thanks,
doctor
Answered by Dr. Naveen Kumar 32 minutes later
Hi

Welcome back

Without a complete examination of the nose, it is very difficult to conclude at this stage whether you suffer from any nerve damage. Yes, the inflammation may not have completely subsided.

It is better to start using a steroid nasal spray at this stage. Steroid nasal spray will help in reducing the inflammation of the olfactory nerves, if any.

Just allow sometime for the mucosa to heal and the infection to subside completely. Meanwhile, please follow my suggestions as mentioned in the previous response and also consult your doctor for a thorough nasal examination.

I wish you good health and good luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naveen Kumar 40 minutes later
Why is it that I can smell everything that is in front of my nose, and identify it, but I am having trouble tasting everything. I thought that if you can smell you should be able to taste. I can smell what I am eating. Yes the smell is diminished from a distance, but when I am on top of it I can smell everything. I thought that if you can smell you can taste. Even though I can breathe through my nose, can their be residual blockage in the upper sinus cavity that is still causing the lessen sense of taste, and smell. Please answer each of my concerns. Thanks,
doctor
Answered by Dr. Naveen Kumar 11 hours later
Hi

Thanks for writing back

To explain this is detail:
Olfaction, taste and trigeminal receptors, all the three put together contribute to flavor. It is during exhalation that the olfaction contribution to flavor occurs, in contrast to that of proper smell, which occurs during the inhalation phase.

The human tongue can distinguish only among five distinct qualities of taste, while the nose can distinguish among hundreds of substances, even in minute quantities.

People who have taste problems often have a smell disorder that can make it hard to identify a food's flavor. Taste problems can be caused by anything that interrupts the transfer of taste sensations to the brain, or by conditions that affect the way the brain interprets these sensations.

In your case, because of the ongoing sinus infection or the anatomical block in the nose, the air is being prevented from reaching the olfactory area. Hence, you are able to perceive the smell close to the nose and not from the far and the same phenomenon is responsible for the reduction in the taste sensation.

Hope this clears your doubts.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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