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Anosmia

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Anosmia 

Definition

The term anosmia means lack of the sense of smell. It may also refer to a decreased sense of smell. Ageusia, a companion word, refers to a lack of taste sensation. Patients who actually have anosmia may complain wrongly of ageusia, although they retain the ability to distinguish salt, sweet, sour, and bitter—humans' only taste sensations.

Description

Of the five senses, smell ranks fourth in importance for humans, although it is much more pronounced in other animals. Bloodhounds, for example, can smell an odor a thousand times weaker than humans. Taste, considered the fifth sense, is mostly the smell of food in the mouth. The sense of smell originates from the first cranial nerves (the olfactory nerves), which sit at the base of the brain's frontal lobes, right behind the eyes and above the nose. Inhaled airborne chemicals stimulate these nerves.
There are other aberrations of smell beside a decrease. Smells can be distorted, intensified, or hallucinated. These changes usually indicate a malfunction of the brain.

Causes and symptoms

The most common cause of anosmia is nasal occlusion caused by rhinitis (inflammation of the nasal membranes). If no air gets to the olfactory nerves, smell will not happen. In turn, rhinitis and nasal polyps (growths on nasal membranes) are caused by irritants such as allergens, infections, cigarette smoke, and other air pollutants. Tumors such as nasal polyps can also block the nasal passages and the olfactory nerves and cause anosmia. Head injury or, rarely, certain viral infections can damage or destroy the olfactory nerves.

Diagnosis

It is difficult to measure a loss of smell, and no one complains of loss of smell in just one nostril. So a physician usually begins by testing each nostril separately with a common, non-irritating odor such as perfume, lemon, vanilla, or coffee. Polyps and rhinitis are obvious causal agents a physician looks for. Imaging studies of the head may be necessary in order to detect brain injury, sinus infection, or tumor.

Treatment

Cessation of smoking is the first step. Many smokers who quit discover new tastes so enthusiastically that they immediately gain weight. Attention to reducing exposure to other nasal irritants and treatment of respiratory allergies or chronic upper respiratory infections will be beneficial. Corticosteroids are particularly helpful.

Alternative treatment

Finding and treating the cause of the loss of smell is the first approach in naturopathic medicine. If rhinitis is the cause, treating acute rhinitis with herbal mast cell stabilizers and herbal decongestants can offer some relief as the body heals. If chronic rhinitis is present, this is often related to an environmental irritant or to food allergies. Removal of the causative factors is the first step to healing. Nasal steams with essential oils offer relief of the blockage and tonification of the membranes. Blockages can sometimes be resolved through naso-specific therapy-a way of realigning the nasal cavities. Polyp blockage can be addressed through botanical medicine treatment as well as hydrotherapy. Olfactory nerve damage may not be regenerable. Some olfactory aberrations, like intensified sense of smell, can be resolved using homeopathic medicine.

Prognosis

If nasal inflammation is the cause of anosmia, the chances of recovery are excellent. However, if nerve damage is the cause of the problem, the recovery of smell is much more difficult.

Resources

Books

Fauci, Anthony S., et al., editors. Harrison's Principles of Internal Medicine. New York: McGraw-Hill, 1997.

Key terms

Allergen — Any substance that irritates only those who are sensitive (allergic) to it.
Corticosteroids — Cortisone, prednisone, and related drugs that reduce inflammation.
Nasal polyps — Drop-shaped overgrowths of the nasal membranes.
Rhinitis — Inflammation and swelling of the nasal membranes.

anosmia /an·os·mia/ (an-oz´me-ah) lack of sense of smell.anos´micanosmat´ic
an·os·mi·a (n-zm-)
n.
Loss of the sense of smell. Also called olfactory anesthesia.

an·osmic adj.

anosmia,
n the inability to smell; may be short-term, selective (only affecting certain aromas), or total and permanent.

anosmia
absence of the sense of smell; characteristic of lesions of the olfactory lobe, peduncle or mucosa. Such deficiencies are difficult to assess in animals.

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When she continued to complain of progressive headaches, right-sided epiphora, and anosmia, limited computed tomography (CT) of the paranasal sinuses was obtained (figure 1).
In addition, an estimated two to four million Americans suffer from anosmia, a complete loss of smell.
During the annual shareholders' meeting, company executives discussed the most recent attacks, which began with a poster presentation by Bruce Jafek, MD, Rocky Mountain Taste and Smell Center at the University of Colorado Medical Center, attempting to link intranasal zinc gluconate gel--the active ingredient in Zicam Cold Remedy nasal gels--to anosmia (loss of smell).
 
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