ENT specialist Dr Sundarrajan in Dubai explains smell disorders

Gulf News

If the onset of the smell disorder is sudden, say after a viral infection like COVID, then there is a role for medications including, but not limited to, steroids in the form of nasal sprays or oral tablets  Read the full story here: https://gulfnews.com/special-reports/why-am-i-getting-that-bad-smell-in-my-nose-how-to-get-rid-of-it-1.1665475222347  See more videos at https://gulfnews.com/videos Read more Gulf News stories here: https://bit.ly/2HLJ2km  Subscribe to Gulf News on YouTube and watch more of our videos: https://www.youtube.com/user/GulfNewsTV  #UAEnews #smelldisorders #health

Transcript

00:00Bad Smell in the Nose or Cacosmia as we call it in medical terms. This problem has come

00:10into sharp focus after the pandemic of COVID has set in, but by no means is a new issue.

00:16Smell is a very basic and important sense needed for a variety of reasons both good

00:20and bad, and when this gets distorted or lost, the effects can be devastating both physically

00:25as well as emotionally. Why does this occur? For us to understand this, we need to understand

00:31how smell occurs or the physiology of smell. Smell molecules get sniffed into the upper

00:37part of the nose where the smell nerves or the olfactory nerves carry the sensation to

00:42the part of the brain where it's interpreted as a particular smell, be it good or bad.

00:48So any disturbances in this pathway can cause altered loss of smell or bad smell, and so

00:55physically something wrong with the nose or the sinuses or the area behind the nose

00:59which we call as nasopharynx or the oral cavity or the teeth can lead to a bad smell and it

01:05also follows that any problems which affects the smell nerve or the part of the brain which

01:10is responsible for interpreting the sensation can also cause the same. The commonest cause

01:16of bad smell would be anything which can cause retained secretions within the nose or the

01:22sinuses, and as all of us know, stagnant water or stagnant secretions can always raise

01:28a stink. So some of the commonest causes that cause retained secretions within the nose

01:34or sinuses would be allergic rhinitis, especially if it's uncontrolled or severe, even common

01:40colds which are severe, acute and chronic sinusitis wherein there is stagnation of secretions

01:46within the sinuses. Amongst all these problems, chronic sinusitis is a particularly important

01:51problem because, you know, you could have stagnation of secretions for a long time and

01:56patients may not have any other symptoms which might make it confusing for them to find out

02:00where the cause of bad smell is arising from, and especially if there's super added fungal

02:04or bacterial infection of the sinuses. COVID-19 is a viral infection which certainly has brought

02:11this into focus, but other viruses like adenoviruses which have traditionally also have caused

02:16the same problem, but in these cases the mechanism of the loss of smell or the perverted

02:22sense of smell is different because these viruses directly attack the smell nerves which

02:26are located in the root of the nose and may cause damage to the smell nerves and can cause

02:30this issue. But most of us who have suffered from COVID have fortunately realized that

02:36this problem is usually self-limiting and usually the recovery is the norm rather than

02:40the exception, though the exact duration of recovery can be highly variable with time

02:45frames as long as about 18 months having been reported. Foreign bodies in the nose

02:51are a very important cause of abnormal smell or bad smell, and though this predominantly

02:55occurs in the pediatric age group, we've also seen adults, and I myself have personally

03:00removed foreign bodies from adults as old as 30 years wherein these foreign bodies have

03:04been ignored since probably their childhood. So we do not have any numerical numbers to

03:12go by to quantify or to describe this loss of smell as with other vision and hearing

03:19we can put in terms of certain numbers. Here we usually have to rely upon the patient's

03:24description for loss of smell, and we as ENT surgeons usually would employ simple techniques

03:30like examination of the nose with speculum or endoscopes, sometimes use x-rays, CT scans

03:35and MRIs to arrive at a diagnosis. As far as treatment of these conditions are concerned,

03:41for conditions like sinusitis and foreign bodies, usually we might employ surgical techniques

03:47to remove the secretions from the sinuses or to provide a pathway so that the secretions

03:52don't get stagnated in the sinuses, and with foreign bodies we would usually have to remove

03:56them. For conditions like allergic rhinitis and common colds, usually it's medical management

04:02so as to decrease the secretions that might help patients to get back the sense of smell.

04:08For patients with viral infections like COVID wherein there's direct damage to the olfactory

04:13epithelium or just to the smell nerve, usually there is a lot of role for oral steroids or

04:19intranasal steroids because it has been proven that these modalities of management not only

04:26do cut short the duration of suffering of the patient but they also enhance the completeness

04:31of recovery. Smell retraining therapy is a technique which is nowadays gaining traction,

04:38especially in patients whose sense of smell is not returning within a few weeks. Basically,

04:43this involves patients to smell various smells which are usually in the form of organic oils

04:50or perfumes and basically it helps retrain their smell organ or the brain to get back

04:55the sense of smell.

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