What causes smell loss?

Smell loss or anosmia can be due to many varied causes, such as acute head trauma, a severe cold, chronic sinusitis, nasal polyps, neurological conditions, and rarely tumors.   An important distinguishing factor is the acuity of onset. Acute smell loss can be due to a severe upper respiratory infection or head trauma. Viruses can cause cell death of the olfactory neurons, and head trauma can shear off the olfactory nerves. Both have the potential for recovery, as olfactory nerves can regenerate, though it can take years.

Brain tumors of the olfactory groove (or anterior base of skull) can cause a gradual smell loss. These can include esthesioneuroblastoma or meningiomas – treatment would be surgical resection.

A common cause of chronic smell loss is chronic sinusitis, which through inflammation can cause swelling of the sinus mucosa, and will block the path of odor molecules to the olfactory groove. Fortunately a combination of nasal topical steroids, prednisone and surgery may be able to improve smell.

Chronic sinusitis with polyps is chronic sinusitis with more inflammation where the normal lining of the sinuses, the mucosa, becomes swollen and edematous forming small grape-like polyps. These physically block the passage of smell molecules. Surgery can help with this.

There is some data out of Stanford showing that olfactory retraining is a beneficial therapeutic option for patients with smell loss. This is a simple, cheap treatment option for patients with smell loss that Dr. Meier offers.

 

Josh Meier, M.D. F.A.R.S.

 

New Cone Beam CT Scanner at Nevada ENT

Nevada ENT and Reno Tahoe Sinus Center are excited to announce that we have just completed installation of a brand new Carestream CS 9300 cone beam CT scanner. Our office has offered in-office CT imaging for the last 7 years, and we recently decided to upgrade to the latest technology. We can image both the paranasal sinuses and temporal bone (ear).

Your doctor will review your images with you immediately after the scan. In addition, the board-certified radiologists at Reno Diagnostic Center will review your scan and send a report to our office.

Advantages of in-office cone beam CT imaging:

  • High resolution, down to 0.09mm, for excellent imaging detail
  • CBCT radiation dose is much lower than low-dose and standard conventional CT exams (approximately 1/10 of the dose)
  • Convenience – imaging can be done in our office without a second trip to an imaging center
  • Images can be used for image-guided sinus surgery

We are pleased to offer this new technology to our patients, please do not hesitate to ask your provider for more information.

 

Josh Meier, M.D. F.A.R.S.

Update on Chronic Sinusitis

Chronic rhinosinusitis (CRS) is a condition that a large segment of the population suffers from, with a significant decrement in quality of life. Symptoms of CRS include nasal drainage, congestion, facial pain or pressure, and smell loss. Frequently nasal allergies can contribute to symptoms. In Reno, the bulk of allergy symptoms occur in the fall, when the sagebrush and rabbit brush bloom.

The first line of treatment for CRS is a saline rinse (Neilmed sinus rinse) and an over the counter topical steroid spray (Flonase, Nasocort). For most CRS patients, this will lead to a significant increase in quality of life.   For patients that do not improve, then a consultation with an otolaryngologist can be helpful, and other treatment options can be discussed.

An option for patients that continue to have symptoms, despite appropriate medical therapy, is endoscopic sinus surgery (ESS). New technology and techniques have resulted in much less discomfort and recovery after ESS. Because of my focus on mucosal preservation, there is less bleeding; as a result I do not use nasal packing or splints for patients that undergo nasal surgery.

If you have any questions about your nose or sinus health, please do not hesitate to call and schedule an appointment.

Josh Meier, M.D. F.A.R.S.

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