My sinusitis has improved after treatment, but I still have hyposmia. Why?

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. Anosmia or hyposmia is a frequent occurrence associated with rhinosinusitis, and many factors lead to it. Firstly sinusitis is an inflammatory condition associated with edema and the release of inflammatory mediators that cause olfactory mucosa to respond less to odors. The second accompanying nasal obstruction also impedes the free flow of odor to the olfactory mucosa, which is higher up and can cause a decreased sense of smell. Third, there is some direct effect on the olfactory nerves, which also affects this sense. So with the successful treatment of allergy and associated rhinosinusitis, the sense of smell should revert back. However, since the nerves might take time to recover from the damage, to restore their functioning to normal physiology, the recovery can be prolonged, maybe even months. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Loss of taste and smell can be particularly recalcitrant to treatment. Even when other symptoms have improved, taste and particularly smell can take longer to recover. Now that CT (computed tomography) did not reveal anything significant or no abnormality was detected on clinical examination, no other active intervention other than pharmacotherapy is needed. The sense of smell should improve with time. You also need to supplement your diet with Omega-3 fatty acids and other antioxidants like Vitamin C, Vitamin E, and Zinc. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, most of the patients do eventually recover. Since smell is a subjective perception, it does vary even normally among individuals. So it will depend upon the individual. Since neurons might take time to return to the original baseline, it is often difficult to predict how early one can regain the smell. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, even when symptoms are well controlled, it might take some time for the sense of smell to return to normal. This is because the nerves might need to recover from the damage and reset again to normal. You do not have to be anxious most often, the sense of smell tends to return to normal. And further, even if the nerves do not regain the full physiological functioning, our brain does, to an extent, adapt to this new normal. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, total permanent anosmia is rare. It may take months or even a year or more to return to normal. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Well, most of them often recover. However, some do complain about certain alterations in the sense of smell. But most of them do not consider it too worrisome. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Well, if this pain or headache is rhinogenic, upon successful treatment, it should go, and slowly, your sense of smell should also regenerate. Have you had a nasal endoscopy? Was it okay? Did you use an antihistamine nasal spray? Sorry I did not receive any file. The thing is that most of the time, mild sinus inflammations are asymptomatic. Only when ostia are blocked, and secretions are pent up, symptoms appear. Symptoms are more of a drag or a sense of fullness over cheeks or around the region of the glabella. So if your symptoms are improving, it means sinus drainage is establishing, and this drag should go, and as free drainage and air circulation are established, other functions, including smell, would also improve. I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. I would say anxiety would definitely make your symptoms worse. Especially the sense of fullness and pressure around the nasal bridge and the tinnitus. How long have you been taking medicines for panic disorder, and what medicines are you taking? I hope this was helpful. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. SSRI (Selective serotonin reuptake inhibitors) like Escitalopram can cause alterations in taste and smell by altering serotonin uptake. Since you have been on SSRI for 20 years, it might be adding to the altered smell. I hope this was helpful. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. You might want to talk to your doctor if he agrees. He might put you on alternative medications. Since your symptoms are improving and the treatment you think is working, it is better to wait. As I told you, as the issue of sinus and nasal allergies clear, your smell might also improve hopefully. I hope this was helpful. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. The course is often difficult to predict. The loss is temporary in most cases. In some cases, it can be permanent. Having 75 percent of recovery might be good enough to restore a good quality of life. Having a sufficient recovery helps to improve the quality of life. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. It would hopefully improve. As I told you earlier, even when your symptoms remain totally controlled, it might take some time for the smell to improve. I suggest you gradually taper down down your Budesonide rinses. Decrease the frequency and quantity initially and then stop it. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Well, I will not say most of them. A few of them have weak sense of smell even when other symptoms are controlled. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Well, very rarely, I have seen patients complaining of permanent loss of sense of smell. Most eventually, patients regain good functionality. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. The thing is that there remains some degree of altered smell definitely. But there is no reason why one should have total and permanent loss even when functioning becomes restored. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. The patients can have decreased sense of smell or hyposmia, absence of smell (anosmia), or even altered smell (parosmia) usually a bad smell like that of rotten rags (cacosmia). I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Well nothing can be said with conviction. But favorable outcome is more likely. More often than not normal physiology is restored. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. The majority of your symptoms are resolving, and your concern now centers around your sense of smell. As previously discussed, these neural functions tend to recover later in the healing process, making it uncertain whether permanent damage has occurred. However, if the ongoing issue has been mitigated to some degree, there is a chance that nerve function will restore, approaching if not entirely reaching normalcy. Additionally, another physiological change might contribute to further recovery. Even if nerve cell damage has transpired, there is a potential for the remaining healthy cells to enhance their function, leading to partial restoration. Given the improvement in some of your symptoms, there is room for optimism that alterations in smell will also show signs of improvement. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. I would like to inform you that cases of patients reporting permanent loss of smell after a sinus infection are quite rare. This outcome is more commonly observed in individuals with a history of head trauma or brain lesions. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.