Smell Disorders

Smell disorders can impact your life in many ways. Sometimes they’re a nuisance. Other times, they can cause bigger problems. And some smell disorders can even be an early sign of more serious health conditions.

Several types of disorders can cause your sense of smell to malfunction in different ways, including:

• Anosmia (total loss of smell).
• Dysosmia (distorted sense of smell).
• Hyperosmia (increased sense of smell).
• Hyposmia (reduced sense of smell).
• Phantosmia (smelling things that aren’t there).

What to expect at your first appointment

The first appointment is a chance for us to get to know each other. Your first visit will start with a physical exam. Your provider will also ask about your lifestyle and health history. And you’ll go over what kind of symptoms you’re having, how long you’ve had them and how they affect you every day.

Your provider will also likely want to hear about what was happening in your life when you first noticed problems with your sense of smell. Did they start with an illness or an injury? Did you have surgery?

Then you may have some tests, including:

Sense of smell tests

Did you ever use scratch-and-sniff stickers? If you did, the University of Pennsylvania Smell Identification Test (UPSIT) might bring back some memories.

This test helps us figure out what you can and can’t smell (olfactory analysis), using a scratch-and-sniff booklet. You’ll smell the sample and then answer questions about it. Your responses can help us to pinpoint the type of smell issues you’re having.

Nasal endoscopy

We often use a simple (and painless) in-office procedure called nasal endoscopy to look inside your nose. This test may show us why odors can’t reach the smell receptors (nerves) high in your nasal cavity. During the test, we may find:

• Nasal polyps.
• Sinonasal tumor.
• Inflammation from chronic sinusitis.

Imaging tests

CT scans or MRIs give us a closer look inside your nose and head and let us take pictures of your brain so we can find possible causes for your smell problems. These tests can help us figure out whether an underlying condition might be affecting your smell organs.

Meet Our Smell Disorder Team

Because many things can cause changes in your sense of smell, it’s important to get the right diagnosis and effective treatment from experienced healthcare providers. When you come to Cleveland Clinic, you’ll have a care team that specializes in finding the reasons for smell disturbances.

Your team could include:

• Otolaryngologists.
• Neurologists.
• Nurse practitioners.
• Physician assistants.

Our specialists have a variety of ways to treat and manage smell disorders, depending on the cause. We’ll work with you to design a personalized treatment plan for your specific smell disorder, along with your lifestyle, goals and overall health. Your treatment might include:

Education

Part of your treatment will focus on understanding how having smell disorders can affect your health and safety. We’ll go over ways to stay safe without relying on your nose — like checking smoke detectors and food expiration labels. And we’ll also help you make sure your smell disorder doesn’t affect your nutrition, weight or overall health. Eating may not be as fun or pleasurable without your sense of smell, but it’s important to staying healthy.

Olfactory training

Olfactory training can help your brain relearn how to remember and recognize familiar kinds of scents. We’ll give you a training kit to use at home and teach you how to use it as you retrain your sense of smell. The kit uses four primary odors, usually in the form of essential oils:

• Flowery: Rose.
• Fruity: Lemon.
• Resinous: Eucalyptus.
• Spicy: Clove.

You’ll breathe in each scent for 15 to 20 seconds twice a day for several months. You’ll need to really concentrate on what you’re doing. Then we might have you switch to a new set of scents. It’s important to understand that this can be a slow process and can take months or even a couple of years.

Medications

Depending on what’s causing your smell disorder, we may recommend medications. If you have an infection that could be affecting your sense of smell, you might take an antibiotic. If we think nasal polyps or inflammation could be causing your smell disorder, we may have you use corticosteroids (pills, nasal steroid wash or steroid spray). These drugs can shrink polyps and reduce inflammation. Or we might have you try new biologic agents that can disrupt the inflammatory process that’s damaging your sense of smell.

Surgery

Some smell disorders, like those caused by polyps or inflammation, often respond best to surgery. Using a precise, minimally invasive surgical navigation system, your surgeons will enter your nasal cavity through your nostrils without making incisions (cuts). Then, they’ll open your sinus passages and remove polyps and inflamed tissue to restore your sense of smell and improve your breathing. You’ll be asleep under anesthesia and won’t feel any discomfort during surgery. In most cases, you’ll be able to go home that same day to recover. Recovery usually takes only a few days.

Taking the Next Step

Until you have problems with your sense of smell, you probably don’t realize how important it is to everyday life. Whether it’s vanished, become more intense or picks up odors that aren’t there, it can be challenging to get through the day when you have a smell disorder. We’re here to help you figure out what’s causing your smell disorder and find ways to help you get back to experiencing the world around you.