At NYU Langone’s Anosmia Center, our team of otolaryngologists—also known as ear, nose, and throat doctors—are experts at diagnosing and treating anosmia, or the loss of smell.
The process of smell is a unique connection between the brain and the nerve cells in the nose, called olfactory cells. When a scent molecule is released from an object such as a warm chocolate chip cookie, it stimulates the olfactory cells, which then send scent information to the brain, where the smell is interpreted and identified.
Without smell, taste is also affected, since our taste buds can detect few flavors on their own. This can lead to a loss of interest in food, which can cause weight loss and possibly malnutrition. Anosmia may also affect quality of life by diminishing the ability to experience enjoyable smells. People who have anosmia are also more likely to consume spoiled or unsafe food, and be less aware of smells that indicate imminent danger such as smoke or natural gas.
Colds, allergies, sinus infections, and viral infections such as the flu or COVID-19 can all cause anosmia. It can also be caused by nasal polyps or other blockages, tumors, or a deviated septum. Conditions such as Alzheimer’s disease or Parkinson’s disease can also damage or deteriorate the nerves leading to the area of the brain that detects smell, causing anosmia.
Anosmia is often temporary, but if your sense of smell does not return after an illness, our otolaryngologists can help. When you come to the Anosmia Center, our physicians determine the cause of your smell disturbance through a thorough evaluation of your medical history and physical examination. To get a closer look at the inside of your nasal passages, your doctor uses a light and a hand-held instrument called a speculum. The speculum is used to gently widen the nostrils, so doctors can see the interior tissues and bone structure of the nose.
Your doctor may also perform a nasal endoscopy, which is a diagnostic exam that provides a detailed view of the nasal passages. To perform this procedure, your doctor first sprays your nose with a decongestant to open up the nasal passages and a local anesthetic solution to reduce any discomfort.
The doctor then inserts a thin fiber-optic instrument called an endoscope through each nostril. An endoscopy of the nasal passages and throat can reveal sources of any obstruction that could cause anosmia. This procedure takes only a couple of minutes and takes place in your doctor’s office.
If your doctor needs more information, they may order an MRI scan, which uses a magnetic field and radio waves to create images. MRI scans can detect whether there is in obstruction or deformity in the soft tissues of the head and neck causing anosmia.
Once your doctor determines the primary cause of anosmia, they can develop a personalized treatment plan. For example, if you have sinusitis, medication can help restore your sense of smell. If a nasal polyp, tumor, or deformity is causing the anosmia, your otolaryngologist may recommend surgery to correct it.
If your loss of smell persists several months after recovering from COVID-19, our doctors may recommend smell retraining. Smell retraining involves repeatedly sniffing different smells while looking at a picture of each scent to help stimulate the olfactory system and establish a memory of that smell.
Your doctor gives you a set of small glass jars with lids that each contain a small amount of an essential oil. The scents are often common smells that everyone can identify, such as grass, chocolate, lemon, mint, and coffee. At least two or three times a day, you smell the oil in each jar for 10 to 20 seconds while looking at a picture of the scent. While sniffing, you concentrate on your memory of the smell.
After smelling each scent, you take a few deep breaths to clear your nasal passages and then move on to the next scent. Smell retraining is performed daily for about 12 weeks.
Since the beginning of the pandemic, NYU Langone doctors have treated large numbers of people with COVID-19. This experience, along with our focus on long-term COVID-19 symptoms, have given our team the skills and experience necessary to understand and address their impact on your health and give you the best possible chance to regain your sense of smell.
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If you are a physician who would like to refer a patient, please call us at 212-263-7505.