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Q. Will my reduced sense of smell due to chronic sinusitis eventually come back with treatment?

Answered by
Dr. Ashok Kumar Srivastava
and medically reviewed by Dr. Infanteena Marily
This is a premium question & answer published on Feb 14, 2022

Hello doctor,

I was diagnosed with chronic sinusitis without nasal polyps two years back. I have had symptoms for this entire time. I received a computed tomography scan and nasal endoscopy from an ear nose throat doctor. I will share these results with you. My doctor said I have mild or mild-to-moderate disease in the ethmoid and maxillary sinuses only. He said there is minimal mucosal thickening and clear mucus. Sinus Ostia are transparent and open. There is no infectious agent. I do not have airborne allergies or asthma. I use Budesonide (Pulmicort) respules rinse two times a day in a nasal saline squeeze bottle. My symptoms are controlled and gone except for a mild clicking sound in my ears when swallowing and a reduced sense of smell. Can you please tell me if my sense of smell will eventually come back since I have responded to treatment and will go back to normal with continued treatment in your experience?

Thank you.

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#

Hi,

Welcome to icliniq.com.

I understand your concern. You have only mucosal thickening in ethmoid and maxillary sinuses with open Ostia, which means sinusitis is there, and such cases are managed usually by conservative medical treatment. However, you have a reduced smelling sensation that should also be considered. Your ENT (ear, nose, throat) doctor is giving you correct treatment in the form of antiallergic nasal spray, and you are feeling well by treatment as far as nasal symptoms are concerned. You have a reduced smelling sensation that may recover, but I suggest two additions in your treatment.

1) Oral steroid- Tablet Methylprednisolone.

2) Vitamin supplements.

Please discuss with your ENT doctor and, by his consent, take these medicines for a speedy recovery.

Thanks.

Hello,

Thank you doctor.

Could there be permanent damage to my sense of smell? My sense of taste appears to be fine but slightly diminished. My sense of smell is still weak, however. Have you encountered many cases in your practice where the sense of smell is permanently damaged from chronic sinusitis without polyps? Perhaps there is still some slight inflammation that needs to go away.

Thank you.

#

Hi,

Welcome back to iclinq.com.

For the past year, I have usually come across patients having either loss of or reduced smell and taste sensation. This usually is managed by oral steroids and vitamin supplements. But before starting steroids, one has to get physically examined by a doctor and take special care for diabetes, hypertension, hypothyroidism, etc. Therefore, you should consult your ENT doctor for the same. As far recovery is concerned, positive results are expected but can't guarantee.

Regards.

Have you had many patients with chronic sinusitis without polyps who have been able to treat all their symptoms but still have a weak sense of smell? Is it permanent? Does this happen often or is it rare?
# Hi
Welcome again in Icliniq
I usually get such type of patients as you are and most of the time patients get recover, though recovery depends on so many factors like -
- Age
- Comorbidity like associated diab, renal failure and liver disorder.
- Duration of disease.
I your case I hope you will recover well.

Thanks for reconditioning Icliniq.
Thankfully, I don't have diabetes, liver disorder or renal failure. I'm 44, however, I have been symptomatic for 25 months now although my ENT termed my disease as "mild or mild-to-moderate." Have you had patients like me who are in a similar situation who have recovered their sense of smell? Thank you.
# Hi
Welcome again in Icliniq.
As you are non diabetic and having no renal or hepatic disorder. I think with concent of your ENT doctor you may add Methicobalamin either in oral or injectible form for your speedy recovery.

Thanks for consulting Icliniq.
Thank you doctor, I will ask my ENT for that. In your practice, have you had many patients with chronic sinusitis without polyps (CRSsNP) who have suffered permanent damage to their sense of smell after being symptomatic for 25 months or more?
# Hi
I treated such cases and got positive results, though most of cases had recovered well but few are still facing problem. Recovery depends on so many factors. please wait and watch.

Thanks for consulting Icliniq
What types of problems do such cases face so I know what to look for?
# Hi
Welcome again in Icliniq.
Perception of smell can't be measured by any scale. You are identifying smell is a good sign. Gradually it will improve and you will face no problem.

Thanks for consulting Icliniq.
Thanks doctor. For your patients who have recovered their sense of smell, is it at normal levels or is it always impaired in some way?
# Hi
The extent of recovery can't be assured but in medical practice it is usual phenomenon that partially recovered pt later on get slow recovery, please keep patience.

Thanks for consulting Icliniq
Do you have many patients with chronic sinusitis without polyps who are able to control all their symptoms but still have a weak sense of smell? If so, is this because of damage to the olfactory mucosa?
# Hi
If there is damage to olfactory mucosa than recovery may become a problem. I have seen this in patients who developed Atrophic Rhinitis. The patients of Atrophic Rhinitis initially presents with symptoms of common cold and there cold becomes chronic and gradually they start loosing there smell sensation. Such cases are usually diagnosed by clinical examination and radiologically by CT scan of paranasal sinuses which shows generalized atrophy of nasal cavity structures.

Thanks for consulting Icliniq.
I don't have atrophic rhinitis. My ENT tested me and told me I don't have this condition. He said I have mild inflammation in my nasal passages and chronic sinusitis without polyps. Have you had many patients with only chronic sinusitis without polyps (CRSsNP) who have suffered permanent damage to their sense of smell?
# Hi
I hope you will recover
Based on what I have told you, what do you think my chances of recovery are?
# Hi
I clearly understand your concern, as you are not having any other disease so fair chances of recovery in your case. Please don't be anxious because worry and anxiety also creates hinderenc in recovery. Be chearful and believe on god for recovery
OK doctor, I will pray too. For my symptoms, sometimes I have a very mild throbbing in my olfactory area. There is not any throbbing anywhere else. Should this eventually go away too? I assume I must get rid of the throbbing in the olfactory area to smell better, right?
#

Hi,

Welcome back to icliniq.com.

As your doctor had told that the mucosa of the olfactory area is inflamed this may also give rise to throbbing.


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