In this article
- Loss may be partial or complete
- Reduced smell affects food and gas/smoke safety
- Recovery varies with the cause
Assessment and treatment
- Nasal and neurological history/examination
- Selected smell testing, endoscopy or imaging
- Cause-based treatment and smell training
At a glance
Definition: Viral illness, allergy, sinus disease, polyps, head injury, ageing or neurological disease can reduce smell.
Key takeaways
- Loss may be partial or complete
- Reduced smell affects food and gas/smoke safety
- Recovery varies with the cause
Clinical steps
- Nasal and neurological history/examination
- Selected smell testing, endoscopy or imaging
- Cause-based treatment and smell training
Red flags: Prompt review is needed after head injury, with new neurological symptoms, or with one-sided bleeding/blockage.
Quick FAQ: When should I see an ENT specialist?
Prompt review is needed after head injury, with new neurological symptoms, or with one-sided bleeding/blockage.
How I assess this in clinic
I first clarify duration, severity, whether symptoms are one-sided or bilateral, and their effect on daily life. I then perform a focused ENT examination and compare the findings with loss may be partial or complete.
Endoscopy or audiometry is not required for everyone. I advise endoscopy when the nose, sinus, throat or voice box needs direct assessment, and audiometry/tympanometry when hearing or middle-ear function is in question.
A common misconception is that every ENT problem needs an antibiotic or an operation. Treatment should instead follow the diagnosis, functional impact, examination findings and evidence-based indications.
Do not wait when: Prompt review is needed after head injury, with new neurological symptoms, or with one-sided bleeding/blockage.
For patient education; not a substitute for individual diagnosis or treatment.