15 W. Dry Creek Circle 6169 S. Balsam Way; Suite 290
Littleton, CO 80120-4427 Littleton, Colorado 80123
Phone: (303) 798-1309 Fax: (303) 798-2319
Ear, Nose & Throat Center
Specialists of the Ear, Nose and Throat / Head and Neck Surgery / Facial Plastic Surgery
Evaluation of Dizziness & Vestibular Disorders
For more information see us at our web site ! http://www.ENT Center.Net
Smell & Taste Disorders
How common are smell and taste disorders?
Once study estimates that more than two million Americans have smell and taste disorders. Another estimate suggests that more than 200,000 people visit a physician for a smell or taste problem each year. Many more smell and taste disturbances go unreported.
Are smell and taste disorders serious?
A person with a faulty sense of smell and taste is deprived of an early warning system that most of us take for granted. Smell and taste alert us to fires, poisonous fumes, leaking gas and spoiled food. A loss of sense of smell may also be a sign of sinus disease, growth in the nasal passages, or in rare circumstances brain tumors. Because an intact sense of smell and taste is required in some professions, chefs and fireman, among others may be subject to economic hardship.
How do smell and taste work ?
Smell and taste belong to our chemical sensing systems, or chemosensation. The complicated process of smelling and tasting begins when the molecules released by the substances around us stimulate special nerve cells in the nose, mouth or throat. The cells transmit messages to the brain, where specific smells or tastes are identified. Olfactory (smell and nerve) cells are stimulated by others around us - the fragrance from a rose or the smell of baking bread. These nerve cells are found in a tiny patch of tissue high up in the nose, and they connect directly to the brain. Taste cells react to food or drink mixed with saliva and are clustered in the taste buds of the mouth and throat. Many of the small bumps that can be seen on the tongue can cause taste buds. These surface cells send taste information to nearby nerve fibers, which send messages to the brain. Taste and smell cells are the only cells in the nervous system that are replaced when they become old and damaged. Scientists are examining this phenomenon while studying ways to replace other damaged nerve cells. A third chemosensory mechanism, called the common chemical sense, contributes to our sense of smell and taste. In this system thousands of free nerve endings - especially on the most surfaces of the eyes, nose, mouth and throat - identify sensations like the sting of ammonia, the coolness of menthol and the heat of chili peppers. We can commonly identify four basic taste sensations: Sweet, sour, bitter and salty. Certain combinations of these tastes - along with a texture, temperature, odor and the sensations from the common chemical sense - produce a flavor. It is a flavor that lets us know whether we are eating peanuts or caviar.
Many flavors are recognized mainly through the sense of smell. If you hold your nose while eating chocolate for example you will have trouble identifying the chocolate flavor - even though you can distinguish the foods sweetness or bitterness. This is because of the familiar flavor of chocolate is sensed largely by odor. So is the well-known flavor of coffee. This is why a person who wishes to fully savor a delicious flavor (i.e. an expert chef testing his own creation) will exhale through his nose after each swallow.
The predominant problem is a natural decline in smelling ability that typically occurs after age 60. Scientists have found that the sense of smell is most accurate between the age of 30 and 60 years. It begins to decline after the age of 60 and a larger portion of elderly persons have lost there ability to smell. Women of all ages are generally more accurate than men identifying odors. Some people are born with a poor sense of smell or taste, but most people develop them after an injury or illness. Upper respiratory tract infections are blamed for some losses, an injury of the head can also cause smell or taste problems. Loss of smell and taste may result from polyps in the nasal cavity or sinus cavities, hormonal disturbances or dental problems. They also can be caused by prolonged exposure to certain chemicals such as insecticides and by some medicines. Tobacco smoking is the most concentrated form of pollution that most people will ever be exposed to. It impairs the ability to identify odors and diminishes the sense of taste. Quitting smoking improves the smell function, but very slowly. For example, two-pack a day smoker must quit for many years as they smoked to completely restore their sense of smell. Many patients have received radiation therapy for cancer of the head and neck and later complain of a loss of smell and taste. They can also be lost in the course of some diseases of the nervous system. Patients who have lost their larynx (voice box) commonly complain of the poor ability to smell and taste. These senses are greatly improved when the laryngectomy patient uses a special “bypass” tube to breathe through the nose again rather than through an opening in the neck (this emphasized the contribution of air flow through the nose for smell and taste).
How are smell and taste disorders diagnosed ?
The extent of loss of smell or taste can be tested with a measurement of the lowest concentration of a chemical that a person can accurately detect or recognize. The patient may also be asked to compare the smell or taste of different chemicals, the intensity of smells or tastes of chemicals or how the intensity of smell or taste grow when the chemicals concentration has decreased. Scientists have developed a “scratch-and-sniff” to evaluate the sense of smell. A person scratches pieces of paper to release different odors, sniffs them and tries to identify each odor from the listed possibilities. In taste testing the patient reacts to different chemical concentrations: This may involve a simple “sip, spit and rinse” test , or chemicals may be applied directly to specific areas of the tongue.
Can smell and taste disorders be treated ?
Sometimes there are certain medications that causes a smell or taste disorder and improvement occurs when that medicine is stopped or changed. Although certain medications can cause chemosensory problems, others, particularly anti-allergy drugs - seem to improve the sense of smell and taste. Some patients - notably those with serious respiratory infections or seasonal allergies - regain their smell or taste simply by waiting for their illness to run its course. In many cases, nasal obstructions such as polyps can be removed to restore airflow to the receptor area and can correct the loss of smell and taste. Occasionally, chemo - senses return to normal just as spontaneously as they disappeared.
What can I do to help myself ?
If you experience a smell or taste problem, try to identify and record the circumstances surrounding it. When did you first become aware of it? Did you have a “cold” or “flu”? Head injury? Where you exposed to air pollutants, pollens, danders or dust to which you might be allergic? Is there a recurring problem? Does it come in any special season, like hay fever time? Bring all of this information with you when you visit a physician who deals with disease of the nose and throat. Also, be prepared to tell him about your general health and medications you are taking. Proper diagnosis by a trained professional can provided reassurance that your illness is not imaginary. You may even be surprised with the results. For example, what you may think is a taste problem could actually be a smell problem, because much of what you think you taste you really smell. Diagnosis may also lead to treatment of an underlying cause for the disturbance. Many types of smell and taste disorders are reversible, but if yours is not, it is important to remember that you are not alone: Thousands of other patients have faced the same situation.
What is otolaryngology-head and neck surgery ?
Otolaryngology-Head and neck surgery is a specialty concerned with the medical and surgical treatment of the ears, nose, throat and related structures of the head and neck. The specialty encompasses cosmetic facial reconstruction, surgery of benign and malignant tumors of the head and neck, management of patients with loss of hearing and balance, endoscopic examination of air and food passages, and treatment of allergic, sinus, laryngeal, thyroid and esophageal disorders. To qualify for the American Board of Otolaryngology certification examination, a physician must complete five or more years of post-M.D. specialty training.
American Academy of Otolaryngology-Head and Neck Surgery, Inc. This leaflet is published as a public service. The material may be freely used for noncommercial purposes so long as attributation is given to the American Academy of Otolaryngology-Head and Neck Surgery, Inc. One Prince Street, Alexandria, VA 22314-3357
