PakMed Biomedical Solutions: http://pakmed.netSmell and Taste Disorders

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Selected Possible Causes of Smell Disturbance



Common causes
Nasal and sinus disease (e.g., allergic or vasomotor rhinitis, chronic sinusitis, nasal polyps, adenoid hypertrophy)
Upper respiratory infection
Head trauma (e.g., frontal skull fracture, occipital injury, nasal fracture)
Cigarette smoking
Neurodegenerative disease (e.g., Alzheimer's disease, Parkinson's disease, multiple sclerosis)
Age

Less common causes
Medications (see Table 2)
Cocaine abuse (intranasal)
Toxic chemical exposure (e.g., benzene, benzol, butyl acetate, carbon disulfide, chlorine, ethyl acetate, formaldehyde, hydrogen selenide, paint solvents, sulfuric acid, thrichloroethylene)
Industrial agent exposure (e.g., ashes, cadmium, chalk, chromium, iron carboxyl, lead, nickel, silicone dioxide)
Nutritional factors (e.g., vitamin deficiency [A, B6, B12], trace metal deficiency [zinc, copper], malnutrition, chronic renal failure, liver disease [including cirrhosis], cancer, acquired immunodeficiency syndrome)
Radiation treatment of head and neck
Congenital conditions (e.g., congenital anosmia, Kallmann's syndrome)

Uncommon causes
Neoplasm or brain tumor (e.g., osteoma, olfactory groove or cribiform plate meningioma, frontal lobe tumor, temporal lobe tumor, pituitary tumor, aneurysm, esthesioneuroblastoma, melanoma, squamous cell carcinoma)
Psychiatric conditions (e.g., malingering, schizophrenia, depression, olfactory reference syndrome)
Endocrine disorders (e.g., adrenocortical insufficiency, Cushing's syndrome, diabetes mellitus, hypothyroidism, primary amenorrhea, pseudohypoparathyroidism, Kallmann's syndrome, Turner's syndrome, pregnancy)
Epilepsy (olfactory aura)
Migraine headache (olfactory aura)
Cerebrovascular accident
Sjögren's syndrome
Systemic lupus erythematosus

 

Causes of Smell Loss
Olfactory disturbance has many possible causes In most instances, loss of smell is caused by nasal and sinus disease, upper respiratory tract infection or head trauma.

It is important to have a high index of suspicion for subacute sinusitis, because decreased smell (hyposmia) can occur without other nasal or sinus symptoms typically associated with sinusitis (e.g., congestion, headache, a "throbbing" pressure sensation). Medications are also an important, frequently overlooked cause of smell impairment. Olfactory impairment is estimated to occur in nearly 10 percent of patients with head trauma.17 Post-traumatic smell loss is usually caused by shearing injuries to the olfactory nerve fibers at the level of the cribiform plate, but it can also be caused by direct injury to the olfactory bulbs, olfactory tracts or frontal and temporal lobes.

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