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Suggest Remedies For Anosmia

Posted on Fri, 17 Jun 2016

Question: I have a difficult ENT issue: in December I was diagnosed with chronic sinus infection due to sore throat and ears filling up. I was proscribed decongestants and steroids. I then got a super sensitive nose and hoarseness. My hypersensitive I mean nerve type pain in the nose if I was anywhere other than outside. I couldn't work. After seven weeks I got an ENT appointment for a month away. I am a mechfatianical engineer but my first generation Asian wife suggested a "remedy". In a fit of stupidity I tried smoking dried lotus leaves. In 5 minutes I noticed I could barely smell and my nose felt like cement the next morning. The pain went away but was replaced with much worse situation as it appeared I had damaged my nose. The ENT appointment came and he could not say for sure. My voice was now painful and he diagnosed chronic laryngitis with fatigue. Now I am finally trying to work again but my nose still feels like cement, smell is ok for strong odors but not mild ones (fluid, grass, etc.). When I try to work if feels as if the mucosa is either burned or dried right up. Voice is still rough. I just quit smoking - cause of most ills - 3 days ago but no change. Voice is adequate in the morning and worsens to severely hoarse by 5:00. Is there anything I can do to help the mucosa or my throat? After smoking the leaves I got some black tissue coming out for a couple of days. Inside nose feels sore if I breathe through it, it gets more sore. I need some advice: is there anything I can do to help the mucosa assuming it is damaged? Is there anything I can do for the loss of smell? It becomes more like a block of cement in my nose the more I try to work or go out for any reason. I have 4 humidifiers at home and monitor humidity at around 35%. I should mention that when I shower there is no sense of steam in my nose only feels congestion. Have overpowering sense of dryness all of the time.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
Allergic rhinosinusitis with laryngitis

Detailed Answer:
Hi

Thanks for posting the query

I have gone through your query thoroughly and understood you problem.

I am of the opinion that, you are suffering from Allergic Rhino-sinusitis with Recurrent Laryngitis. According your description, you seem to be having nasal congestion which is not getting better. This is the chief culprit of all your problems. Nasal block leads to mouth breathing. During mouth breathing, the water in the throat and that on vocal cords gets evaporated leaving the mucosa sore and dry.

My suggestions to you are:
1. Get a nasal endoscopy done to look for any other pathology inside the nose.
2. X-ray or CT scan of the paranasal sinuses can help in identifying the status of the paranasal sinuses.
3. Do steam inhalation 2-3 times a day, for at least 3 minutes.
4. Drink frequent sips of warm water. Warm water improves the blood circulation and reduces the congestion in the nose and the vocal cords.
5. Use saline nasal spray as frequently as possible. Saline helps in cleansing of the nose, opening up of the clogged sinuses and keeping the nose fresh and moist.
6. Try using steroid nasal spray such as Mometasone or Fluticasone, twice a day.
7. If there is acid reflux, you need to address the problem with proton pump inhibitor.
8. Avoid sleeping right in front of the air conditioner.
9. Avoid coffee, smoking, chilled food & beverages, greasy food and fizzy drinks.
10. Avoid taking hot liquids and food. The food and beverages should be warm. This improves the blood circulation and reduces your problems.

You may have tried many of the suggestions I have made above, but, I would insist you to continue with same. Hope with the above measures you would get better. Revert back to me if you have any further queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)

Thank you. I should mention that at no time did I have congestion. This is why I believe the original diagnosis may have been incomplete. There was no sinus pressure of any kind but uncomfortability due to a nerve-type pain in nose and subsequent headache while at home. I have had sinus infections and this wasn't it. At work it was painful with each breath. It was like little knives pricking my nose from the inside. This was the same at other business establishments. I had an endoscopy with the result being clear as well as CT scan showing clear. After I smoked the evil leaves the pain was gone but replaced by lack of detection of mild odors of any kind and different feeling in my nose where it is hard to get a full nasal breath like the mucosa had thickened suddenly. My further question is: it is possible that the nasal mucosa is permanently damaged now as I cannot sense fluid (eg steam in shower) thanks to smoking these leaves (burn). When I breathe in I feel like I am smelling only dust which is quite disconcerting. Secondly if the mucosa is not totally destroyed can it regenerate?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (25 hours later)

Brief Answer:
Yes, the olfactory nerve endings have been damaged...

Detailed Answer:
Hi

Thanks for writing back

Your detailed response has greatly helped me in analysing your problem. The smoke emanated from the lotus leaf could have damaged the sensitive nerve endings of both the olfactory nerves and nasal mucosa. The damaged olfactory nerve endings can alter the smell you perceive.

Also, the sensitive microscopic upper gel layer draping the nasal mucosa could have been damaged, leading to frequent drying sensation.

1. The damaged olfactory nerves may or may not regenerate; but the nasal mucosa will definitely regenerate. Intranasal steroid and saline nasal sprays when used regularly for few months can help in reducing the inflammation of the nerve endings and help in rejuvenation of the nasal mucosa. This is only hope for us.

2. Try taking Vitamin B-complex capsules or tablets. This can help in arresting the further damage to the nerves. Also, eat plenty of fresh fruits and vegetables; the rich vitamins present in the above foods can hasten the regeneration of the nasal mucosa.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (18 hours later)

Doctor thank you that was very helpful. On the mucosa, I have also quit smoking which I hope will help. If I load on the B vitamins, and do the nasal mist and try my best to keep stress down would you have any idea on how long it might take to see improvement in the mucosa? I know it is hard without seeing me. Also my ENT is thinking of doing a biopsy but some risk of further damage. From a biopsy can we tell the state of the membranes at the different levels to see if they can be saved or not? I badly need tangible progress or solid hope to say the least. Lastly, I have read that using a Neti-pot for daily irrigation is helpful but also read that it could be harmful. Do you have an opinion on whether or not using this is a good idea?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (6 hours later)

Brief Answer:
The damaged mucosa and the nerve endings may take 6 months to regenerate...

Detailed Answer:
Hi

Welcome back

1. Please take the vitamin B-complex in the optimum level. Overloading may not give an edge over the normal dosage, in rejuvenating the damaged nerves.

2. It can take up to six months for the damaged mucosa to regenerate.

3. Biopsy can help in determining the histological status of the nasal mucosa. Most of times, the mucosa lining the nasal cavity remains the same at different levels, except for the olfactory area and front of the nose adjacent to the skin. Biopsy will be a tiny cut in the nasal mucosa and may not cause significant problems.

4. The suggestions I gave in my earlier response, can help you to recover faster.

5. Neti pot is a very good technique to cleanse your nose and sinuses. It can keep the nose moist, clean and fresh. It also hastens the recovery process. If potable water is used for this purpose, there should not be any problems

Hope this clarifies your doubts. Wish you speedy recovery.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T