MO: How many of these can be treated—or cured?
CP: None can be cured as such, but chronic rhinosinusitis is very treatable: More than 90 percent of patients in this category can regain their sense of smell after steroid treatment to reduce inflammation. In the other cases, there are medications we can use. Oral corticosteroids are always tried first, to make sure the underlying condition is not caused by inflammation from allergies, for example.
Distortions of smell, or parosmias, can sometimes be treated with small doses of anti-epileptics. That's because these distortions can be caused by the brain misinterpreting signals it receives—leading people to experience a range of things, from everyday foods tasting strange to detecting foul smells all the time. These can be very distressing and cause severe eating disorders, ruining individuals' lives.
MO: Given the lack of attention to olfactory illness, have there been many recent medical advances in treatment?
CP: There is a lot of ongoing research, but unfortunately not much is translating into new treatments. Essentially that is why the clinic exists—to explore these. At the moment, I am completing a study to evaluate a spray containing sodium citrate that may temporarily reverse poor sense of smell. I am also applying for funding for further drug trials. As always, though, it's a slow process.
MO: What coping strategies do you propose for those who will never regain the sense of smell or taste?
CP: We advise people about issues of domestic safety, using a gas detector, for example; and personal hygiene, to be sure you wash a lot. And we talk to people about smell training, to heighten what little olfaction they may still possess.
MO: How can people improve their sense of smell through training?
CP: It is about making the most of what you have. We provide suggestions for enhancing food—altering spiciness or texture, for example—to make it more enjoyable. If you can still slightly taste spices, make your food hotter using chilies. Or alter the texture: Make it more creamy or crunchy.
MO: What are the hardest parts of life without the sense of taste or smell?
CP: Anosmia sufferers really miss the enjoyment of food. Some find mealtimes to be the most dreadful moments of their lives. They know they have to eat to live, but all the pleasure has gone. Many will avoid restaurants and will find social situations that involve food and drink very difficult to deal with. They feel disconnected from their environment in a way that non-anosmics do not appreciate. It's like being invited to a concert when you can't hear the music.
This article originally appeared in New Scientist.