Smell is a sense dating back to ancient times and is found in almost all living things in the air, in water or on land. In humans, this sensory system plays an important role in the taste of food and beverages, safe nutrition and quality of life. Some patients experience significant psychological, even physical and social disorders due to loss of smell. The most common cooking-related accidents, less commonly spoiled food, not being able to detect gas leaks and not being able to smell fire, are dangers that may be related to impaired sense of smell.
Decreased taste sensation indicates the loss of taste sensation resulting from spontaneous retronasal stimulation of olfactory receptors. A careful physician should not forget that odor disorder may be an early sign of many serious diseases such as ALZHEIMER'S disease, PARKINSON'S disease, MULTIPLE SCLEROSIS, FRONTAL MENINGIOMA, NASOPHARYNX CARCINOMA and CHRONIC RHINOSINUSITIS.
Olfactory neuroepithelium, which has a pseudostratified columnar epithelial structure; It is located in the cribriform plate, the upper part of the septum, and both the superior and middle turbinates. Bipolar receptor cells reach the brain from the nasal cavity. While the total surface of cilia in humans is 22 cm2, it exceeds 700 cm2 in the German Shepherd dog.
The important fact is that decreased olfactory function is not uncommon in normal elderly persons and decreases markedly with age. Smoking increases this effect.
ODOR DISORDERS
Anosmia; It is the loss of the ability to smell.
Hyposmia or Microsmia is the decrease in the ability to smell.
Hyperosmia; It is interpreted as hypersensitivity to odors.
Dysosmia; It is the sense of smell perceived as bad or distorted.
Parosmia and cacosmia are deterioration in the quality of smell.
Pantosmia is the perception of smell without an olfactory stimulus.
Olfactory agnosia; It is the absence of odor perception although the odor processing process, language and general functions are normal. Agnosia can be seen in patients who have had cerebral infarction and encephalitis.
The term presbiosmia refers to age-related decrease in the sense of smell.
CONDUCTION TYPE OR SENSORINEURAL SMELL DISORDERS
Chemical sensory disorders are common in many cases. It may be caused by a reason. Head trauma causes anosmia or hyposmia. Similarly, toxic substances, drugs Pure and systemic diseases may have different effects. In general, dysfunction occurs in two ways.
Default in conduction or transport pathways (e.g. sinonasal disease)
Sensorineural disorder; This occurs as a result of direct damage to the olfactory epithelium or injury to the central olfactory neural structures (e.g., tumors and other masses compressing the olfactory tract).
COMMON CAUSES OF ANOSMIA AND HYPOSMIA
Previous upper respiratory tract infections, head trauma, nasal and paranasal sinus diseases, neurodegenerative diseases (ALZHEIMER's disease, PARKINSON's disease), interventions (septoplasty, turbinate resection and radiotherapy), intranasal neoplasms (inverted papilloma, hemangioma), intracranial tumors and lesions, epilepsy, psychiatric diseases, exposure to environmental chemicals and hypothyroidism.
PHYSICAL EXAMINATION
A complete ear, nose and throat examination is performed with emphasis on anterior rhinoscopy. Thin-section coronal paranasal tomography is required. Brain computed tomography may be required. High resolution CT is the test used in the evaluation of sinonasal inflammatory diseases.
Patients with odor disorders should be warned to have an adequate number of smoke and gas detectors at home and, if possible, replace gas-powered appliances with electric ones.
Salt water sprays and medications can improve olfactory function in patients with dry nose. Quitting smoking can significantly improve olfactory function. Systemic steroid treatment is curative in those with conduction type loss.
As a result, recent studies on the subject show that smell impairment is associated with a wide group of diseases, including Alzheimer's disease and idiopathic Parkinson's disease.
Key Points:
Viral and bacterial infections of the upper respiratory tract,
Peripheral damage to the mucosa and olfactory receptors is common due to environmental and industrial chemicals and chronic nasal diseases.
Although edema or mucus changes on the olfactory neuroepithelium play a role, loss of smell due to conduction-type factors can be attributed to allergy or nasal polyposis. Contains.
As examples of treatments that reorganize olfactory function; These include allergy treatment, topical and systemic corticosteroids, antibiotics, and various surgeries, including endoscopic sinus surgery.
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