Hello doctor, I was diagnosed with chronic sinusitis last week. I have a very weak sense of smell and taste, tinnitus, post-nasal drip, and congestion. My sense of smell is also getting weaker for the last five days. Can chronic sinusitis permanently damage my sense of smell at this time? Or can it be reversed? I have used nasal sprays, antibiotics, and Prednisone to no avail. This has lasted nine weeks.
Hello. Chronic rhinosinusitis is a chronic inflammation of the nose and sinuses where there will be significant dysfunction in sinus physiology. This causes swelling of the nose tissues leading to symptoms such as nasal congestion, nasal discharge, post nasal drip and heaviness of head. Decreased sense of smell or loss of sense of smell is also one of the symptoms of chronic rhinosinusitis. Disturbance in sense of smell in chronic rhinosinusitis is usually due to mechanical obstruction to the passage of air to the nerves which carry the sense of smell rather than actual injury to the nerves. Usually, there will be recovery of sense of smell and may take a few months with treatment for rhinosinusitis. You may need to take better antibiotics such as Clarithromycin for a week, along with a repeat course of steroids. Nasal washes with saline mixed with steroid respules are also useful in reducing the swelling and improving the sense of smell. I can say that permanent loss of sense of smell is very unlikely in chronic rhinosinusitis. Treatment of rhinosinusitis either by medicines or surgery usually brings back the sense of smell. CT (computed tomography) scan of paranasal sinuses, diagnostic nasal endoscopy. Clarithromycin 500 mg once daily after food for seven days. Montair LC (Montelukast and Cetirizine) once daily in the night for a week. Wysolone (Prednisolone) 10 mg two times daily for five days. Nasowash saline washes two times daily (mix two respules of Budecort to 500 ml of solution for washing). Pan 40 (Pantoprazole) once daily before food for seven days.