LOSS OF TASTE AND SMELL
Question: At the age of 54,1 seem to be losing my sense of taste and smell. What might be causing this?
Answer: Like hearing and vision, taste and smell tend to deteriorate with age. In addition, various illnesses and injuries can damage the nerves connecting the sense organs to the brain. Loss of smell, for example, can be caused by nasal or sinus infections, nasal polyps, meningitis, or brain tumors. Loss of smell can affect taste. So can allergies, tongue injuries, stroke, or tumors. You should consult your physician to rule out possible underlying disorders.
Question: My sense of smell has gradually deteriorated to the point that even pungent odors such as skunk spray don’t register. I’m 35 years old and in excellent health with the exception of asthma, for which I take allergy injections, a steroid nasal spray, and other medications. Why am I losing my sense of smell?
Answer: Two factors may be to blame. Your nasal passages may be sufficiently swollen from allergy-related causes, including nasal polyps, to limit your ability to detect odors. In addition, long-term use of a nasal spray could affect the smell receptors in your nasal membranes. A consultation with an otorhino-laryngologist (ear, nose, and throat specialist) may help.
Question: I often notice a metallic taste in my mouth. What causes this and what can I do about it?
Answer: Possible causes of your “dysgeusia,” or distorted taste, range from allergies and nasal polyps to a prior head trauma or exposure to chemicals. It can also be a side effect of certain medications, particularly the antibiotics metronidazole (Flagyl), clarithromycin (Biaxin), or tetracycline. Sometimes metal fillings in your teeth may be the reason. Most often, however, no cause can be found.
In that case, there’s nothing to do but wait it out. The sensation may last for years before it mysteriously disappears.
NAY TO NOSE SURGERY?
Question: How necessary is surgery for a deviated septum? I believe this common operation corrects a birth defect and question its value on my 56-year-old nose.
Answer: Most people are born with a straight septum, the cartilage-and-bone partition inside the nose. While some septal deviations are hereditary, many people incur slight deviations from minor childhood mishaps. Frequently, nasal congestion blamed on a deviated septum is caused by allergies, air pollution, pregnancy, or certain drugs. Short-term use of decongestants can usually clear the blocked airways.
When the deviation is severe and causes chronic breathing difficulty, repeated sinus infections, or chronic postnasal drip, removal of the obstructing portion of the septum can often provide permanent relief. However, a decision for surgery may be based on inadequate evidence of airway obstruction. So a second opinion should always be sought.
PROBLEMS WITH NASAL POLYPS
Question: I have a nasal polyp that flares up each year for about a month and causes unbearable headaches. 1 had one removed surgically three years ago, but now the problem has recurred. Steroid nasal sprays seem to help, but I’m worried about using them. Are there any safer treatments?
Answer: It’s probably safe to continue with the sprays, especially for just one month a year. Very little of the steroid gets absorbed into the blood. A nasal polyp is actually swollen sinus tissue that protrudes into the nasal cavity. Polyps occur singly or in grapelike clusters. Since they’re often caused by allergies, polyps can be treated the way allergies are—with antihistamines, decongestants, corticosteroid sprays, or even allergy shots. Alternatively, polyps can be removed surgically under local anesthesia. But as you can attest, additional ones can eventually appear.
RECURRENT SINUS INFECTIONS
Question: What can I do about recurrent sinus infections? They up temporarily after antibiotics, but return in a couple of months. My doctor says X-rays show thickening in my sinuses.
Answer: That thickening is due to chronic inflammation of the sinus lining. And an inflamed lining secretes excessive amounts of mucus, which predisposes you to yet another infection. You may need aggressive treatment with longer courses of antibiotics to break the cycle. Failing that, you should be evaluated by an otorhinolaryngologist (ear, nose, and throat specialist) for possible surgery to permit better drainage.
Question: I suffer from postnasal drip, which constantly fills my throat with phlegm. What can I do about it?
Answer: Probably not much. Postnasal drip is typically caused by air pollution, allergies, or infections. The irritated membranes in your nose and sinuses thicken and produce too much mucus. When the condition becomes chronic, it’s often difficult to tell what caused it. And it’s seldom cured.
Side effects from the standard medications used for postnasal drip—antibiotics, antihistamines, and decongestants—often outweigh their meager benefits. If you should try those drugs and they don’t work, see an otorhinolaryngologist (ear; nose, and throat specialist). Once cysts, polyps, and tumors have been ruled out, either a corticosteroid nasal spray or cortisone injections into the nasal membranes may help.
Question: I’ve had allergies since I was a child. Four years ago, I bad an operation for a broken nose. Now my nose bleeds if I happen to rub it—even only gently. Why?
Answer: The problem probably has nothing to do with your broken nose or operation. But it may be related to your aller-gies—or, more precisely, your allergy medications. Anti-histamines and decongestants can dry the mucous lining of the nasal passages. Rubbing, scratching, or other trauma can eas-ily cause bleeding in a dry nose. To lessen drying, minimize your use of those medications and keep your environment comfortably humidified.
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