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Anosmia is the inability to perceive odours, that is, the loss of smell. This loss can be temporary, sometimes long-lasting, or permanent, and congenital (from birth) or acquired.

It is important to know that anosmia is a symptom and not a diagnosis. Fortunately, the causes of anosmia are mostly benign. Consequently, the general prognosis is good, although the loss of smell can cause risk by preventing noxious odours from being perceived.

Given the relationship between smell and taste, anosmia prevents enjoying the taste of food and consequently significantly affects the quality of life of sufferers.

What are the causes of anosmia?

First, we must emphasize that the sense of smell is lost with age. In a study carried out in the USA, it was found that in the age group between 40 and 49 years the prevalence of smell alteration was 4%, while in the age group between 70 and 79 years it was 25% and the percentage reached 40% in those over 80 years of age.

The most common cause of anosmia is inflammatory disorders affecting the nasal and sinus mucosa, including rhinitis and sinusitis, especially when polyps are present.

Another common cause of anosmia is head trauma. It can damage the nasal structures causing an obstruction, and the consequent accumulation of mucus in the sinuses and the olfactory organs and areas can also be damaged. Fortunately, olfactory neurons are able to regenerate, and over time, depending on the area and extent of the injury, the sense of smell can be regained.

Neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease, and Lewy body dementia are also fewer common causes of anosmia. Some studies have linked the loss of smell to an increased risk of developing neurodegenerative diseases.

With regard to acquired causes of anosmia, we cannot fail to mention the coronavirus infection (COVID-19), since around 50% of patients with this disease have anosmia, very frequently associated with loss of taste and with an average duration of one month.

Regarding congenital causes of anosmia, Turner and Kallmann syndromes stand out.

Turner syndrome is the lack of an X chromosome and therefore only affects women. It is characterized by short stature, abnormal function of the ovaries, and sterility.

Kallmann syndrome is due to the null or deficient production of sex hormones in both men and women with the consequent alterations in the development and functioning of the sexual organs.

Finally, a series of medications can cause alterations and loss of smell: antihypertensives (beta-blockers, ACE inhibitors, dihydropyridine), antithyroid drugs, and intranasal zinc, among others.

What is the treatment for anosmia?

The treatment and management of anosmia depend on the cause and response to treatment or surgery.

For all causes of anosmia, treatment and management depend on the treatment and management of the underlying disease and whether that disease is refractory to medical intervention.

When the cause is sinusitis, relief of symptoms, including anosmia, is achieved by draining the accumulated mucus from the sinuses.

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