Sinonasal polyposis (SNP) is a chronic condition characterized by the growth of nasal polyps—benign, grape-like masses that develop in the nasal passages and sinuses. This condition leads to persistent nasal congestion, sinus pressure, and postnasal drip, significantly impacting daily life. However, one of the most frustrating and frequently overlooked symptoms of SNP is anosmia, or the loss of smell.

How Does Sinonasal Polyposis Cause Anosmia?

The loss of smell in nasal polyps is primarily due to physical obstruction. Polyps block the olfactory cleft, preventing odor molecules from reaching the smell receptors. However, other factors also contribute, including:

• Chronic Inflammation: The persistent inflammation in chronic sinusitis and loss of smell can damage the olfactory epithelium, further impairing the sense of smell.
• Mucosal Changes: Structural and functional changes in the nasal lining reduce the ability to perceive odors.
• Sinus Congestion: Blocked sinuses limit airflow, preventing scent molecules from reaching the olfactory nerves.

The Impact of Anosmia on Daily Life

A diminished sense of smell affects more than just the ability to enjoy fragrances. It also leads to:

• Loss of Taste Perception: How SNP affects sense of smell directly impacts the sense of taste, making food less enjoyable.
• Safety Concerns: Patients struggle to detect smoke, gas leaks, or spoiled food.
• Mental Health Issues: Anxiety and depression are common in those who experience chronic anosmia due to nasal polyps.

Diagnosing Nasal Polyps and Smell Loss

A thorough evaluation is necessary to determine the severity of smell loss in sinonasal polyposis. Common diagnostic methods include:

• Nasal Endoscopy: Helps visualize nasal polyps and smell loss severity.
• CT Scan: Determines the extent of sinus blockage and inflammation.
• Smell Tests: Assess the degree of olfactory dysfunction.

Treatment for Anosmia in Nasal Polyps

Early intervention is key in how to restore smell after nasal polyps. Treatment options include:

1. Medications to Reduce Inflammation and Shrink Polyps

• Intranasal Corticosteroids – First-line treatment to manage inflammation.
• Oral Corticosteroids – Short courses may be prescribed for severe cases.
• Monoclonal Antibodies for Nasal Polyps – Biologics like Dupilumab, Omalizumab, and Mepolizumab are effective for severe SNP, especially for patients with comorbid asthma.

2. Functional Endoscopic Sinus Surgery (FESS)

For cases where medication fails, FESS for SNP is performed to remove polyps and restore airflow. This sinus surgery for nasal polyps can significantly improve smell restoration after FESS in many patients.

Can Smell Be Fully Restored?

While treatments improve olfactory function, complete restoration is not always guaranteed. The chances of regaining the sense of smell depend on early treatment, severity of inflammation, and adherence to medication.

The Takeaway

Anosmia in sinonasal polyposis is a significant issue affecting quality of life. Managing nasal congestion and anosmia through medications, biologics, and surgery can help patients regain their sense of smell and overall well-being.

By prioritizing the restoration of smell, we can significantly improve the quality of life for patients suffering from sinonasal polyposis. Contact us to clear your doubts.