Full loss of smell sensations - anosmia - is a violation of the functions of the olfactory sensory system and occurs for various reasons, being a symptom of a sufficiently large number of diseases.
In addition, a lot of diseases, in the symptoms of which there is a decrease or partial loss of smell - hyposum. Both options are classified according to ICD-10 as one of the manifestations of diagnosed painful states and pathologies associated with perception, and have the R43.0 code.
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Code of the ICD-10
R43.0 Alosmia
Epidemiology
Judging by how few doctors speak of anosmia (biochemistry of smell perception is studied, but it is not clear to the end), the data regarding its prevalence is contradictory. However, experts of the American Academy of Neurology (AAN) argue that about 14 million Americans over 55-60 have problems with sense of smell, and more than 200 thousand people are addressed annually on this issue to doctors.
Men more often women lose sense of smell, especially smokers and those who survived the stroke or suffer from chronic rhinitis and nasal congestion.
According to British Rhinological Society, not me by 220 thousand adults of the British complain about the decline in the smell. A survey is almost 10 thousand people in Spain showed that two of every ten respondents have a one or another form of a worsening of smell perception.
Complete anosmia in 2004 was diagnosed in 1.4 thousand adult Swedes (with a population of 10 million). Basically, these are the elderly, and experts explain it atrophy and reducing the number of olfactory neurons or sensuously disorders characteristic of people of old age.
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Causes of Alosmia
The key causes of anosmia have gradation, which is based on the neurophysiology of the perception of odors and the clinical features of respiratory and parapasal diseases, as well as neurosensory pathologies.
Under the duration of the loss of smelling may be temporary and constant, and in etiology - congenital (genetically determined) and acquired. Most often, the symptoms of anosmia occur at the level of the epithelium of the nasal cavity and olfactory receptors (neurosensory cells).
Thus, the initial or essential anosmium is determined by destructive changes in the olfactory epithelium, when the receptors cease to catch the smells, that is, react to particles of volatile substances that fall into the nasal cavity with air. This form of smell loss is considered peripheral and as a symptom occurs in infections, in particular, as a loss of sense of smell during a cold.
First of all, there is a loss of smelling during a cold, however, it should be borne in mind that 25% of rhinoviruses do not give symptoms, and perhaps the only sign may be the loss of smelling without a cold, diagnosed as idiopathic.
As a rule, the temporal loss of smell after influenza does not cause anxiety in people, since the cells of the olfactory epithelium can be recovered (about it in more detail in the section Treatment of Alosmia).
It is much stronger than the olfactory sensory neurons from bacterial toxins. Thus, the loss of smelling during sinusitis, especially chronic, is explained by the otolaryngologists by the fact that the inflammatory process, localized in the incomplete sinuses, can spread above - into the frontal sinuses, and the edema the olfactory nerve arising from this. A serious relationship requires acute inflammation of the lattice labyrinth, which can be a complication of sinusitis and lead to complete sense of smell. Irritation of mucous membranes, their dystrophy and partial sense loss are characteristic of chronic atrophic rhinitis, sinusitis, frontis, ozia.
Strong swelling of mucous and nasal occlusion with discharge of various consistency and decrease in smell - symptoms of hay fever (allergic rhinitis).
At any age, the nasal congestion and the loss of smell due to the obturation of the nasal moves may occur not only in the cold, but also in connection with the revocation of the nasal partition, adenoids, the presence of foreign bodies in the nose cavity, as well as the presence of polyps and malignant nose tumors. Moreover, the problems with distinguishing odors cause not only the nasal polyposis itself: the rustologists are recognized that the smelling loss occurs after removing polyps or tumors, as well as after unsuccessful rhinoplasty - due to the formation of scarring or cartilage jumpers (synech).
The olfactory receptors are affected by inhalation of toxic chemicals, pesticides, heavy metals and at radiation therapy: the complete loss of smell after irradiation is the consequence of the treatment of gamma-radiation of brain tumors, bone tissue and skin of the face of the skull.
Some nasal means, in particular, relieve the nasal congestion, can damage the olfactory epithelium and even cause dependence on the drops into the nose.
Frequent swelling of the nasal mucosa causes folk treatment with a non-nose homemade garlic or onion drops, burning mucous membranes. There may be a loss of smell after cyclamena (Cyclamen Purpurascens) used in homeopathy: When instilled in the nose of undiluted juice from its tubers containing poisonous saponins, the mucosa can appear as when a chemical burn.
Loss of sense of smell during pregnancy In most cases, a partial, resulting from the edema of the nasal mucosa in response to changes in the hormonal background, as well as with a conventional rheorch or exacerbation of allergies.
What is neurotransitory and central anosmia?
The ability to feel odors can be lost due to disorders of signal transmission from olfactory sensory neurons in the brain (sensory transduction) or damage and dysfunction of the basic structures of the brain analyzing the nerve impulses and the generating response - the sensation of the smell mediated by the limbic system. In the first case, we are talking about neurotransitory (conductor) anosmia, and in the second - about the central (brain) or sensorsuleveral.
An alimony of the sensory transduction is caused by anosmia after the head injury - with a fracture of the base of the anterior cranial fossa or a lattice bone. Many patients as a result of a minor head injury may experience an unilateral (one-sided) anosmia (or hemicoamia). And the causes of the anosmia of central origin during crank-brain injuries are associated with damage to the olfactory bulbs in the frontal fractions of the brain or temporal fractions.
The loss of smelling without a runny nose is one of the clinical symptoms: Pehkranz syndrome (adiposogenital dystrophy, developing due to the lesion of the hypothalamus); Foster-Kennedy syndrome; epilepsy, significant increase in intracranial pressure, dementia (including levies), Alzheimer's diseases.
Bilateral or bilateral anosmium may be a consequence of herpetic encephalitis, primary amoebic meningoencephalitis, neurosophilisa. To the loss of smell sensations lead meningiomes of the anterior cranial fossa; Malignant neoplasms in the area of \u200b\u200bthe bridge-cerebel angle or the pyramid of temporal bone; neurosurgical operations; Neurotoxic drugs.
The simultaneous loss of smell and taste is possible - an almia and Agevia (code on the ICD-10 - R43.8): both sensory systems have specialized receptors stimulated by chemical molecules, and their functions often complement each other as special visceral afferets of one limbic system. In addition, the olfactory system through the reticular formation is associated with the vegetative CNS centers, which explains the reflexes with olfactory receptors for digestion and breathing, for example, nausea and vomiting with particularly unpleasant odors.
And the loss of tanging and smelling (anaphia and anosmia) is evidence that somatosensoric is violated: skin receptors do not respond to external stimuli. Most often this is a consequence of traumatic damage to the frontal and temporal fractions of the brain or the loss of the functions of the structures of the limbic brain system at the CHTMT, stroke, intracranial aneurysm, brain tumors, sclerosis dissipated.
Congenital anosmia is rarely detected and sometimes happened in hereditary cylinathy (Martageer syndrome), Callman and Refsum syndromes, with an innate dermoid nasal cyst and some other forms of embryonic development anomalies.
Risk factors
It is logical that the risk factors of the appearance of symptom are diseases. So all the disease listed above are from a cold to the brain tumor - treats with physicians to their number.
But separately it should be said about Zinc (Zn), more precisely - about its deficiency in the body. In clinical medicine, the loss of smell is considered one of the first signs of chronic zinc deficiency, in which the production of blood leukocytes is also reduced and resistance to infections is reduced.
This trace element is an integral part of at least three thousand different proteins of our organism, it is necessary for the production of carboanhydrase metallotherapy (CAS VI), which ensures the maintenance of the optimal pH, tissue regeneration and nervous conductivity.
Pathogenesis
Explaining the pathogenesis of the loss of sense of smelling at Orzi and a cold, it is necessary to keep in mind that it perceives the smells of not respiratory fiscilable epithelium (REGIO RESPIRATORIA), covering the nasal cavity, but a special olfactory, localized in the sense of smell or olfactory slit (Regio Olfactoria) - between the upper parts of the shell and nasal partition.
The mucous membrane of the olfactory area of \u200b\u200bthe nose has a very complex structure: almost 10 million olfactory sensory neurons are concentrated here, each of them has dendrites with cilia at one end and axon on the opposite. The olfactory epithelium is covered with a mucous secret, and cilia of chemoreceptors - binding protein produced by tubulialveolar glands, which are located around the cilia. In addition, there is a supporting epithelium (for the protection of chemoreceptors) and cells of the base plate of the mucous epithelium.
It is assumed that the pathogenesis of essential anosmia under rhinitis lies in reducing the functional activity (or full blocking) of the neuronal epithelium ciliations due to the hyperproduction of mucus, and in cases of chronic inflammation of the mucous membrane or chemical effect on it - in atrophy of the olfactory epithelium and replacing it with respiratory.
Central olfactory ways are formed by axons of olfactory sensory neurons. They are connected in two beams of non-myelin shell afferent fibers - olfactory nerves (I pair of cranial nerves). These nerves passes through the lattice bone, the prefrontal boron of the frontal share and olfactory bulbs (clusters of reinforcing the neurons operating as a relay of the olfactory analyzer). Any damage to these structures creates an obstacle to the transfer of pulses and can lead to a complete or partial sense of smell (single or two-sided).
According to the olfactory nerves, the signal falls into the final point - the structures of the limbic brain system: a pyroform and the entoring bark of the temporal shares of large hemispheres and the almond-shaped body (responsible for the final encoding of the signals of the smell of neurons and behavioral reactions to smells). Pathology in the listed locations lead to the absence of signal analysis from olfactory sensory neurons, without which it is simply impossible to feel the smell.
Complications and consequences
Based on the functions performed by the smell, the main consequences and complications of its partial or complete absence relate to the recognition of the degree of food fitness to use: without perceiving the smell of spoiled product easily get food poisoning. And in some situations, for example, when the gas leakage, electrical appliances or the presence of toxic gaseous substances in the air, there is a direct threat to life.
At the same time, the ammamines most often maintain a normal feeling of taste, but there are no ordinary psycho-emotional reactions to smells.
Even the partial loss of smell can lead to a decrease in appetite and depressive state. According to some reports, 17% of people suffering from an acquired anosmium fall into depression that does not feel smells that cause positive emotions or related to pleasant memories.
The right to disability under anosmia (with the purpose of the manual) may occur only when this state - along with other symptoms - prevents person to work, and this happens in strokes, diseases and traumatic damage to the brain, psychosomatic disorders, etc.
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Diagnosis of anosmia
The loss of smell is a symptom of various diseases, and the diagnosis of anosmium is reduced to identifying them.
Usually with acute rhinitis, the diagnosis of special problems does not cause any problems: the ENT doctor is enough to listen to the patient's complaints and to hold rhinoscopy (inspection of the nasal passages and the nasal cavity). But if a patient has a protracted or chronic runny nose, nasal congestion and loss of smell, then analyzes will be required, including the study of cranial nerves. I pair: olfactory nerve spray from nasal congestion. The appointment of topical glucocorticoids (corticosteroids) is practiced as a means against the edema of the mucous membrane, for example, NOZONEX, with a loss of smell, apply in cases of allergic rhinitis or acute sinusitis - read Nazonex sinus (instructions for use).
But the use of intranasal tools does not guarantee the reduction of smell, moreover, the mechanism of their pharmacological action and does not take into account the damage to the olfactory nasal cavity epithelium. In the same way, inhalation, with loss of sense of smell, they are aimed at eliminating the congestion of the nasal passages, and they certainly bring relief during the cold. It will be more efficient than the treatment of herbs: hot steam inhalations with the addition of chamomile flowers or lavender, plantain leaves, eucalyptus or grass Sage and Timyan - five minutes every day, three or four times a week or every other day. It is also possible and physiotherapeutic treatment - see physiotherapy with ritin
It is not excluded the appointment of oral administration of dexamethasone (dr. Trade names - Dexacrort, Deadin, Cortadex, Hexadol, Millicitan, Ortadekson, Rebstikort) - on a tablet (0.5 g) times a day (in the morning). GCS is contraindicated with sharp viral, bacterial and fungal infections, Cushing syndrome, osteoporosis, chronic hepatitis, pregnancy and lactation. Among its side effects: a decrease in the level of calcium in the body and increasing the fragility of bones, a reduction in lymphocytes and an increase in the level of erythrocytes in the blood, deterioration of the functions of the adrenal and pituitary-hypothemic system.
Vitamins of groups B are used, zinc drugs - vitamins with zinc, as well as lipoic acid (protogenic, thioactacide), which contributes to improving the smell of rinoviral diseases; Recommended to take 0.5-0.6 g per day (for one to two months). Lipoic CSTLOT is contraindicated in gastritis with increased acidity and a stomach and duodenal ulcer.
Antibacterial therapy is necessary in sinusitis of bacterial etiology, under meningitis, and surgical treatment is carried out with patients with polyps in the nose and tumors.
In case of damage to the olfactory periphery, the population of olfactory sensory neurons is destroyed, but the olfactory receptor cells serve, on average, two months. Like the taste papillas of the language, the olfactory neuroreceptors are periodically updated, and this occurs due to the development of basal cells of the primary olfactory epithelium of the main growth factor of fibroblasts (BFGF), which let them differ in sensory neurons, ignite the loss and regenerating damage.
In Japan, try to treat acquired anosmia by applying the gelatin hydrogel nose mucosa with BFGF.
It's important to know!
Allergies to smells can be provoked by polluting, chemicals, pollen flowering plants. The reasons affecting the possible appearance of allergies are: structural changes in the infectious disease itself, worsening conditions of the external environment, hereditary factors.
The smell is one of the 5 major human sensations. In the life of a modern man, his role is not so great as vision or hearing, but still violations of this function or the complete loss of the scent significantly depletes the perceived picture of the world and can lead to serious consequences. Food, the fragrance of which a person does not feel, loses half of his attractiveness. Sharp, unpleasant odors can warn about danger.
For representatives of some professions, sharp smell is simply necessary, and his loss becomes a disaster, the end of the career. By itself, the loss of sense of danger to life does not represent, but it can be a symptom of formidable diseases, so this problem should be treated with all seriousness.
Loss of smell - anosmia
The child recognizes the main odors from 4 months, in a pubertal period, this feeling reaches maximum sharpness, and after 45 years it begins to gradually decrease, a sharp decrease in smell occurs after 70 years.
Reducing the acute sense of smell and its full loss can be associated not only with age-related changes, but also with a number of diseases, injuries, structural pathologies.
The loss of smell is also called an alimony, but this word is not at all tinned by the word "nose". It goes back to the Greek OSME, that is, the smell, and the weakening of this feeling is called hyposhythmia.
Possible reasons for reducing the perception of smells
The receptors responsible for the perception of odors are concentrated in the nasal mucosa, olfactory centers - in the brain, and the conductor of signals between them is the olfactory nerve. Therefore, injuries and diseases affecting any section of the chain can be caused to malfunctional disorders: nose-nerve brain.
- structural changes and anomalies of the nasal cavity: polyps, curvature of the partition;
- inflammation of the nasal mucosa associated with the rhinitis of any etiology, sinusitis, colds;
- violation of the secretion of the mucous membrane, its age atrophy;
- destruction of neuroepithelia or neurons of the brain viruses, toxic substances or drug drugs;
- card and brain injuries, bruises, blows, resulting in damage to the olfactory nerve, bulbies;
- any neoplasms that have pressure on olfactory centers, aneurysms, tumors;
- surgical interventions, in particular, brain operations or rhinoplasty;
- degenerative processes, Alzheimer's disease, Parkinson, Dementia;
- abuse smoking.
Rarely anosmia is quite rarely congenital associated with Callmann syndrome (genetically determined hormonal disorder), underdevelopment of olfactory routes, anomalous structure of the facial skeleton.
Symptoms of immunity receptors
Talking about the symptoms of the loss of smell is not quite correct, this condition itself is a sign of a number of diseases, and in a complex with other signs allows you to diagnose.
- in combination with a hoped nasal breathing, swelling of the mucous membrane, the discharge of the anosmia is usually indicated by ritin;
- if the smell was not restored after the cure of the cold, ARVI, high the likelihood of the development of post-Russian essential anosmia caused by the destruction of the olfactory epithelium and its replacement;
- if a person perceives odors, but does not recognize them, it is a symptom of the defeat of the central nervous system;
- with the loss of smell caused by injury, it can recover, but the perception of smells will be perverted;
- the weakening and loss of smell, accompanied by constant dryness in the nose, may be symptoms of age atrophy of the mucous.
The smell loss can be a complete or partial, temporary or constant, congenital or acquired. If a person does not react to smells, including quite pronounced, you can suspect he has an innate anosmia.
The main symptom of the acquired loss of smell is the weakening or loss of the ability to distinguish odors. The simplest way to independently diagnose anosmia or hyposimy: Small soap, vinegar, Valerian tincture.
If the patient does not distinguistrates only some of the ten thousand odors available to the human face, we are talking about partial anosmia. When he does not feel odors in general - this is a complete loss of smell, which is rare enough.
The specific loss of smell is also distinguished, the inability to distinguish between one particular smell or a group of odors.
The smell loss is one-sided or bilateral.
The reason for appealing to the doctor more often becomes bilateral anosmia, which is subjectively perceived by patients as a violation of the sense of smell. This is a fairly innocuous phenomenon, usually associated with respiratory disorders, the lesion of the nasal mucosa.
One-sided process can be asymptomatic, a person does not feel discomfort, continues to take odors. Since this violation is usually accompanied by an intracranial tumor, refer to the specialist forcing the symptoms characteristic of this dangerous pathology.
Only a separate study of both nasal cavities makes it possible to identify one-sided smelling loss.
Evaluate the severity of the anosmia allow special tests.
The methods of diagnosis of anosmia also include the biopsy of olfactory neuroepithelium. But the results of this study are not sufficiently reliable, degenerative changes of the epithelium do not always lead to the loss of sense of smell.
Treatment methods
The success of treatment depends on the cause of the loss of smell.
- use the aroma, spend with essential oils or medicinal herbs, inhaling the evaporation of vinegar, poured into a hot frying pan (the eyes need to be closed);
- purchase into the nose: Fresh Cupiolete Juice (about methods for the treatment of adenoids in children), cabbage, water with the addition of a small amount of onion or garlic juice, menthol oil;
- laying tampons impregnated with a mixture of propolis with vegetable and melted butter in proportions 1: 3: 3;
- exercises, straining the nose for a minute, then relaxing.
Drugs and preparations
The loss of smell is treated with the same drugs that caused its disease.
A number of specialists also associate a disorder of ignition with a deficiency of zinc and vitamin A and includes appropriate drug therapy.
- Zincteral 124 mg, 25 tablets 255-346 rub.
- Vitamin A: Retinol acetate in capsules for 33 thousand meters - 10 capsules 6-7 rubles, Babenen 90 capsules 119-156 rubles.
Prevention of smell loss
Preventive measures are reduced to eliminating the cause of the loss of smell:
What to do with the loss of smell, quite unpleasant phenomenon, even if it is temporary. Any sense of smell can signal the pathologies of the central nervous system, the violation of the blood supply of the brain, neoplasms in the skull cavity.
Therefore, weakening and loss of smell, not accompanied by a feeling of nasal congestion, should be a "anxious bell" and the reason for the visit to the doctor.
A comprehensive examination will allow the treatment timely on which the patient's life may depend on.
It is also necessary to take care of your own nose, fencing it and from mechanical injuries, and from contact with aggressive substances. In the case of loss of sense of smell, there will be less positive emotions in life, and expensive memories will be resurrected much more difficult.
What causes the loss of smell. This is reasoning the leading and invited experts in the studio of the program "On the most important thing". You also learn about the newest ways of treating the illness while watching an interesting plot.
The ability of a person to feel and distinguished the smells is an extremely complex process, the implementation of which is ensured by the optimal relationship of the anatomical structures of the nasal cavity, balanced by the activities of all levels of the olfactory analyzer, the trigeminal nerve, the vegetative nervous system, eliminating centers, which in turn are linked with many effector centers Intermediate, medium brain, limbic system, hypothalamus, reticular formation.
Conducting the olfactory analyzer paths have a complex structure and set out several schematic. The olfactory receptors of the mucous membrane of the nasal cavity perceive changes in air chemistry and are the most sensitive compared to receptors of other senses. The first neuron is formed by bipolar cells located in the mucous membrane of the upper nasal shell and the nasal partition. Dendrites of olfactory cells have beam-shaped thickening with numerous cilia, perceiving air chemicals; Axes are connected to the olfactory threads (Fila Olfactoria), penetrating through the holes of the lattice plate into the skull cavity, and switch to the olfactory glittering of the olfactory bulb (Bulbus Ofactorius) on the II neuron. AXSONS II neuron (mitral cells) form an olfactory tract (TR. OFACTORIUS) and end in an olfactory triangle (TRIGONUM OLFORTIA) and in the front reinforced substance (SUBSTATIA PERFORATA ANTERIOR), where neurones III cells are located. Akssees III of the neuron are grouped into three beams - outdoor, intermediate and medial, which are sent to various brain structures. The outer beam, encroaching the Sulcus Lateralis of a large brain, reaches the cortical center of smelling, located in the hook (UNCUS) of the temporal share. The intermediate bundle, passing in the hypotalamic area, ends in the deputy bodies and in the middle brain (red core). The medial beam is divided into two parts: one part of the fibers, passing through Gyrus Paraterminalis, envelopes Corpus Callosum, enters Gyrus Fornicatus, reaches hippocampus and hook; Another part of the medial beam forms an olfactory-leashed bundle of nerve fibers passing in the Stria Medullaris of the Talamus of his own side. The olfactory-leased beam ends in the triangle kernels of the bridle of the propellant region, where the downward path is starting connecting the spinal cord motioneons. The kernel of the triangular bridle is duplicated by the second system of fibers coming from mastoid bodies.
The ability to feel and define odors depends not only on the good patency of the nose and the unhindered transport of fragile substances into the olfactory zone, but also from the balanced activity of all levels of the olfactory analyzer, the chemoreceptors of the trigeminal nerve, the vegetative nervous system, eliminating centers.
On the modern methods of research of the olfactory analyzer you can read ...
The occurrence of olfactory dysfunction (olfactory disassensions), according to various sources, ranges from 1 to 19% of cases. In most cases (13.3%) there is a decrease in the evolving of smell, less often (5.8%) - an alms. The most frequent causes of dysosmia are respiratory and viral infection (39%), diseases of the nose and the incompassal sinuses (21%), the effects of the cranial injury (17%), congenital anosmia (3%), in 18% of cases we are talking about infringement of smell Unidentified etiology, 3% - about other reasons (Hendriks AP AT ALL, 1987; DeEMS DA AT ALL, 1991; BRAMERSON A. AT ALL, 2004;).
Practically distinguished the following types of infringement of the sense of smell (Hendriks a.p. Olfactory Disfunction. Rhinology 1988):
1 - Alosmia (patient's inability to feel smells);
2 - hyposumia (reduction of the ability to perceive odors);
3 - Parosmia (distorted smell perception);
4 - Fantosmia - olfactory hallucinations (the perception of odors in the absence of an olfactory incentive);
5 - olfactory agnosia (inability to recognize the smell).
1 - respiratory dysosmia - due to impaired air movement in the olfactory gap;
2 - epithelial dysosmia - is associated with changes in the mucous membrane in the olfactory region; The reason for the restriction of the contact of the spacious substance with neuroepithelium receptor cells in these cases is the insufficiency of the secret of the bowman glands in atrophically ritin, ozen, the dystrophic form of the scleroma;
3 - combined dysosmia - occurs when combining ventilation disorders and changes in the mucous membrane of the olfactory region;
4 - Neural dysiamia is due to the defeat of FILIA OLFACTORIAE and is often observed in patients undergoing flu, acute respiratory infection, as well as with acute and chronic sinusitis, intoxication with antibiotics, irradiation of the global zone mucosal over the nasopharynx tumors, pituitary gland; In this case, various changes in neurodynamic nature can occur - from the symptoms of irritation (hyperosmia, steaming, olfactory hallucinations) to loss (reduction, lack of smell, violation of odor recognition);
5 - Central Dysiamia occurs in pathology of conducting ways and obligatory centers; Insulated damage to the conducting paths occurs mainly during crank-brain injury, especially the occipital and frontal-facial areas, intracranial hemorrhage.
Non-generation. With the potential risk of the occurrence of olfactory disorders, the use of intranasal drugs is often conjugate. Fortunately, in the absolute majority of cases, we are talking about transient disorders due to changes in the mucous membrane, which are usually stopped for several weeks. However, in some cases, for example, after endonazal surgical interventions, resistant dysiamia may occur. In this regard, before starting treatment, it is important to know the initial state of the olfactory function, and at the preoperative examination stage it is necessary to prevent the patient about the probability of temporary oppression of sense of smell in the postoperative period and the prospects for its recovery.
The effect of anatomical changes in the nasal cavity on the state of the olfactory function. In 83% of cases of infringement of the sense of smell, the nasal septum (Prostasevich G., 1995), disorders of intrainosum structures in the olfactory zone (Zusho H., 1982). Pretty changes in intrainosum architectonics are observed at traumatic damage to the outer nasal pyramid. In particular, various deformations of the olfactory gap can be associated with the dislocation of the lateral wall of the nose. This circumstance is the cause of violation of the sense of smell in 32.8 - 42.8% of patients with deformations of the outer nose (Martinkenas Y.V., 1987). It should be emphasized that the state of the olfactory function in these cases is a very sensitive marker reflecting the features of structural disorders in the nasal cavity.
It must be remembered that even perfectly performed rinosurgical intervention may not lead to an improvement in the smell, the violation of which is due, for example, with a severe injury of the nose-facial region, pronounced dystrophic changes in the mucous membrane. In addition, about 1/3 patients there is a temporary oppression of the perception of odors associated with postoperative reactive changes in the mucous membrane, which will be bought independently. However, some patients may have postoperative anosmia, the reasons for which are not always amenable to explain. In these cases, a non-profitable infringement of the smell may be a source of conflict situations and legal conflicts, when the presence of olfactory dysfunction is associated with the patient with the transferred operation. Therefore, a preoperative study of smell, comparison of the results obtained with postoperative testing data is a serious argument in assessing the effectiveness of rinosurgical intervention, the likelihood of / aggravation of olof violations and forecast.
One of the most frequent causes of Dysosmia / Alosmia are rhinitis and rhinosinusitis. According to European conciliation documents on rhinosinusitis and Nasal Polyposinusitis and Nasal Polyposis, a disorder of the smell along with the difficulty of nasal respiration, pathological discharge from the nose and headache is included in the list of the most frequent subjective signs of acute rhinosinusitis. According to experts, the frequency of olfactory dysfunction in such patients reaches 14 - 30%. The sense of smell allows an otorhinolaryngologist not only to state the presence of one of the most common symptoms of rhinosinusitis, but may also be quite a useful indicator of the effectiveness of the treatment.
About changes in the olfactory function during the period pregnancy You can read ...
Obllary violations play an important role in the formation of a clinical picture of mental disorders. It is noted, in particular, high (in 44% of patients) the frequency of olfactory dysfunction at neurosis (Popelyansky A.Ya., 1998). The features of the state of an olfactory analyzer in patients with epilepsy (Dimov D., 1998) were revealed. Obony dysfunction is an early sign of Parkinson's disease, Alzheimer, Schizophrenia (Eibenstein A. Et All, 2005). Increasing the thresholds of perception and identification of odors in schizophrenia can be due to the insufficiency of central mechanisms for analyzing this information, a change in the structure and volume of olfactory bulbs identified by MRI (Moberg P.J. ET ALL, 2003; Eibenstein A. Et ALL, 2003). To a certain extent, the increase in the smell thresholds in patients with schizophrenia may be associated with a long admission of psychotropic drugs. Having α-adrenoblocking and anticholinergic properties, these drugs adversely affect the functional state of the mucous membrane, which affects the activities of the peripheral department of the olfactory analyzer (Borisenko G.N. and Sovt., 2005). Along with the elimination of psycho-emotional voltage, they have an inhibitory effect on vascular centers, the rate of transmission of the nerve impulse in the sympathetic ganglia. This adversely affects the activity of the central departments of the olfactory analyzer, causing secondary changes of the olfactory center and associative connections (Raisky V.A., 1988).
Schizophrenia patients are often allowed by resorting to characterize their sensations to specific images (solid smell, etc.). The olfactory gallery of the barbecue is evidenced about the serious flow of schizophrenia, which manifests itself with a feeling of sickness sickness, allegedly emanating from its own body, without an olfactory incentive. The smell impairment is considered as a reliable predictor of emerging psychosis and can be used in the diagnosis of schizophrenia.
Smean (Olfactus) - a type of sensitivity aimed at the perception of smells. The sense of smell gives us the opportunity to enjoy pleasant smells, and sometimes you can save our life: do not give a drink a vinegar instead of vodka, tell me that you should not have a pie with a jerny or remind you that when the gas is not closed, you cannot click the switch.
However, the odors around us have the properties that many may not even suspect. Something like the human sense of smell, there is even microorganisms: Chemotaxis - the ability to move to sources of food and away from hazardous substances - exhibit all movable single-cell milking.
Selication authorities
In humans, the sense of smell is located in the upper departure of the nasal cavity. The olfactory area of \u200b\u200bthe nasal mucosa includes the mucous membrane, covering the upper hand sink and the top of the nasal partition.
The receptor layer of the mucous membrane is represented by olfactory neurosensory cells that perceive the presence of fragile substances. Under the olfactory cells are supporting cells.
In the mucous membrane there are olfactory (bookmen) gland, the secret of which moisturizes the surface of the receptor layer. The peripheral processes of olfactory cells carry olfactory hairs (cilia), and the central forming 15-20 olfactory nerves.
The olfactory nerves through the holes of the lattice plate of the same name penetrate into the skull cavity, then into an olfactory bulb, where the axons of olfactory neurosensory cells in the olfactory gloms come into contact with mitral cells.
The process of mitral cells in the thickness of the olfactory tract is sent to the olfactory triangle, and then in the composition of the olfactory strips (intermediate and medial), enter the front forced substance, into the submractive field and the diagonal strip (broom strips).
As part of the lateral strip, the process of mitral cells is followed in paragippocampal will and in the hook, in which the smell cortex center is.
Disorders of smell
Selief disorders include:
- hypospheres - deterioration of smell;
- anosmia - loss of smell;
- hyperosmia - an increase in smell is rarely found;
- cocasmia is a perversion of smell.
Anosmia can be respiratory and essential, congenital and acquired.
The respiratory disorder of the smell is due to pathological processes in the nasal cavity, in which the access of inhaled air containing odorous substances is difficult to the olfactory slit (hyposhythmia comes) or completely discontinued (which causes anosmia).
In childhood, in adult, respiratory hypo- and anosmia occur due to the swelling of the mucous membrane of the nasal shell, Atresia Hoang, congenital nose anomaly, nose, traumatic or other nature of sobbins (synechia) in the nasal cavity, polyposis and nose tumors, etc. .
Virtually any mechanical impairment of air penetration into the olfactory slit causes the infringement of the sense of smell. Essential anosmia arises with the defeat of an olfactory receptor or an olfactory nerve.
Deep atrophy of the mucous membrane of the nose, which occurs, in particular, during ozone (stenchable runny nose), is accompanied at the beginning of essential hyposhythmia, and then hyposhythmia due to the damage to the olfactory receptor atrophic process.
The relatively frequent cause of essential disorder of smell is infectious diseases: viral, children's infections. In rare cases, in the localization of the tuberculosis or syphilitic process, essential anosmia may occur in the nose. Poisoning with some poisons, and in some cases and drugs also sometimes cause violation of the sense of smell.
One of the symptoms of tumor processes in the upper salt of the nose and intracranial in the course of the olfactory tract is essential defeat of the sense of smell. The irreversible lesions of the olfactory sensitivity causes an injury of the olfactory zone of the nasal cavity or damage to the conductive paths and the center of the sense of smell.
The disorder of smell can be a symptom of the following diseases:
Loss of smell
Loss of smell, like loss of taste, is a big problem for a person. After all, the feeling of fragrance and taste of food is, in his own kind, a certain joyful moment in the life of every person, who deliver an incomparable pleasure.
Without the feeling of odors, simply speaking, it is impossible to enjoy life. For many people, the smell is generally fundamental in life, since their labor activity is directly related to this (cooks, winemakers, perfumers).
Why is the loss of smell
We highlight the main reasons for this unpleasant symptom.
Violation of air transport containing odorous substances to the olfactory brain department
This is due to the strong nasal congestion at rhinitis (cold and aragic) and sinusites, as well as with polyps in the nose and the curvature of the nasal partition. The smell will be fully restored, if you eliminate these factors - cure a runny nose and sinusitis, remove the polyps or correct the novel partition (this is a simple operation).
Other reasons
It may be launched chronic rhinitis, the reception of some drugs (antibiotics, heart and diabetic drugs), inhalation of poisonous substances and long-term work on dusty production, malicious smoking.
Restoration of smell in these cases requires more time. But for this you need to restore the nose mucosa, refuse tobacco, observe labor hygiene at production or change the work.
With long-term reception of drugs accompanied by smelling, consult your doctor and pick up other drugs.
The defeat of the nerves transmitting information from the nose to the brain
The third group of reasons is most dangerous and is associated with the defeat of the nerves responsible for the transfer of information from the nose to the brain. They are very subtle and vulnerable, so often in injuries of the head or directly nose, as well as with incorrect operations or the presence of tumors can be destroyed.
Some diseases (problems with thyroid gland, Parkinson and Alzheimer's disease) are also accompanied by informations of smell. In these cases, do not do without the help of a neurologist's doctor.
Treatment with sense of smell
Treatment of patients with exemplary transportation disorders arising from allergic rhinitis, bacterial rhinitis and sinusites, polyps, tumors and organic lesions of the nasal cavity can be successful.
The reduction of smell contributes to the treatment of allergies, antibacterial therapy (local and general), treatment with corticosteroids, removal of nasal polyps, correction of the nasal partition, operational treatment of chronic hyperplastic sinusitis.
With sensory-neural disorders, sense of efficient means and treatment methods do not exist. Nevertheless, it is often possible to spontaneous relief of smell.
Some experts offer treatment with zinc drugs and vitamins, since a pronounced zinc deficiency leads to violations and distortions of smell. However, this pathology is found only in some limited geographical zones.
Vitamins are most often used vitamin A. Degeneration of epithelium, due to its insufficiency, can lead to anosmia.
Diagnosis of evaluations of smell
Diagnosis of evaluation disorder is based on a study of smelling smelting substances without dosing and more accurately with an olfactometer. The rhinoscopic picture is estimated, while the olfactory region is carefully examined, its configuration and width.
In respiratory form of the disorder, treatment is usually surgical in order to restore the nasal respiration and ensuring air passage through the olfactory slot into the olfactory zone of the nose.
More often produce the following operations:
- nasal polypotomy,
- sublimatic resection of the nasal partition,
- partial conehotomy and others.
Treatment of evaluations of smell
The treatment of evaluating evidence of an essential form should be aimed at combating causal factor.
In hyperosmia and cokasmia, it is shown to eliminate causal factors:
- neurasthenia,
- vegeth-vascular dystonia,
- hysteria,
- disease of the central nervous system.
How to restore the sense of smell at home
There are many ways to restore the smell - from physiotherapeutic to surgical. Consider those that are convenient to apply at home.
| The washed river sand is mixed with a cooking salt in a 1: 1 ratio, the mixture is placed on the pan and put on fire. Fully drying the mixture, it is adjusted to 50 s. Then quickly spend the prepared rag bag and tie. The pouch is applied to the back of the nose for 15-20 minutes. Course treatment - 8-10 procedures daily or every other day. |
| A glass of water is poured into an enameled pan, it is adjusted to a boil and add 10-12 drops of lemon juice and 1 drop of lavender or mint essential oil. Breathing over the ferry for 3-5 minutes each nozzles, making forced breaths. Course treatment - 10 procedures daily or every other day. |
| Coin dignity into one or two rubles is lubricated with honey, impose on the middle of the back of the nose and fixed the plaster. It is even better to use the old copper coin. Keep the coin you need at least 30 minutes daily. Often after 15-20, the ignition procedures are completely restored. |
| A small aluminum plate is washed, dryly wipe and attached to the leukoplasty to the nose overnight. Effect, that is, the restoration of the olfactory function may appear after three procedures. |
| In a glass with water heated to 50 ° C, 10 drops of lemon juice and cologne are added. The gauze or cotton fabric is impregnated with this water and impose on the entire surface of the nose for 5-7 minutes. Course treatment - 10 daily procedures. |
| Vietnamese balm "Golden Star" put on the sun for several hours in a closed jar, then rub it into the back of the nose and in the middle of the forehead. Course treatment - 7-10 daily procedures. |
| It is useful to learn to strain and relax the nose muscles. This exercise is well restored by the smell. Keep the muscles in a stressful state at least a minute. Exercise is necessary daily for 10 minutes. |
| Warming up with a blue lamp also gives a positive effect in hyposhythmia. Instead of blue, you can use a conventional 40 W bulb. Put on the sun glasses, remove the lamps of the lamp from the table lamp, reject the head back so that the light falls inside the nasal cavity. The distance from the lamp to the nose should be no more than 25 cm. Conduct the procedure for 10-15 minutes daily or every other day during the week. |
| A piece of quartz of a small magnitude is put in a glass jar and put on the sun for 3 hours. After that, the stone is applied to the middle part of the nose back for 15-20 minutes. So that the stone does not fall, he holds his fingers. |
| It helps to improve the sense of smell and the famous yogan procedure to draw the nose with the nose of warm salted water. A salt on a knife tip is added to a glass of boiled water. By closing one nostril with a finger, slowly draw the water open nozzles until it turns out to be in the throat. Then water is fluttered. The same is the other nozzles. You can produce water not through the mouth, but through the nose. It is advisable to use all pouring water. The course of treatment is at least ten procedures. |
Prevention of evaluations of smell
In most cases, it depends on each person whether it will develop a loss of smell or not. Since very often launched nasal cavity or other organs become the cause of anosmia or hyposmy, in order to prevent the degradation of smelling, it is necessary to adhere to such recommendations:
| In time to treat rhinitis or other diseases of the apparent sinuses, causing persistent and long swelling of the mucous membrane. In chronic rheores, it is necessary to regularly make hygienic procedures for the nasal cavity. For example, it is good to use clients of therapeutic herbs (chamomile, eucalyptus, mint, calendulas) or saline solutions for washing the nasal strokes. Avoid contact with allergens, which cause allergic rhinitis. |
| Enhance immunity, adhering to the principles of health food: rich in vitamins, minerals, useful elements. This will help the organism to be resistant to inflammation caused by infections. |
| Very often, anosmia appears in those who smoke, so it is better to throw this bad habit. |
| When working with chemicals and poisonous evaporation, be sure to use respirators and PPEs, which will not allow harmful chemicals to influence the olfactory receptors. |
| Do our best to avoid the injuries of the head and nasal cavity: to wear a helmet while riding a bike or motorcycle, fasten the belt in the car and others. |
Questions and answers on the topic "Smeaning"
Question: Hello! After a disease rinitis, more than a year ago there was a partial sense of smell - I do not feel the smell of cucumber. Tell me, please, what to do.
Answer: Partial sense of smell after a runny nose occurs due to edema mucous. You need full-time consultation Laura.
Question: Hello. What is the loss of smell, if the nose is not laid?
Answer: Hello. The smell loss is for different reasons. Often, the loss of wannings occurs after the changed cold (rhinitis, sinusitis, runny nose), after ARVI, usually happening after recovery, with timely treatment, wanning can be restored. Other reasons may possibly be the absence of hoarfrough - may be due to the brain injury, inflammation of the sinuses, nasal polyps, inhalation of toxic substances, curvature of the nasal partition, harmful habits (more often due to smoking), side effect of some drugs. In general, if the loss of awnings lasts for a long time, just right to contact a specialist for accurate refinement and treatment.
Question: Hello, I am 23 years old. At the end of September received the CMT. Epidural hematoma formed. He was treated in the hospital, took pills, were injections. The head has ceased to hurt, cured. The smell was never restored. Foreign smells live in the nose, not always pleasant and change regularly. One chemical smell may change several times a week. Does it make sense to treat anosmia of folk remedies or is everything useless? Answer please.
Answer: Hello. To treat an alosum of folk remedies is useless. Take preparations of the Cavinton type, Fesame, pierce the prozer's course.
Question: Hello. What should I do if the smell was missing?
Answer: Hello. After the identified diagnosis (the type of disorder of the sense of smell), the otolaryngologist is a treatment regimen. As a rule, local and general therapy is assigned. Treatment of infringement of sense of smell after transferred rhinch starts with the sanitation of the nasal cavity and eliminate all the reasons that make breathing through the nose. Summarizing drops (tizin, naphtizin, galasoline, napazoline) are prescribed, if swelling is preserved. Apply procedures for washing the nasal cavity with salt solutions, and also conduct the nasal injection with silver solutions - protargole or collargol. In some cases, they resort to surgery when polyps, adenoids or other anatomical problems are constant cause of nasal congestion and edema of mucous membranes, and colds only enhance this chronic process.
Question: Hello. Is it true that from excessive load on the smell it can relax?
Answer: Hello. Perfumes, cooks, some other experts protect their working tools - nose - no less than a pianist hands. Due to the fact that they constantly train receptors, the smell of them is developed better than that of ordinary people, they are able to distinguish the shades of smells, other people inaccessible. By itself, the fact of the daily burden on the smell is not the cause for its deterioration. However, work with fragile substances (spices, aromatic oils) can be dangerous in that these substances often cause allergies. The mucous edema will entail an inevitable decrease in the olfactory function.
Question: Hello. In March 2016, a long time was hijacked by Rinitis. As a result, the smell almost completely lost, although now there is no nose congestion. Almost not smells, only a little feel of soap, acetone, alcohol, etc., i.e. Liquids with a sharp smell. In general, I do not feel the smell of food (very annoying), originally did not feel the taste of food and drinks. Now the taste is restored, but there is no sense of smell. Help please how to restore the smell. The situation is aggravated by the fact that in our village there is no doctor-Laura, directed to the city did washing, inhalation, but there is no result. Until March 2016, there were no problems with the smell, opposite I felt the slightest smells.
Answer: Hello. In this case, it is desirable to inspect the top floors of the cavity of the nose with an endoscope and then develop the healing tactics. Neurological changes should also be eliminated. Consult a neurologist.
One of the serious pathological states of the body is a violation of either a complete loss, which can significantly worsen the life of a person. In fact, such pathology, like anosmia, may pose a threat to human health as a whole.
Today, treatment of the absence of smell is carried out in various ways and the choice of each of them depends on the cause of the development of pathology. It is possible to restore the normal operation of the sense of smell, both with the help of special medical procedures and funds and thanks to the recipes of traditional medicine.
In fact, the loss of smell is either its decline can be congenital and acquired character. In the event that the patient is diagnosed in congenital absence of smell, it is most often the result of the complete lack of respiratory tract or a violation of the process of their development. In most cases, anosmia and hyposimia are developing together with congenital anomalies of the nasal cavity or facial skull.
When examining the patient, the acquired smelling loss can be diagnosed, and experts share such pathology into two types:
- violation of peripheral origin develops if the lesions are localized in the field of own nose
- pathology of central origin is detected by damage to the organic nature of the central nervous system
In medical practice there are various types of peripheral anosmia:
- functional
- street
- essential
- respiratory
Each of these types of peripheral anosmia develops for various reasons, and when influencing the human body of some adverse factors.
Causes of the development of anosmia
The main location of the receptors responsible for the normal perception of smells is the nasal mucosa. The location of the localization of the olfactory centers becomes the brain, and the conductor of signals is the olfactory nerve.
The main cause of various violations of the evolve process becomes various injuries and pathologies that affect one of the sections of the nose-nerve chain.
Often, anosmia develops when progressing in the body of adults and children of the following pathologies:
- ARVI
- rinithic of bacterial and allergic origin
- in a new cavity
Violation of the evaluation process during such diseases is developing due to the swelling of the mucous membrane. There are problems with disruption of secretion of the mucous membrane, and the result of this may also be a violation of the sense of smell. The development of a pathological state can provoke and destruction of neuroepithels or brain neurons by various viruses, drugs and toxic substances.
The reasons for the appearance of problems with the smell can be the following violations:
- progression in the human body of various infections of viral origin
- continuous effects of toxic substances that create obstacles to normal change of epithelium cells
- injuries of the skull of different character, which are accompanied by a fracture of the base of the front cranial fossa
- conducting neurosurgical intervention
- durable and uncontrolled neurotoxic drugs
- progression of various tumors
- various diseases of a congenital character
Rarely specialists diagnose congenital anosmia, and its development is associated with a disease such as Callman syndrome.
Dangerous signs of illness
Disruption of the sense of smell is one of the symptoms of many pathologies progressing in the human body.
The combination of such a symptom with other signs allows you to determine the accurate diagnosis and assign effective treatment:
- In the event that anosmia is combined with a violation of the nasal respiration, swelling the mucous and advent of the selection, then such a diagnosis is usually raised as ".
- Often, disorders of the sense of smell are developing with such pathologies as ARVI. However, after recovery, the patient is usually normalized. In the event that this did not happen, then the high probability that the patient developed post-examiner essential anosmia due to the destruction of the olfactory epithelium and its replacement.
- The perception of the smells by man, but their not recognition can signal the damage to the central nervous system.
- In some cases, the decline in the smell is either its complete loss is accompanied by the emergence of increased dryness in the nasal cavity. In such a situation, anosmia more often will signal the development of age.
- The most common cause of infringement of smell is injuries. After recovering the patient, anosmia may disappear, however, the smells will be badly perceived.
Most often, bilateral anosmia becomes a reason for accessing a specialist, which the patient takes for violation of the sentence. Such a phenomenon is considered fairly harmless and occurs during respiratory disorders and lesions of the nasal mucosa.
With a unilateral process, there is usually no appearance of additional symptoms, a person does not have any discomfort and continues to perceive odors. The reason for the development of such a violation in most cases becomes a tumor localizing inside the skull. In such a situation, it seems the emergence of additional characteristic symptoms for such pathology for help.
Medical treatment of disease
For the appointment of effective and proper treatment in violation of the sentence, it is necessary to find out the causes of such a pathological condition.
The development of functional anosmia is usually observed due to edema of the mucous membrane and it occurs on the background of the following diseases:
After recovering the patient, such a type of anosmia disappears independently without special treatment. In order to speed up the process of recovery of the patient with experts, the use of the following methods of drug treatment is recommended:
- use of saline for washing the nasal cavity
- reception of drugs with antibacterial, antiviral and antihistamine action
- appointment of corticosteroids
- conducting physiotherapy procedures
It is not rare in the patient a persistent respiratory loss of smell is diagnosed and this is due to development in the body of various diseases and anatomical changes. Treatment of this type of anosmium is carried out only with the help of surgical intervention.
More information about the causes of the loss of smell can be found with the video:
Holy nasal partition: causes and methods of treatment of nose diseases
A rather complex pathological condition of the body is considered to be the loss of evaluating central origin and it develops with any violations of the nervous system.The forecast for such pathology is the least favorable, since it is not amenable to treatment.
A specialist is prescribed to conduct therapy of the main disease and the elimination of the cause of violation in the future can lead to the restoration of the sentence.
Anomalies The structure of the facial skull department leads to the development of congenital anosmia, and it is not amenable to correction. Such operational interventions are not conducted in childhood, and after 3-4 years, the process of the destruction of the neurons responsible for smell becomes irreversible.
Folk treatments
Antimony treatment can be carried out with the help of folk remedies that are aimed at washing the nose and the special solutions in it.
Folk recipes:
- For the treatment of anosmia, it is possible to use chiurela juice, however, it is considered a rather toxic substance. Before starting treatment, it is recommended to dilute the juice of the plant with boiled water in a 1: 1 ratio and bonded the resulting solution into each nostril. It is necessary to carry out such a procedure several times a day, instiling in each nostril 3-4 drops of solution.
- To purify the nasal cavity from the accumulation of toxins, pus and unwanted substances can be used. For its preparation, it is necessary to dissolve in 200 ml of warm water 1-6 grams of sea salt and use the resulting solution for washing the nasal cavity. You can add several drops of iodes to the saline solution, which will further enhance the effect of the cooked agent.
- Folk Medicine advises to treat disruption of sense of smell with the help of horseradish and you can prepare a drug according to the following recipe:it is necessary to crush the fuck on the fine grater, from the resulting mass, the juice should be carefully squeezed, which is subsequently used for injection into the nasal sinuses, before starting treatment, it is necessary to mix the juice of the hyrine with vinegar in the 2: 1 ratio and bury the solution into the nose several times a day. . For complete recovery and elimination of anosmia, it is usually enough to be enough 10-12 days.
- A good effect in the restoration of normal sense of smell gives various chasters prepared on the basis of various herbs. At home, you can take advantage of the healing decoction, consisting of Majorant, Leaves of Celebre, Exchanges and Beets. It is necessary to mix all these components among themselves and pour into a small capacity of 10 grams of the resulting rattle. After that, the mass should be poured with water, and to withstand it on fire before boiling. The cooked decoction must be removed from the fire, cool and bury it into the nostrils.
Operations under anosmia
In the event that the cause of the violation of the smell was the polyps in the nasal cavity, then it is possible to get rid of them with the help of surgical intervention. Only due to the operation, it is possible to eliminate any kind of neoplasms that appeared in the nasal cavity. With the malignant nature of the tumor, in addition to surgery, radiation and chemotherapy is also appointed. However, the use of such treatment methods does not provide a complete guarantee that it will fully restore the smell.
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