Can sinus infection cause you to lose taste

COVID-19—The loss of smell, with or without changes in taste, related to COVID-19 infection typically occurs without the nasal congestion or runny nose that is typically seen with a cold. Associated symptoms may also include headache, a dry cough, shortness of breath, high fever, stomach problems, and a persistent sore throat. More severe symptoms such as these often point to COVID-19 or the flu. During the pandemic, anyone who has a new loss of smell or taste, even without any of those other symptoms, should be suspected of having COVID-19 and be tested, whether or not they have been previously vaccinated. Polymerase chain reaction (PCR) testing for COVID-19 can be easily obtained and will identify those patients with COVID-19.

Patients that experience a loss of smell from COVID-19 that does not get better after several months may benefit from, smell retraining therapy. This treatment, which can be done at home by sniffing four different scents twice a day for four to six months, has proven to improve the smell for some, but not all patients. An ENT specialist may advise additional therapies, such as sinus rinses with topical nasal steroids. Parosmia, or altered sense of smell, may occur weeks or months after loss of smell with COVID-19.

URI (Upper Respiratory Infection)—Nasal obstruction and thick nasal drainage with or without the loss of smell commonly occur with a cold (viral URI). These self-confined symptoms are usually limited to the nasal and sinus areas and most times go away in five to seven days. These URIs are often associated with a mild fever. Initial treatment of URIs often benefits from symptomatic care alone without the need for an antibiotic, and they usually clear without the need for a physician visit. If the symptoms do not go away or get worse after five to seven days, a physician visit might be needed. Occasionally, a viral URI will have a lingering effect on your sense of smell, and you should see an ENT (ear, nose, and throat) specialist, or otolaryngologist, for further evaluation if it persists after your nasal breathing returns to normal.

Allergic Rhinitis—Environmental allergies can result in acute or chronic symptoms that can be mistaken for a viral URI or sinus issues. Depending on where you live, allergic rhinitis is usually seasonal. Allergic patients have a clear nasal discharge and nasal congestion with post-nasal drainage or drip as well as runny eyes, sneezing, and itching. Some patients will only experience congestion or obstruction.

Over the counter (OTC) allergy medications or prescription medications that your primary care physician provides usually control the symptoms well. Those who are still suffering from allergies after trying medications can benefit from an evaluation by an ENT specialist to identify your allergies and other related problems that prevent improvement. They will be able to offer additional medical treatments, drops, or shots.

Acute Rhinosinusitis (commonly known as Acute Sinusitis)—Although less common, an URI, bad dental infection of the upper teeth, or severe allergy disease can lead to acute bacterial sinusitis. Symptoms include nasal congestion, which can lead to changes in smell and taste, facial pain and pressure, fever, foul nasal discharge, and occasionally swelling. It often hurts to just touch your face. Antibiotics are sometimes needed and can be obtained from your primary care physician or an ENT specialist.

Many healthy people can get well from acute bacterial rhinosinusitis without antibiotics using supportive therapy such as saltwater rinsing. If the sinus infection is caused by tooth infections, then they often improve when the tooth infection is addressed by your dentist. If not, the patient should see an ENT specialist for further treatment.

Chronic Rhinosinusitis (commonly known as Chronic Sinusitis or CRS)—Once sinus infections last more than three months, they are considered “chronic.” Patients with chronic rhinosinusitis usually complain of nasal blockage and thick nasal drainage with or without loss of smell, facial pain or tenderness and sometimes headaches. Chronic rhinosinusitis can occur with or without nasal polyps, and the presence of polyps often will require more individualized care An evaluation by an ENT specialist is recommended for proper diagnosis and treatment.

In adults, the two most common causes of smell problems that we see at our Clinic are: (1) Smell loss due to an ongoing process in the nose and/or sinuses such as nasal allergies and (2) smell loss due to injury of the specialized nerve tissue at the top of the nose (or possibly the higher smell pathways in the brain) from a previous viral upper respiratory infection. Individuals who lose their sense of smell as a result of a respiratory virus generally give us a very clear history of dating their smell loss from a time when they were experiencing cold or flu symptoms. These patients are typically in the older age groups. The smell loss is partial rather than total for many, and can be associated with taste loss, parosmias and/or dysgeusias. There is no known effective therapy for taste and/or smell problems due to presumed viral damage. Specifically, treatment with zinc is not recommended because it was not demonstrated to be any more effective than placebo. Some patients will recover function with time. We have followed some individuals with this disorder long-term. Of these, only 18 percent significantly improved their smell function on retesting. Improvement was gradual. Although this low improvement rate is discouraging, it should be remembered that we typically see the worst cases here at the Taste and Smell Clinic. There are probably many individuals out in the community who lost their sense of smell as a result of a virus and recovered it within short periods of time.

The other most common cause of smell loss is that due to an ongoing process in the nose and/or sinuses, specifically rhinitis (inflammation in the nose), nasal polyps and/or sinusitis. The history usually is that of gradual loss of smell ability proceeding to total loss. Recurrent, rapid, temporary improvement in the ability to smell, often after exercise or showering, is often reported. Some patients report temporary improvement with medications, such as antibiotics or corticosteroids. True taste loss does not occur, but patients sometimes report the presence of foul tastes/smells. Other important features include difficulty breathing through the nose, post nasal drip, nasal allergies, and a history of sinusitis and/or nasal polyps. Chronic sinusitis may present with smell loss and no other chronic symptoms, however.

In people who date the onset of smell loss to a viral infection, it can be difficult discerning between viral damage and an ongoing process in the nose and/or sinuses as the cause of the loss. Viral infection can lead to sinusitis in susceptible patients. This group of patients will have sinusitis as a key feature of their smell loss, but will report a sudden loss of smell as a result of an upper respiratory virus. In these cases, the virus interferes with the ability of the nose and/or sinuses to drain properly and sinusitis ensues. The specialized smell tissue at the top of the nose is not damaged, however. It is important to discern between viral damage and sinusitis as only the latter is treatable.

If an active process in the nose and/or sinuses is believed to be present and evaluation by an otorhinolaryngologist (ENT specialist) that includes nasopharyngoscopy should be considered. Thought should also be given to a CT (computerized tomography) scan of the sinuses. Once diagnosed, patients should be treated; normalization of smell function is possible with optimal management.

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