Nasal Septum Deviation and Its Impact on Smell

Deviated septum and olfactory issues?

Hello Doctor, since October of last year, I have experienced complete loss of smell on one side (which may have been happening for a long time, but I didn't notice it because the other side was normal), along with chronic nasal congestion and post-nasal drip.
I went to a large hospital for an endoscopic examination, which revealed issues such as a deviated septum and enlarged nasal polyps (the endoscopy did not show any tumors).
Initially, I thought it was allergic rhinitis, but blood tests showed only slightly elevated allergy levels.
Is it possible for such symptoms to cause loss of smell on one side while the other side remains normal? I have undergone an olfactory test, which showed that the left side is completely normal, while the right side has no sense of smell at all.
Later, the doctor decided to perform a CT scan of the sinuses, suggesting that there might be something concerning (though the likelihood is low).
I would like to ask if you have encountered similar symptoms before.
Thank you, Doctor.

Mr. He, 20~29 year old female. Ask Date: 2022/04/08

Dr. Ji Zhaoyun reply Otolaryngology

Hello, if there is only a deviated septum and hypertrophy of the nasal turbinates, theoretically there should not be any unilateral olfactory issues.
It is recommended to wait for the examination report results.
Wishing you peace and good health.

Reply Date: 2022/04/08

More Info

Dear Patient,
Thank you for sharing your concerns regarding your nasal symptoms, particularly the loss of smell and the associated issues with nasal congestion and post-nasal drip. Based on your description, it appears that you are experiencing a combination of nasal septum deviation and possibly nasal polyps, which can significantly impact your sense of smell.

Nasal septum deviation occurs when the thin wall between your nasal passages (the septum) is displaced to one side. This can lead to an obstruction in one or both nasal passages, resulting in difficulty breathing through the nose, chronic nasal congestion, and sometimes post-nasal drip. When the airflow is disrupted, it can also affect the olfactory nerves responsible for your sense of smell. In your case, it seems that the right side of your nasal passage is more affected, leading to complete anosmia (loss of smell) on that side while the left side remains functional.

Nasal polyps are soft, painless growths that can develop in the lining of your nasal passages or sinuses due to chronic inflammation, often associated with conditions like allergic rhinitis or asthma. They can further obstruct airflow and contribute to the loss of smell. The fact that you have undergone an endoscopic examination and that no tumors were found is reassuring, but it is essential to address the underlying issues to restore your olfactory function.

The symptoms you describe, including the complete loss of smell on one side and the presence of nasal congestion, are indeed consistent with the effects of a deviated septum and nasal polyps. It is not uncommon for individuals with these conditions to experience unilateral (one-sided) anosmia, especially if the obstruction is more pronounced on one side. Allergic rhinitis can exacerbate these symptoms, but it is also possible for anatomical issues to be the primary cause.

In terms of management, treatment options may include medical therapies such as nasal corticosteroids to reduce inflammation and shrink nasal polyps. If these conservative measures do not provide sufficient relief, surgical intervention, such as septoplasty (to correct the deviated septum) or polypectomy (to remove nasal polyps), may be considered. These procedures can help restore normal airflow and improve your sense of smell.

It is also important to consider environmental factors that may contribute to your symptoms. Allergens, irritants, and even certain medications can exacerbate nasal congestion and affect your olfactory function. Keeping a symptom diary may help identify triggers that worsen your condition.

In conclusion, your symptoms of unilateral anosmia, nasal congestion, and post-nasal drip are likely related to the anatomical issues of a deviated septum and possibly nasal polyps. A thorough evaluation by an ear, nose, and throat (ENT) specialist is crucial for determining the best course of action. They can provide a tailored treatment plan to address your specific needs and help restore your sense of smell.

Best wishes for your upcoming appointment, and I hope you find relief soon.

Sincerely,
Doctor Q&A Teams

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