Smell loss following rhinoplasty surgery. Need help understanding what may have gone wrong?

I underwent open rhinoplasty surgery in late Oct. 2012, receiving bridge , tip and nostril work, turbinate reduction and correction to a mildly deviated septum. While I suffered chronic nasal congestion due to swelling, approx. 1-2 weeks after surgery I re-gained smell. Toward the end of November, I developed a sore throat/cold symptoms that lasted 1 week. Again, I lost smell but it never returned back normal. Approx. 1 year later, my sense of smell and taste of foods remains distorted.

Doctor Answers 3

Loss of smell

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The loss of smell in this case happened after a cold. The cold viruses can sometimes affect the Olfactory Nerve (smell nerve) and destroy it completely. In these cases the chances of recovery are slim. However it is very important to make sure there is no other reason for loss of smell such as nasal polyps, tumor in the nose etc. This merits a visit to an Otolaryngologist and nasal endoscopy and may be a CT scan of sinuses. 
Dr. J
Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Loss of smell following rhinoplasty

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I believe your loss of sense of smell is more likely related to your upper respiratory infection than to your operation, although the operation may have predisposed the olfactory nerves to being more sensitized to the virus. It is common for people to have diminished sense of smell after surgery due to swelling and congestion because less of the chemicals can actually be delivered to the Olfactory nerves and the nerves themselves may be swollen. Usually this returns within 6 weeks . In your case function returned so one would expect that any recurrence subsequently had to do with something else. It is a known fact that viruses can cause irreversible damage tot he olfactory nerves and that is likely what happened.
I know of a very good neurologist in Chicago named Alan Hirsch that has a smell and taste disorders center and I would recommend that you contact them for a potential work up. There are things that might work to return your sense of smell.

Loss of Smell Following Surgery and Cold

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In my opinion, it is more likely the cold is the causative factor in your loss of smell. A cold is essentially the result of a virus and it is known that this type infection can adversely effect the olfactory nerves (smell nerves) in the upper portion of the nasal cavity. It is much less likely that surgery was the causative factor - especially since your smell returned within 2 weeks of the procedure. I would recommend you consult with an expert rhinologist in your local area. Wishing you the best.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.