Why Can Your Sense of Smell Come and Go With Nasal Polyps?

Why Does Your Sense of Smell Change With Nasal Polyps?

Your sense of smell depends partly on airborne odor molecules reaching specialized sensory cells located high inside the nose. These cells send signals to the brain, which identifies the odors you encounter.

Nasal polyps are soft, noncancerous growths associated with chronic inflammation in the nose and sinuses. They can interfere with smell in two primary ways:

• Polyps and surrounding swelling can restrict airflow to the smell receptors.
• Chronic inflammation may impair normal olfactory function, even when the nasal passage is not completely blocked.

When swelling increases, your ability to smell may become more limited. If the inflammation temporarily decreases, more air may reach the upper nasal cavity and your sense of smell may improve.

That is why some people experience an inconsistent or fluctuating sense of smell rather than a complete, continuous loss.

Why Does Your Sense of Smell Sometimes Return?

A temporary return of smell does not necessarily mean the polyps have disappeared. Nasal and sinus inflammation can vary because of allergies, respiratory infections, environmental exposures, medications, and other factors.

You might notice an improvement:

• After using a nasal medication prescribed by your healthcare provider
• As a cold or respiratory infection resolves
• When allergy symptoms are less active
• When congestion and nasal swelling temporarily decrease

If inflammation returns or the polyps continue obstructing airflow, the improvement may not last.

How Do Nasal Polyps Affect Smell and Taste?

Many people first notice that food seems different before realizing their sense of smell has changed. This happens because smell contributes significantly to the perception of flavor.

According to the National Institute on Deafness and Other Communication Disorders, odor molecules reach smell receptors both through the nostrils and through a passage connecting the throat and nose while you eat. When congestion or nasal growths interfere with those pathways, food may seem bland even though the basic ability to detect sweet, salty, sour, bitter, and savory tastes remains intact.

Possible changes include:

• Food seems less flavorful than usual.
• Coffee, spices, perfume, and other familiar scents seem faint.
• Certain smells become difficult or impossible to recognize.
• Smell improves temporarily before becoming limited again.
• Smoke, spoiled food, or leaking gas becomes harder to detect.

Because smell serves as an important warning system, people with reduced smell should make sure their smoke and natural-gas detectors work properly. They should also check food expiration dates rather than relying solely on smell.

Why Do Nasal Polyps Develop?

Nasal polyps are associated with ongoing inflammation in the lining of the nose and sinuses. They are commonly seen in people with chronic rhinosinusitis with nasal polyps, but the underlying inflammatory process can vary among patients.

Conditions that may occur alongside nasal polyps include:

• Chronic rhinosinusitis
• Asthma
• Allergic rhinitis
• Aspirin-exacerbated respiratory disease
• Certain immune or inflammatory conditions
• Cystic fibrosis, particularly when polyps occur in children

Allergies do not explain every case of nasal polyps, but allergy-related inflammation may worsen congestion and smell problems in some patients.

Can Allergies Make Smell Problems Worse?

Yes. Allergies can increase inflammation and swelling inside the nose. When nasal polyps are already present, additional swelling may further restrict airflow to the smell receptors.

Seasonal pollen, dust mites, pet dander, and mold are among the allergens that may contribute to nasal symptoms. Because Northeast Florida has a long growing season, some patients may experience allergy symptoms during several parts of the year.

However, fluctuating smell should not automatically be attributed to allergies. Viral illnesses, medications, head injuries, smoking, nasal growths, and certain neurological conditions can also affect smell.

What Other Symptoms Can Occur With Nasal Polyps?

Smell changes may occur alongside other nasal and sinus symptoms, including:

• Persistent nasal congestion
• Difficulty breathing through the nose
• Nasal drainage or postnasal drip
• Facial pressure or fullness
• Snoring or mouth breathing
• Recurrent sinus symptoms
• Reduced perception of flavor

These symptoms are not unique to nasal polyps. An examination is necessary to determine whether polyps, inflammation, infection, a structural problem, or another condition is responsible.

How Does an ENT Evaluate Loss of Smell?

An evaluation typically begins with questions about when the smell changes started, whether they are constant or intermittent, and whether they appeared after an illness, head injury, medication change, or increase in allergy symptoms.

The evaluation may include:

• A review of your medical history and current medications
• An examination of the nose, sinuses, ears, mouth, and throat
• Nasal endoscopy to look for polyps, swelling, or another obstruction
• Smell testing when appropriate
• Allergy testing when symptoms suggest an allergic trigger
• CT imaging when additional information about the sinuses is needed

Imaging is not necessary for every patient. The appropriate testing depends on the symptoms and examination findings. The NIDCD recommends medical evaluation because smell disorders can have many different causes.

Can Treating Nasal Polyps Improve Your Sense of Smell?

Treating the inflammation or obstruction associated with nasal polyps may improve smell for some patients, but the amount and duration of improvement vary.

Depending on the diagnosis and severity of the condition, treatment may include:

• Corticosteroid nasal sprays or rinses
• Saline nasal rinses
• Short-term oral corticosteroids in selected cases
• Treatment for contributing allergies
• Biologic medications for certain patients with chronic rhinosinusitis with nasal polyps
• Endoscopic sinus surgery when appropriate

Treatment usually begins with medication intended to reduce inflammation and shrink the polyps. If symptoms remain significant despite medical treatment, an ENT may discuss additional options.

Nasal polyps can return after treatment, including after surgery, so ongoing medical management and follow-up may be recommended. The Mayo Clinic’s nasal-polyp treatment overview describes the range of medications and procedures that may be considered.

How Long Does It Take for Smell to Return?

There is no single recovery timeline. Some people notice improvement as swelling decreases, while others recover more gradually or continue to experience reduced smell.

The outcome can depend on:

• The severity of the inflammation
• The extent and location of the polyps
• How long smell has been affected
• Whether another condition is contributing
• How the condition responds to treatment

Treatment may improve smell, but complete recovery cannot be guaranteed. Your ENT can provide expectations based on your examination, diagnosis, and response to treatment.

When Should You Schedule an Evaluation?

Temporary smell loss during a cold or other respiratory infection may improve as the illness resolves. Consider scheduling an evaluation when smell changes:

• Continue for more than a few weeks
• Repeatedly improve and disappear
• Occur with persistent nasal congestion or facial pressure
• Affect appetite, nutrition, or quality of life
• Remain after other respiratory symptoms have resolved
• Are accompanied by recurring sinus symptoms
• Do not improve with your usual allergy treatment

Seek more immediate medical attention if smell loss follows a head injury or occurs with neurological symptoms, vision changes, severe headache, swelling around an eye, confusion, or weakness.

New symptoms affecting only one side of the nose—particularly one-sided obstruction, recurrent bleeding, bloody drainage, or facial swelling—also warrant prompt medical evaluation. Not every growth inside the nose is a nasal polyp.

Frequently Asked Questions

Can nasal polyps cause complete loss of smell?

Yes. Nasal polyps and the inflammation associated with them can cause a reduced sense of smell, called hyposmia, or a complete loss of smell, called anosmia. The severity varies among patients.

Why can I smell some days but not others?

Changes in inflammation, congestion, and airflow may temporarily allow more or fewer odor molecules to reach the smell receptors. This can cause smell ability to fluctuate.

Does improved smell mean my nasal polyps are gone?

Not necessarily. Reduced swelling may temporarily improve airflow even when polyps remain present. An examination is needed to determine whether polyps are still present.

Can nasal polyps change how food tastes?

They can change the perception of flavor by reducing your ability to smell food. This is different from losing the basic ability to detect sweet, salty, sour, bitter, or savory tastes.

Will removing nasal polyps restore my sense of smell?

Treatment may improve smell, but results vary. Recovery depends on the degree of inflammation, how long smell has been impaired, other medical conditions, and the individual response to treatment.

Don’t Ignore a Sense of Smell That Keeps Changing

A fluctuating sense of smell may indicate that inflammation or an obstruction inside the nose is affecting airflow to the smell receptors. Nasal polyps are one possible cause, but allergies, respiratory infections, medications, injuries, and other medical conditions can produce similar symptoms.

If your sense of smell continues to change or does not return, an ENT evaluation may help identify the cause and determine which treatment options are appropriate.

Schedule an appointment with Jacksonville Breathe Free Sinus & Allergy Centers to find out whether nasal polyps or another nasal or sinus condition may be affecting your sense of smell.