Phantom smells may be sinus issue
DEAR DOCTOR: Last year, for four months, I smelled cigarette smoke all the time, even though I wasn’t near smokers. The problem went away, but now it’s back. I have been diagnosed with benign paroxysmal positional vertigo. Is there a connection?
DEAR READER: The condition is called phantosmia, meaning the smelling of an odor that isn’t actually there.
The condition is more often reported by women than men, with many women having had a prior short-lived episode between the ages of 15 and 30. For the majority, the phantom odors are unpleasant, often described as the smell of something burned, spoiled, rotten or foul. Thus, the smell of cigarette smoke is not unusual. Symptoms can last from two minutes to 30 minutes at a time; fortunately, they’re rarely chronic.
Phantosmia can have a variety of causes, some of them serious. The most common one is inflammation within the nasal cavity or within the sinuses. This is most likely in people who have chronic allergies or recurrent sinus infections, but the condition also can occur with nasal passage inflammation not
related to allergies, such as that linked to exposure to solvents, ammonia, benzene, cigarette smoke and drugs inhaled through the nose.
Your diagnosis of benign paroxysmal positional vertigo could theoretically be linked to the condition in that this type of vertigo can be related to middle ear and Eustachian tube dysfunction.
Trauma to the nose or the sinuses also can lead to phantosmia, as can head trauma that damages the areas of the brain that process smell. Blood pressure medications, such as beta blockers, calcium channel blockers and ACE inhibitors, can occasionally be linked to both loss of smell and phantosmia. Other potential causes include tumors within the brain or nasal cavity, as well as seizures.
Often, however, no cause can be found. This is termed idiopathic phantosmia and, on the plus side, it improves with time.
In the meantime, try nasal rinses, which could decrease the sense of phantom smells, and work with your physician to identify, if possible, a cause for the problem.