Dr. Charles Kimmelman has devoted much of his career to the treatment and understanding of olfaction, or the sense of smell. He has developed a proven methodology to diagnose and treat patients who may be experiencing a smell disorder to help them restore this critical sense. From the inability to detect danger signals, such as the smell of fire or leaking natural gas to the inability to fully enjoy your favorite meal or smell your favorite perfume, Dr. Kimmelman approaches smell disorders with the care and priority that they deserve.

How does our sense of smell work?
The sense of smell is part of our chemical sensing system, or the chemosenses. Sensory cells in our nose, mouth and throat have a role in helping us interpret smells, as well as taste flavors.

Olfactory, or smell nerve cells, are stimulated by the odors around us – the fragrance of a flower or the smell of cookies baking. These nerve cells are found in a small patch of tissue high inside the nose, and they connect directly to the brain. There are additional nerve endings in our eyes, nose, mouth, and throat that help us sense the feelings stimulated by different chemical substances. These nerves cause our eyes to water as we’re slicing an onion and help us recognize the refreshing coolness of peppermint.

It’s surprising to many people that we recognize flavors mainly through our sense of smell. Along with texture and temperature, the perception of flavor comes from a combination of odors and taste. Without the olfactory cells, familiar flavors like chocolate or strawberries would be hard to distinguish. You may have actually experienced this loss when you have a cold or a stuffed nose because your favorite foods no longer taste the same or you don’t want to eat at all and you may loose the desire to eat.

What are smell disorders? Smell disorders may cause either a loss in the ability to smell or a change in the way odors are perceived. Some people who loose smell function have hyposmia, which is when their ability to detect odor is reduced. Other people can't detect odor at all, which is called anosmia. As for changes in the perception of odors, some people notice that familiar odors become distorted. Or an odor that usually smells pleasant, instead smells foul. Still other people may be bothered by the constant perception of smells that are not present at all. What causes smell disorders? Smell disorders have many causes. A few people are born without a sense of smell. Most people who develop a smell disorder recently experienced an illness or an injury. Common causes are upper respiratory infections and head injuries. Among other causes of smell disorders are polyps in the nasal cavities, sinus infections, hormonal disturbances or dental problems. Exposures to certain chemicals, such as insecticides and certain medicines have also been associated with smell disorders. People with head and neck cancers who receive radiation treatment are also among those who sometimes experience problems with their sense of smell.

Click on the above thumbnail to read more information on smell disorders in Smell Disorders: Nothing to Sniff At.

Are smell disorders serious?
As with all of our senses, our sense of smell plays an important part in our lives. Beyond acting as a first warning signal, alerting us to dangers such as chemical fumes or smoke, our sense of smell can actually provide a signal of serious health problems. Smell disorders can be related to important diseases such as obesity, diabetes, malnutrition, Parkinson's disease, Alzheimer's disease and multiple sclerosis.

How are smell disorders diagnosed?
After gathering a patient’s general health information, Dr. Kimmelman will then examine the nose, throat, ears and neck. Next, he will administer an innovative smell test that he helped developed while conducting groundbreaking research at the University of Pennsylvania. This “Smell Identification Test” (SIT) is performed in Dr. Kimmelman’s office and is designed to measure the accuracy of a patient’s ability to identify different smells as well as the severity and nature of the smell disorder. If necessary, Dr. Kimmelman will recommend that a patient undergo a CT scan or MRI to provide additional information. Other blood testing or neurological evaluations may be recommended.

Can smell disorders be treated?
Many of Dr. Kimmelman’s patients experience relief from their smell disorders. Depending on the cause and duration of the problem, treatments vary but may include surgical and/or medical therapies. Because certain medications can cause problems, Dr. Kimmelman may also recommend adjusting or changing that medicine to ease its effect on the sense of smell. Patients may also experience spontaneous recovery because olfactory neurons have the ability to regenerate following damage or injury.

Disorders of Taste and Smell written by Charles Kimmelman, M.D. As an expert in Taste & Smell disorders, the American Academy of Otolaryngology has published Dr. Charles Kimmelman’s educational book, Disorders of Taste and Smell, for the past 20 years. The third edition of this classic has been updated in 2006. The book is distributed by the American Academy of Otolaryngology - Head and Neck Surgery Foundation, www.entnet.org. To purchase online one can click here.