Phantom smells: What to Know about Phantosmia

What is phantosmia?

Phantosmia, also called a phantom smell or olfactory hallucination, occurs when a person smells something that is not there. The smells are usually foul, it could be metallic, burnt toast, or chemical smells.

Phantosma is a disorder linked to the sense of smell. It could be caused by problems with the nose, such as conditions affecting the brain, nervous system or it could be caused by sinusitis.

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It occurs when a person can smell something that is not actually there. The smell may be on one or both nostrils. Phantosmia is an uncommon condition, with about 10 to 20 percent of disorders related to the sense of smell. Phantosmia will resolve on not a cause for concern and will go away on its own.

However, phantosmia can be a sign of a serious underlying condition, so people should always discuss this symptom with their doctor.

Some phantom smells are pleasant, but people with phantosmia more often describe unpleasant, foul, or disgusting odors. These may include:

  • cigarette smoke
  • rotting smell
  • burnt toast
  • burning rubber
  • a chemical or metallic smell
  • a stale or moldy smell

Most people find it hard to identify the specific smell, or it may be a smell that they have never encountered before.

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Phantosmia can feel distressing and may get in the way of daily life. It can influence a person’s sense of taste, leading to a reduced appetite and weight loss.

Causes of phantosmia

Phantosmia may be related to the nose (peripheral phantosmia), or to the brain (central phantosmia). The most common causes of smell-related disorders are problems with the nasal cavity. These include:

  • chronic sinus infections
  • nasal polyps
  • tumors
  • nasal polyps
  • hay fever
  • non-allergic rhinitis

Phantom smells can also be caused by problems on how the brain understands smells. These include:

People may notice a stronger smell in one nostril when phantosmia is related to nosal problems. Saline rinses and anesthetic pads can often help reduce the smell.

When phantosmia is related to the central nervous system, the smells are often more insistent. They can be noticeable during the day and night, and both nostrils rather than only one experience the same smell.

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Some persons may feel they are noticing a phantom smell, when they may instead be noticing an unexpected smell.

Possible sources of unexpected smells include:

  • recent changes in deodorant
  • new air-conditioning unit or heater which may still contain chemicals from the factory
  • new materials, products, or packaging

Differentiating phantosmia from parosmia

Parosmia is a distorted sense of smell. People with parosmia smell actual smells, but they are misleading or distorted. The smell of flowers for instance could trigger a smell of chemicals instead. Most people with parosmia describe the distorted smells as unpleasant.

The symptoms of parosmia can range from mild to severe. Severe parosmia may be incapacitating. People with severe parosmia may struggle hard to deal with their symptoms.

Diagnosis

A doctor will first perform a physical exam of the person’s head and neck to diagnose phantosmia. A doctor may order an endoscopy or rhinoscopy to examine the nasal cavity and check for issues that could cause phantosmia. Some test used to check for irregularities in the nervous system, brain or nasal cavity are Imaging tests, including CT scans, MRI scans, and EEG scans.

Treatment

Treatment for phantosmia varies depending on the original cause of the phantom smell. People with chronic sinusitis or other long-lasting nasal inflammation can talk to a doctor about the best treatment options. The phantom smell should stop after the core conditions are treated.

Doctors may recommend saline solution to rinse the nasal passages if the symptoms persist for more than a few days. Drugs that may help people with phantosmia control their symptoms are:

  • steroid creams or sprays
  • anesthetic to numb the nerve cells
  • drugs to narrow blood vessels in the nose

In severe cases, doctors may turn to oral drugs or surgery to treat phantosmia.

 

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