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Doc...... what's wrong? I can't smell my favourite Mao Shan Wang Liu Lian!

Updated: Jul 6

Welcome back, dear readers! TGIF 😊


The good news is that we are hitting the PEAK of the Durian Season now.


Photo illustration of mouth-watering Mao Shan Wang Durian (courtesy of johorkaki.blogspot.com)


but imagine your worst nightmare!


The King of fruits DURIAN has no more aroma, and even tastes bland & insipid!


We seldom realise that 80 percent of taste comes from the aroma / smell of the dish / fruit / flower in front of us.


Artwork depicting the sense of smell (olfaction) from Monell Center for the sense

of taste & smell


Anosmia is the complete loss of smell, whilst hyposmia is a reduced sense of smell.


Most of us take our sense of smell for granted until we lose it! Without it, we cannot enjoy the fragrance of a flower, or even place ourselves in a dangerous situation without knowing it eg: we would not be able to smell a gas leak, smoke from a fire etc.


Fortunately, most of the time, anosmia / hyposmia is a temporary issue, caused by the common cold and a stuffy nose. Once the cold is gone, we recover our sense of smell.


Most recently, one particular viral infection has been seen to cause more cases of Anosmia / Hyposmia:


the dreaded COVID-19 coronavirus!


Illustration to show the effect of the COVID - 19 coronavirus causing Anosmia (cartoon from

The Guardian.com)


It soon came to light amongst the ENT fraternity that COVID patients had a much higher incidence of the loss of smell and de novo patients were presenting with this unusual complaint of being unable to smell.


So what might cause you to lose your sense of smell? well........A stuffy nose from a cold is a common cause for a partial, temporary loss of smell. A blockage in the nasal passages caused by nasal polyps or a nasal fracture also is a common cause. Normal ageing can cause a loss of smell too, particularly after age 60.


Loss of smell caused by colds, allergies or sinus infections usually clears up on its own after some time.


If this doesn't happen, consult your doctor so that he or she can rule out more-serious conditions such as certain tumours in the nose / paranasal sinuses eg SNUC (Sino-Nasal Undifferentiated Carcinoma)


Additionally, loss of smell can sometimes be treated, depending on the cause. Your doctor may give you an antibiotic to treat a bacterial infection, or remove blockages in your nasal passage.


In some cases, the loss of smell can be permanent especially after trauma.


If you / your family member are experiencing a loss. / reduced sense of smell, do consult your GP or your ENT specialist. For us ENT surgeons, you can expect a Naso-Endoscopy whereby we insert a small camera into your nose to inspect the nasal passages, looking for any polyps / tumours.


Sometimes, we will also arrange a CT scan of your sinuses to look for any deep seated infections or tumours eg SNUC.


Well, you may also ask:


Can a loss in the sense of smell be reversed?


According to the US National Institutes of Health, there currently are no evidence-based preventive measures, interventions, or treatments available for anosmia. However, there now are a number of lines of evidence suggesting that regular, intermittent exposure to odours, with efforts to identify smells, can lead to some improvement in olfaction. Just as athletic injuries and stroke-induced disabilities can be improved through early rehabilitation, smell loss can be helped through olfactory retraining.


Those who have lost their smell can put together a set of four or five non-irritating odours eg: perfumes, coffee grounds, flavour extracts and try to smell, discriminate and identify them a couple of times each day. In other words, stimulating and re-training the olfactory system may help, especially if is commenced within 12 months after the onset of the anosmia.


You can find out more on this URL:


https://monell.org/smell-taste-loss/


Finally, you may also want to refer to some of these articles on Anosmia:

  1. Ropper AH, et al. Disorders of smell and taste. In: Adams and Victor's Principles of Neurology. 11th ed. McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed Oct. 17, 2019.

  2. Smell disorders. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/smell-disorders. Accessed Oct. 16, 2019.

  3. Lalwani AK, ed. Olfactory dysfunction. In Current Diagnosis & Treatment: Otolaryngology—Head and Neck Surgery. 5th ed. McGraw-Hill Education; 2012. https://accessmedicine.mhmedical.com. Accessed Oct. 16, 2019.

  4. Mann NM, et al. Anatomy and etiology of taste and smell disorders. https://www.uptodate.com/contents/search. Accessed Oct. 17, 2019.

  5. Anosmia. Merck Manual Professional Version. https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/approach-to-the-patient-with-nasal-and-pharyngeal-symptoms/anosmia. Accessed Oct. 16, 2019.

  6. Kuehn BM. Zicam update. JAMA. 2010; doi: 10.1001/jama.2010.457.

  7. Flint PW, et al., eds. Physiology of olfaction. In: Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed Oct. 17, 2019.



Meanwhile, Happy Durian sniffing to find the BEST Mao Shan Wang durian next week! That's when vendors predict the arrival of a bumper harvest from Pahang!


ENJOY 😊 & keep safe from COVID!





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