Dysomia: The Phenomenon of “Phantom Smells”

What is Dysomia?

Smelling cigarette smoke

 

Dysomia is a disorder characterized by the distortion of smell. This may mean that the patient experiences one smell as something entirely different. It may also mean that a patient smells odors that are not present at the time, such as smelling cigarette smoke without any exposure to cigarette smoke. Dysomia does not occur on its own, but is rather the result of other underlying conditions such as nasal polyps or sinus infections.

Causes

Dysomia is not necessarily a condition in itself, but rather a result of another underlying condition. Some conditions that can cause dysomia include, but are not limited to, the following:

  • Neurological disorders/diseases
  • Head trauma
  • Nasal polyps
  • Nasal tumors
  • Hormonal imbalances
  • Nutrient deficiency
  • Dental issues
  • Aging
  • Using certain medications
  • Sinus infections

Sense of smell

Types

There are two recognized types of dysomia:

Phantosmia

Phantosmia is the phenomenon of one smelling an odor that is not present to them at the time. Patients most often describe smelling cigarette smoke when they have absolutely no exposure to cigarette smoke. Patients may also smell perfumes or colognes when they are not around anyone wearing a fragrance. Instances of phantosmia are often fleeting, lasting only a few seconds to minutes at a time. When an incident lasts longer than a few minutes, it is referred to as an “olfactory hallucination”.

Parosmia

Parosmia refers to a distorted sense of smell that causes a patient to smell odors differently than the odor should smell. For instance, a patient may sniff a vanilla candle and smell the scent of citrus rather than the scent of vanilla. Parosmia also refers to patients who suddenly find odors that were once pleasant to be repulsive. This may be someone who once enjoyed the smell of roses, and then suddenly finds the smell nauseating. Parosmia is often experienced by pregnant women, due to the imbalance of hormones that occurs in pregnancy.

Dysomia

Symptoms

  • Smelling an odor that is not present
  • Suddenly finding certain odors unpleasant
  • Misinterpreting one odor as something else

Diagnosis

Dysomia

A CT scan of the head can reveal nasal polyps causing dysomia.

If you suspect that you have dysomia, your primary care physician will likely refer you to an ENT (ear, nose and throat specialist). An ENT will perform a thorough examination of your nasal passages and will often send you for diagnostic testing to rule out serious causes of dysomia, like neurological disorders or nasal tumors. Diagnostic testing may include a CT or MRI scan of the head to check for nasal tumors or anything causing neurological issues, like a brain tumor. If serious conditions are ruled out, your ENT may order blood panels to check hormone levels.

Treatment

Treating dysomia consists of treating the underlying condition that is causing the dysomia. For example, if your dysomia is caused by medications you are taking, you may change your medication or change your dosage. Removing nasal polyps can relieve your dysomia if that is the cause. Treating allergies or sinus infections can resolve the issue if either of those is causing dysomia. Dysomia caused by hormone imbalances can be treated by balancing your hormones. If the underlying cause cannot be treated, the patient may have to live with dysomia. It is important to note that dysomia is not dangerous to your health, but rather just an unpleasant occurrence.

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