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Why do I have loss of smell (anosmia) even after two surgeries for nasal polyps?

Q: I am a 28 years old male suffering from anosmia due to nasal polyps. I have been operated twice upon for nasal polyps in the last five years. The first surgery was done five years back and second one some three years back. After the second surgery, I was able to smell and got relieved of blockage. But again I have lost my smelling sensation. Currently I am in Singapore for a small assignment. I made a visit to an ENT specialist, who diagnosed it. I underwent for Bronchoscopy (for which I was charged eleven thousand rupees), which showed me the inside of nose for its current status of polyp formation. I would like know four things.

  1. Was my previous surgery not done properly?
  2. Is it common for people to get revision surgery for such cases as the doctor said?
  3. If I am getting operated again for this, will it have any side affects/chances of recurrence?
  4. Is the charge for Bronchoscopy fine?

A:You seem to have allergic nasal polyps. They have a tendency to recur. It occurs in patients who have allergy and allergic polyps are secondary to allergic reaction to an allergen. Once patient is allergic, he remains allergic through out his life and that explains the chance of recurrence.

The treatment for polyps is both medical as well as surgical. Surgery does not mean total cure. One needs to take medical treatment, 2 - 3 courses in a year. Clinically patient feels loss of smell, nasal blockage, heavy headedness, body weakness or nasal drip which can be anterior or posterior. Loss of smell is the first symptom to develop, when polyps are still limited to upper part of the nose. That is the best time to start the medical treatment. By the time you have nasal blockage your polyps are so big that you do not respond to medical treatment thus necessitating surgical intervention.

Examination of nose with endoscope is nasal endoscopy and examination of bronchus related to lungs and chest is bronchoscopy. The cost of procedures vary from country to country and even in same country it may be different in different places. In Delhi the range of nasal endoscopy varies from 400 INR to 1200 INR.

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