The most important chemical sense is olfaction. It is currently estimated that 1–2 percent of the American population suffer from the loss of the sense of smell. For these 2 1/2 to 5 million individuals the world has lost some of its excitement. The most obvious and primary complaint is that food no longer has a taste, for indeed 95 percent of the sensory input received from food (and that which allows us to distinguish a good steak from a bad steak, a good cheese from a bad cheese) is the sense of smell. But smell means a great deal more than just the ability to taste and enjoy food. First and foremost it´s a warning sign. Smoke is an early warning of fire. Most gasolines are odorized and a gas leak is detected by its noxious mercaptan smell. Spoiled food smells horrible but those without a sense of smell will never know that their food was spoiled.
Smell is a major pleasure sense and when one smells the fragrance of cut grass, of flowers, of the forest, of autumn, of spring, one derives not only information but pleasure. We all know the smell of our loved ones, the smell of their skin, the smell of their perfumes and even the smell of their body odors. The sense of smell plays an important role in sexual excitement and while we as Americans have done a great deal to camouflage body odor and sexual smells they are still perceived and remain important. The sense of smell is necessary for body hygiene. How would one know when to take a shower without the sense of smell.
The nose is the entrance to the respiratory tract. We use it to breathe. When one or both sides are obstructed, one can not breathe and most people perceive this as an uncomfortable inconvenience. Inflammation such as allergy will cause the mucosa to swell, and your nose to feel congested. In this case neither side will breathe well. If your anatomy is crooked, such as found with a deviated nasal septum, one side will be obstructed relative to the other. This impairs your nasal functioning. Your body likes to have both sides symmetric, and when the airway is out of balance, one side to the other, you perceive an asymmetry, and for many this is an unpleasant condition.
With the increasing concentrations of pollutants in the air we breathe, and with the chemicals that we are exposed to in homes and at work, nasal irritation is becoming an increasingly common and important problem. We are just beginning to learn the importance of nasal irritation, and are at the very beginnings of our ability to observe and measure the nose´s response to chemical irritants.
Sitting to either side of the nose are the sinuses, more properly termed the paranasal sinuses. Their normal function requires open communication with the nose. When this communication is impaired, secretions accumulate and infection ensues, a condition we all know as sinusitis. This can be acute, or it can be chronic. It can be an inconvenience or it can be disabling. We now have the tools to diagnose and treat sinusitis.
Sinusitis is one of the most common causes for patients to seek medical care. Nasal disease collectively has single-handedly supported the pharmaceutical industry. We all wish we had a penny for every time someone in the United States used a kleenex, or someone purchased yet another over-the-counter nasal medication. It is these kinds of illnesses, and many, many more that we at the UCSD Nasal Dysfunction Clinic spend our lives understanding, diagnosing and treating.