Loss of smell and hearing: what to know

A blocked nose from allergic rhinitis, chronic sinusitis, a common cold, or COVID-19 can reduce smell. Pressure or fluid behind the eardrum during a respiratory infection can make hearing seem muffled. Long COVID may also be considered when symptoms continue after an infection. The two changes can occur at the same time without having one single cause. Ear pain, discharge, ringing, dizziness, or neurological symptoms help guide the examination.

Record when each symptom began and whether it affects one side or both. Keep the volume low on headphones, avoid inserting cotton buds or objects into the ears, and protect yourself from smoke or gas hazards if smell is reduced. Treat a cold or nasal allergy only with products suitable for you; ask a pharmacist or clinician before using decongestant sprays or drops. A clinician may look in the ears and nose and arrange hearing or smell testing.

Seek urgent medical care for sudden hearing loss, sudden loss of smell without nasal blockage, severe dizziness, facial weakness, new weakness or numbness, confusion, trouble speaking, or a severe headache. Prompt review is also needed for ear discharge, significant pain, fever, or symptoms after a head injury. Make a routine appointment when either sense remains reduced, progressively worsens, or interferes with eating, communication, work, or safety.

Ask whether wax, fluid, infection, nasal swelling, medicines, or another cause could explain the pattern. Ask if you need an audiogram, nasal examination, smell testing, or referral. Bring a list of medicines and describe recent infections, allergies, injury, tinnitus, dizziness, and whether symptoms are one-sided.