I was unable to smell anything for three years and my favourite food and beer tasted rancid. Nothing helped, until I was given revolutionary new treatment

Jake Moulson has always loved the smell of freshly mown grass, or hawthorn in country hedges.

But for three years he was virtually unable to smell anything – and many foods lost their flavour, while others, including his favourite craft beers, tasted rancid. But he's now able to enjoy smells and food again – thanks to a pioneering new operation that boosts air flow in the nasal cavity to 'kick-start' your cells' ability to detect aromas.

Experts say it could help many people who, like Jake, lost their sense of smell after having Covid.

Around 9.6 million people in the UK are thought to have suffered loss of smell as a result of Covid infection – some experiencing anosmia (complete loss) and others olfactory dysfunction (partial loss). But while most recovered their sense of smell within a month, for around 7 per cent (more than 600,000 people), it lasted longer than a year.

Jake, 45, and his partner Heather, 46, caught Covid in March 2020 and suffered symptoms for two days before realising their sense of smell had also been affected.

'We'd left a pan of rice on the hob which boiled dry and we didn't smell it burning,' says Jake, a university lecturer from east London.

While Heather's sense of smell returned three months later, Jake's did not. 'The smell and taste of coffee had gone, which took away my pleasure in it, and when I was out walking our border collie, Marj, I couldn't smell the plants,' he says.

Lots of his favourite treats, meanwhile, tasted foul – a condition called parosmia.

'I gave up drinking alcohol as things such as craft beer suddenly tasted unpleasant – sometimes like overboiled sprouts,' says Jake.

'And I stopped eating chips as they had a rancid, oily taste. What was really disconcerting was I didn't even know if I smelled sweaty, so I had to ask Heather.'

Jake's GP initially advised him to 'sit it out', but in September 2020 agreed to refer him to the long Covid clinic at University College London Hospitals (UCLH).

He was put on olfactory (or smell) training to try to restore his ability to pick up scents, a technique which is effective in about half of cases. It's thought to work by stimulating a layer of tissue – the olfactory mucosa – that lines the inside of the nasal cavity, reinvigorating cells there that are vital for detecting different odours.

But after two years of daily training, which involves sniffing aromatherapy oils for 20 seconds at a time, there was little improvement.

Then in 2023 Jake was invited to take part in a clinical trial at UCLH involving a type of surgery called functional septorhinoplasty (fSRP).

It was already widely used to treat patients with breathing problems caused by a deviated septum (where the strip of cartilage and bone that divides the nose is bent or misshapen, often as a result of injury, blocking air flow).

Professor Peter Andrews, a consultant surgeon in rhinology and facial plastic surgery, led the trial.

He'd discovered in 2019 that the fSRP procedure not only increased air flow through the nose, but also improved the sense of smell in patients who'd lost it due to trauma or infections.

This is because part of the procedure involves strengthening and widening the internal nasal valve, which helps to clean, warm and moisten the air as it passes through the nose. The valve is located around the narrowest part of the nasal airway, and as we age it can lose its elasticity and collapse, affecting breathing.

'The wider the internal nasal valve is, the more air reaches the olfactory system,' explains Professor Andrews. 'It's a bit like a muscle – the more you use it, the stronger and bigger it becomes.'

He and his team wanted to see if widening the valve could help long Covid sufferers regain their sense of smell by increasing air flow.

The roof of the nose contains around ten million nerve cells, called olfactory neurons, which detect odours and pass the information along nerve fibres to the brain. These are constantly being replaced every few weeks, says Professor Andrews. The theory is that significantly improving the air supply will kick-start olfactory neuron growth.

He says: 'We think this operation sort of shakes the olfactory system around and reactivates it to begin this natural regeneration process.'

The trial involved 25 patients; 13 didn't have the surgery but continued with olfactory training.

Jake had his operation in March 2023 to widen his left nasal valve, which was narrower than the right.

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With Jake under a general anaesthetic, Professor Andrews made an incision from his upper lip to the tip of his nose. Cartilage was then harvested from his septum and grafted to the valve to strengthen and widen it by 2mm.

Following the two-hour operation, Jake left hospital the same day and was advised to try to avoid sneezing. 'I didn't want to get too excited in case nothing had changed,' he says. 'But after two weeks, my sense of smell started coming back. Now it's almost back to how it was before Covid.

'I enjoy smelling hawthorn in the countryside, or flowers in the garden,' he says. 'I thought I might not be able to do that again.'

Data published in the Facial Plastic Surgery journal in March showed that six months post-surgery, patients scored higher on smelling 'sniff' tests compared to the control group. Professor Andrews says the next step would be a larger trial.

However, Carl Philpott, a professor of rhinology and olfactology at the University of East Anglia, told Good Health it's not clear yet to what extent improved air flow would benefit other long Covid patients. 'We have a relative understanding of what is happening at a microscopic level in terms of damage to our smell, but how to correct that is somewhat limited.'