The intranasal trigeminal and the olfactory system are intimately connected. There is evidence showing that acquired olfactory loss leads to reduced trigeminal sensitivity due to the lack of a central-nervous interaction. Both, the orbitofrontal cortex and the rostral insula appear to be of significance in the amplification of trigeminal input which is missing in patients with olfactory loss. On peripheral levels, however, adaptive mechanisms seem to produce an increase in the trigeminal responsiveness of patients with hyposmia or anosmia.