Olfactory dysfunction after head injury.
OBJECTIVE
To determine the incidence of olfactory dysfunction after head trauma using clinical and radiologic findings, quantitative assessment, and electro-physiologic methods.


METHODS
A total of 190 patients with head trauma of different severity (n = 32 with mild traumatic brain injury (TBI), n = 94 with signs of moderate TBI, and n = 64 with severe TBI) 6 to 32 months prior to the study.


METHODS
Patients were selected retrospectively, surveyed by telephone (n = 190), and screened for olfactory function with Brief Smell Identification Test (n = 82). Those with olfactory dysfunction were assessed as outpatients using the Sniffin' Sticks (n = 19) and olfactory-evoked potential recording (n = 16).


RESULTS
Twenty-one participants (11%) reported a decreased sense of smell after trauma. The incidence of olfactory dysfunction after head injury was 12.8%. The results of the odor-evoked potentials were heterogeneous. A significant correlation was found between olfactory dysfunction and the appearance of skull base fractures and intracranial hemorrhage or hematoma.


CONCLUSIONS
The site of trauma may be more relevant to prognosis than a simple probability (of olfactory loss) based on incidence. Odor-evoked potentials indicate that functional anosmia can occur even when there is some evidence of intact olfactory nerve function.
Haxel
Boris R
BR
Department of Otolaryngology, Head and Neck Surgery, University of Mainz, School of Medicine, Mainz, Germany. haxel@hno.klinik.uni-mainz.de
Grant
Leah
L
Mackay-Sim
Alan
A
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D015331:Cohort Studies; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000209:etiology*; D055696:Olfactory Perception; D012189:Retrospective Studies; D012306:Risk; D012684:Sensory Thresholds; D055815:Young Adult