Olfaction and traumatic head injury - Is it possible to discriminate between malingering and patients with smell disorders based on nowadays knowledge?

BACKGROUND. Olfaction is one the most important senses; however, even nowadays it is incompletely known in humans from an anatomical and physiological point of view, but also as concerns the assessment methods and treatment. The main causes for acquired olfactory dysfunctions involve inflammatory pathology (local or general) and head trauma. Olfactory impairment after traumatic head injury (THI) is more frequent than believed. Today there are a number of tests for assessing the loss of smell, but more studies are needed in order to establish standardized protocols for patients with such pathology after THI. This uncertainty is more and more exploited by malingerers.

OBJECTIVE. The aim of the paper was to find in literature the necessary information in order to permit a correct management of a patient with olfactory impairment after head trauma and to establish new protocols that may help identify malingerers when medico-legal implications exists.

MATERIAL AND METHODS. We studied an amount of works and studies in order to highlight the diagnosis options specialist have, if such a case is encountered (olfactory loss after THI).

RESULTS. Recent studies show that great progress has been made, but more scientific research is needed. Specialists still search correlation between all diagnosis methods.

CONCLUSION. Olfactory disorders are an important topic given their importance in patient quality of life, but also for the medico-legal implications.