1 Center of excellence for research of sensorial and sensitive disorders, study of infecto-inflammatory, tumoral and obstructive aero-digestive pathology (CESITO), ENT&HNS Department, “Sfanta Maria” Clinical Hospital, Bucharest, Romania
2 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Head trauma is considered to be the third cause of olfactory function disorders. Olfactometric assessment in patients accusing anosmia following head injury produced by car accident or aggression is important, because most of them are involved in law trials in order to obtain financial compensations from the author. It is compulsory to use both subjective and objective olfactory evaluation methods combined with a detailed anamnesis, a complete ENT examination and a good cranio-facial imaging (computed tomography or MRI) in order to exclude malingerers and to obtain an accurate diagnosis.
“Sfanta Maria” ENT Department from Bucharest is the only center in Romania where the olfactory function in completely investigated. We use chemosensory (Snap and Sniff Test and n-Butanol Dynamic Olfactometry) and electrophysiological tests (electric olfactory evoked potentials of the olfactory bulb).
Unfortunately, we confront with a series of difficulties in what concerns the smell function evaluation: 1) there is scarce information in the literature regarding the olfactory electric evoked potentials; 2) the electric olfactory evoked potentials register only the electrical activity in the olfactory bulb; 3) in case of olfactory impairment medically confirmed, we cannot establish a cause-effect relationship between the disturbance and the event; 4) the most accurate electrophysiological assessment method currently available in Europe is the time-frequency analysis of chemosensory event-related potentials, but we do not dispose of the necessary equipment yet; 5) sometimes patients do not give us the informed consent for a complete olfactory evaluation.
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1. Huart C Eloy P Rombaux P. Olfaction. In: Önerci TM editor. Nasal Physiology and Pathophysiology of Nasal Disorders. Berlin Heidelberg Springer-Verlag; 2013 p.113.
2. Leopold DA Hummel T Schwob JE Hong SC Knecht M Kobal G. Anterior distribution of human olfactory epithelium. Laryngoscope. 2000;110(3 Pt 1):417–21. DOI: 10.1097/00005537-200003000-00016.
3. Huart C Eloy P Rombaux P. Olfaction. In: Önerci TM editor. Nasal Physiology and Pathophysiology of Nasal Disorders. Berlin Heidelberg Springer-Verlag; 2013 p.114-117.
4. Nordin S Brämerson A. Complaints of olfactory disorders: epidemiology assessment and clinical implications. Curr Opin Allergy Clin Immunol. 2008;8(1):10-5. DOI: 10.1097/ACI.0b013e3282f3f473.
5. Reden J Maroldt H Fritz A Zahnert T Hummel T. A study on the prognostic significance of qualitative olfactory dysfunction. Eur Arch Otorhinolaryngol. 2007;264(2):139-44. Epub 2006 Sep 28.
6. Swann IJ Bauza-Rodriguez B Currans R Riley J Shukla V. The significance of post-traumatic amnesia as a risk factor in the development of olfactory dysfunction following head injury. Emerg Med J. 2006;23(8):618-21.
7. Hummel T Smitka M Puschmann S Gerber JC Schaal B Buschhüter D. Correlation between olfactory bulb volume and olfactory function in children and adolescents. Exp Brain Res. 2011;214(2):285-91. DOI: 10.1007/s00221-011-2832-7. Epub 2011 Aug 13.
8. Huart C Rombaux P Hummel T. Plasticity of the human olfactory system: the olfactory bulb. Molecules. 2013;18(9):11586-600. DOI: 10.3390/molecules180911586.
9. Buschhüter D Smitka M Puschmann S Gerber JC Witt M Abolmaali ND et al. Correlation between olfactory bulb volume and olfactory function. Neuroimage. 2008;42(2):498-502. DOI: 10.1016/j.neuroimage.2008.05.004. Epub 2008 May 10.
10. Turetsky BI Moberg PJ Yousem DM Doty RL Arnold SE Gur RE. Reduced olfactory bulb volume in patients with schizophrenia. Am J Psychiatry. 2000;157(5):828-30.
11. Doty RL. Handbook of Olfaction and Gustation. 3rd Edition. John Wiley & Sons; 2015 p.228-231.
12. Reden J Mueller A Mueller C Konstantinidis I Frasnelli J Landis BN et al. Recovery of olfactory function following closed head injury or infections of the upper respiratory tract. Arch Otolaryngol Head Neck Surg. 2006;132(3):265–9. DOI: 10.1001/archotol.132.3.265.
13. Lötsch J Hummel T. The clinical significance of electrophysiological measures of olfactory function. Behav Brain Res. 2006;170(1):78-83. Epub 2006 Mar 24.