Research Reports - Post-traumatic anosmia in patients with mild traumatic brain injury

Surg Neurol Int. 2016 May 6;7(Suppl 10):S263-75. doi: 10.4103/2152-7806.181981.
eCollection 2016.

Proskynitopoulos PJ(1), Stippler M(1), Kasper EM(1).

BACKGROUND: Olfactory dysfunction (OD) is a disorder associated with traumatic
brain injury (TBI), which is prevalent in up to 20% of patients suffering from
TBI. Nevertheless, most studies focusing on the relationship between OD and TBIs
do not differentiate between the different types of TBI (mild, medium, and
severe). In this paper, we conducted a comprehensive and systematic review of the
existing literature for the association between mild TBI (mTBI) and OD in order
to examine their relationship, focusing on its neurosurgical management and the
radiographic characteristics.
METHODS: The MEDLINE database was systematically reviewed according to the
Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We
found 66 articles, of which 10 fulfilled our criteria.
RESULTS: All except two studies reported a significant association between trauma
severity and olfaction. Two studies found a negative correlation between TBI
severity and olfactory bulb volume with one reporting an r value of -0.62). Three
studies reported an association between the observation of radiographic
intracranial hemorrhage or skull base fractures and the history of TBI.
CONCLUSION: According to our search results, we conclude that OD is a prevalent
but underdiagnosed problem in mTBI. Because OD is associated with a significant
decrease in quality of life, we think that neurosurgical teams need to asses
olfactory function in mTBI patients when they report to clinics. To illustrate
this scenario, we include two distinct cases of patients with anosmia after mTBI
in this review. Finally, we suggest a treatment algorithm for patients with mTBI
so that a possible OD can be diagnosed and treated as early as possible. 

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