Clin Exp Otorhinolaryngol.  2014 Sep;7(3):188-192. 10.3342/ceo.2014.7.3.188.

Cortical Magnetic Resonance Imaging Findings in Patients With Posttraumatic Olfactory Dysfunction: Comparison According to the Interval Between Trauma and Evaluation

• Kim SW
• Kim DW
• Yim YJ
• Rhee CS
• Lee CH
• Kim JW

• KMID: 1973468
• DOI: http://doi.org/10.3342/ceo.2014.7.3.188

Abstract

OBJECTIVES
Patients with smell loss after craniocerebral trauma are known to have some brain abnormalities, but there was no study to analyze the findings according to the time interval between injury and evaluation. We aimed to identify whether the time interval may influence on the findings in the brain.
METHODS
Medical records of 19 patients with posttraumatic olfactory dysfunction were reviewed. All of them underwent a magnetic resonance imaging and olfactory function tests. The patients were divided into early (n=10) and delayed (n=9) groups according to the time interval.
RESULTS
Magnetic resonance imaging was taken at a mean time of 2.2 and 59.6 months after trauma in the early and delayed groups, respectively. Abnormal findings in the brain were found in 6 and 8 patients in the early and delayed groups, respectively. The olfactory bulb and orbitofrontal cortex were commonly affected olfactory pathways in both groups. In the early group, the abnormalities were brain tissue defect, hemorrhage, and focal edema whereas tissue defect was the only finding in the delayed group. In the early group, 5 of 6 patients with severe olfactory dysfunction showed brain abnormality while 1 of 4 patients with mild dysfunction had abnormality. In the delayed group, all the patients had severe dysfunction and 8 of 9 patients showed brain abnormality.
CONCLUSION
Most patients with traumatic olfactory dysfunction had abnormality in the brain, and brain abnormality might be different according to the timing of evaluation. Furthermore, there might be an association between the severity of olfactory dysfunction and radiological abnormalities.

Keyword

Craniocerebral trauma; Olfactory bulb; Olfactory pathways; Magnetic resonance imaging; Smell

MeSH Terms

Brain
Craniocerebral Trauma
Edema
Hemorrhage
Humans
Magnetic Resonance Imaging*
Medical Records
Olfactory Bulb
Olfactory Pathways
Smell

Figure

• 

  Fig. 1 Representative abnormal magnetic resonance findings. (A) Subarachnoid hemorrhage in the bilateral olfactory bulb and orbitofrontal cortex, (B) focal edema in the bilateral orbitofrontal cortices, (C) a large defect in the right orbitofrontal cortex filled with cerebrospinal fluid.

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