[Post-traumatic anosmia: description of a clinical case, proposal of a standardized protocol and medico-legal comments]

Acta Otorhinolaryngol Ital. 2002 Jun;22(3):142-9.
[Article in Italian]

Abstract

Man's olfactory perception is considerably limited compared to that of other animals; this sense is, however, extremely important in our social lives: it helps us to "savour" our food, it enables us to appreciate perfumes and, even more important, to pick up smells that signal a danger, such as a gas leak or a fire. We describe the clinical case of a patient with anosmia and hypogeusia that appeared immediately after suffering a concussive head injury. We go through the diagnostic protocol for medico-legal assessment of hypoanosmias previously described in the literature, which includes a clinical and an imaging section. In 9% of all anosmic patients, a traumatic event precedes the onset of the disorder, with repercussions on the olfactory channels and centres of the peripherical and/or central nervous system. The overall rate of anosmia following head injury is estimated to be around 7.5%. Among the principal causes of anosmia, those of medico-legal interest constitute 35% of the total. On the basis of our personal experience and of clinical studies conducted by other Authors, we propose that a bioptic investigation of the olfactory mucosa be added to the existing protocol. The olfactory neuroepithelium of patients suffering from post-traumatic anosmia, in fact, evidences some characteristic degenerative aspects. In conclusion, we report several comments regarding the quantification of the reduction of the olfactory function in different areas of medico-legal interest.

Publication types

  • Case Reports
  • Evaluation Study

MeSH terms

  • Adult
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / pathology
  • Female
  • Forensic Medicine / legislation & jurisprudence*
  • Humans
  • Magnetic Resonance Imaging
  • Olfaction Disorders / diagnosis
  • Olfaction Disorders / etiology*
  • Olfactory Mucosa / pathology
  • Research Design