Olfactory Dysfunction (Anosmia)

Olfactory dysfunction is a common consequence of TBI, most frequently associated with severe injury, and has also been seen with PTA of more than 5 minutes (105). Bakker and colleagues (106) report an association between severity of anosmia and executive function in children.

The incidence of anosmia varies from 5% to 65%, depending on the type and severity of the brain injury (107). Olfactory dysfunction can be a partial loss of the sense of smell (microsomia) or a complete loss of sense of smell (anosmia) (108). In a study carried out by Yousem and colleagues (109) to locate and quantify the deficits using radiographic studies, most patients with impaired olfaction showed damage to the olfactory bulbs and tracts, followed by the inferior frontal lobes and volume loss in the olfactory bulbs and tracts. Both patients and their parents are seldom aware of their deficits (110) and therefore formal testing should be done in children with TBI. The three-screen test can be used for quick, gross identification, but the University of Pennsylvania Smell Identification Test (UPSIT) is more reliable in identifying all patients with deficits (111). There is usually poor recovery from anosmia in comparison to parosmia (107). Impairment in the sense of smell may have social and safety implications (108). Those with anosmia must be cautioned to use other senses to look for dangers, such as a gas burner left on, fire hazard, or similar problems. Teenagers and young adults may need to be advised about the use of fragrance when they cannot receive any feedback about its strength.

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Source: Alexander M.A., Matthews D.J.. Pediatric Rehabilitation: Principles and Practice. 4 th. еd. — New York: Demos Medical Publishing,2010. — 540 р.. 2010

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