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

  • 1Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.
  • 2Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Korea.
  • 3Department of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 6Research Center for Sensory Organs, Medical Research Institute, Seoul National University College of Medicine, Seoul, Korea.


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.
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.
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.
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.


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

MeSH Terms

Craniocerebral Trauma
Magnetic Resonance Imaging*
Medical Records
Olfactory Bulb
Olfactory Pathways


  • 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.


1. Sumner D. Post-traumatic anosmia. Brain. 1964; 3. 87(1):107–120. PMID: 14156077.
2. Yousem DM, Geckle RJ, Bilker WB, Kroger H, Doty RL. Posttraumatic smell loss: relationship of psychophysical tests and volumes of the olfactory bulbs and tracts and the temporal lobes. Acad Radiol. 1999; 5. 6(5):264–272. PMID: 10228615.
3. Reiter ER, DiNardo LJ, Costanzo RM. Effects of head injury on olfaction and taste. Otolaryngol Clin North Am. 2004; 12. 37(6):1167–1184. PMID: 15563909.
4. Duncan HJ, Seiden AM. Long-term follow-up of olfactory loss secondary to head trauma and upper respiratory tract infection. Arch Otolaryngol Head Neck Surg. 1995; 10. 121(10):1183–1187. PMID: 7546588.
5. Fujii M, Fukazawa K, Takayasu S, Sakagami M. Olfactory dysfunction in patients with head trauma. Auris Nasus Larynx. 2002; 1. 29(1):35–40. PMID: 11772488.
6. Kern RC, Quinn B, Rosseau G, Farbman AI. Post-traumatic olfactory dysfunction. Laryngoscope. 2000; 12. 110(12):2106–2109. PMID: 11129030.
7. Moran DT, Jafek BW, Rowley JC 3rd, Eller PM. Electron microscopy of olfactory epithelia in two patients with anosmia. Arch Otolaryngol. 1985; 2. 111(2):122–126. PMID: 3977726.
8. Duprez TP, Rombaux P. Imaging the olfactory tract (cranial nerve #1). Eur J Radiol. 2010; 5. 74(2):288–298. PMID: 20303227.
9. Wise JB, Moonis G, Mirza N. Magnetic resonance imaging findings in the evaluation of traumatic anosmia. Ann Otol Rhinol Laryngol. 2006; 2. 115(2):124–127. PMID: 16514795.
10. Eftekhari M, Assadi M, Kazemi M, Saghari M, Esfahani AF, Sichani BF, et al. A preliminary study of neuroSPECT evaluation of patients with post-traumatic smell impairment. BMC Nucl Med. 2005; 11. 5:6. PMID: 16313675.
11. Varney NR, Pinkston JB, Wu JC. Quantitative PET findings in patients with posttraumatic anosmia. J Head Trauma Rehabil. 2001; 6. 16(3):253–259. PMID: 11346447.
12. Yousem DM, Geckle RJ, Bilker WB, McKeown DA, Doty RL. Posttraumatic olfactory dysfunction: MR and clinical evaluation. AJNR Am J Neuroradiol. 1996; Jun-Jul. 17(6):1171–1179. PMID: 8791933.
13. Li C, Yousem DM, Doty RL, Kennedy DW. Neuroimaging in patients with olfactory dysfunction. AJR Am J Roentgenol. 1994; 2. 162(2):411–418. PMID: 8310937.
14. Hong SC, Yoo YS, Kim ES, Kim SC, Park SH, Kim JK, et al. Development of KVSS test (Korean version of Sniffin' sticks test). Korean J Otolaryngol-Head Neck Surg. 1999; 7. 42(7):855–860.
15. An SY, Kong IG, Lee CH, Kim JW. Analysis of the correct-answer rate of the odor identification test in KVSS (Korean version of Sniffin' sticks) test. Korean J Otorhinolaryngol-Head Neck Surg. 2007; 12. 50(12):1109–1113.
16. Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G. 'Sniffin' sticks': olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses. 1997; 2. 22(1):39–52. PMID: 9056084.
17. Sande A, West C. Traumatic brain injury: a review of pathophysiology and management. J Vet Emerg Crit Care (San Antonio). 2010; 4. 20(2):177–190. PMID: 20487246.
Full Text Links
  • CEO
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: