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Chemosensory Disorders and Nutrition
Published in Alan R. Hirsch, Nutrition and Sensation, 2023
Carl M. Wahlstrom, Alan R. Hirsch, Bradley W. Whitman
Since the first report appeared in 1864 (Jackson 1864), much has been written about this complication. In a survey of 1,000 head trauma victims, an estimated 7.2% suffered some form of olfactory dysfunction following their injury (Leigh 1943). The cause of the dysosmia was originally believed to be the shearing of olfactory nerve axons, specifically the fila olfactoria at the cribriform plate, which occurs during trauma when the brain is rapidly accelerated against the skull (Russell 1960). Pathological changes in the olfactory nerves have been well identified following such injuries (Jafek, Eller, Esses, and Moran 1989).
Clinical aspects of head injury
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
A number of cranial nerves may be damaged by a head injury, with resultant clinical features associated with their function. Anosmia (loss of smell) may result from damage to olfactory nerve fibres passing through a fractured cribriform plate.
Asphyxia
Published in Kevin L. Erskine, Erica J. Armstrong, Water-Related Death Investigation, 2021
Hydrogen sulfide is a gas originating from the natural environment, organic decomposition, and industry. Specific sources include sewers, septic tanks, the manufacture of petroleum-containing products and paper, natural gas, and volcanoes.8 It is commonly described as having a rotten egg odor. At higher concentrations in the ambient environment and with prolonged inhalation, its odor becomes undetectable due to paralysis of the olfactory nerves, and respiratory impairment and unconsciousness may ensue.8 Due to the occupational hazards and past reports of deaths, OSHA regulations restrict the amount of exposure and require training, equipment for detection of the gas, and the use of respiratory protective equipment.13,14 The action of H2S is at the cellular level, similar to cyanide. During the scene investigation, blackening of metal objects, including coins, may be noted. At autopsy, a greenish discoloration of the tissues, in addition to the characteristic odor, may be noted. Prompt toxicological testing may reveal elevated sulfate ion or thiosulfate levels.8
Loss of Ocular Surface Sensation in a Covid-19 Patient–a Novel Finding
Published in Ocular Immunology and Inflammation, 2022
Sertaç Argun Kivanç, Berna Akova
Syn-ropanethial-S-oxide, released when the onion is cut, is known as the lacrimator factor and it stimulates the ocular surface and the lacrimal gland without damaging it and allows this substance to move away from the eye surface by irrigating the eye.3 Therefore, it is expected to increase tearing in a normal ocular surface. However, our patient had no response to onion. He had decreased ocular surface sensation, loss of smell and taste. It has been reported that the coronavirus impairs the smell and taste.4 In COVID-19 autopsy cases, presence of high amount of high SARS CoV-2 was detected in the olfactory mucosa underneath the cribriform plate, olfactory bulb, trigeminal ganglion, and medulla oblongata.5 In another study, the virions of SARS CoV-2 were identified in the olfactory nerve, gyrus rectus and brain stem of COVID 19 patients and ultrastructural damage to the axons was shown.6 The anosmia or hyposmia is likely to be associated with the SARS CoV-2 damage to the neurons of olfactory nerve and bulb.
Treatment of posttraumatic olfactory dysfunction with corticosteroids and olfactory training
Published in Acta Oto-Laryngologica, 2020
Mette Bratt, Kent G. Moen, Ståle Nordgård, Anne-S. Helvik, Toril Skandsen
In contrast to most previous studies [12,20], in this study, we retested the patients 1 year after baseline, with the last assessment 8 months after ended OT. We observed an increase in TDI score immediately after intervention (T2) followed by a further statistically significant increase after the non-interventional period (T3). This suggests that the improved sense of smell was sustained, at a minimum, for 8 months without treatment. We could speculate that this indicates an increased functionality of the olfactory nerve obtained during treatment. The possibility of a long-lasting alteration in the olfactory nerve system following a limited period of OT should be further explored. The one study of posttraumatic OD that included OT with a follow-up beyond OT found, in contrast to ours, that the increase in olfactory function after OT was temporary and declined after 3 months. Thus, it is important for future treatment studies to explore longer-term olfactory outcome.
Lateralization of odor identification in right-handers
Published in Acta Oto-Laryngologica, 2020
Yunpeng Zang, Pengfei Han, Thomas Hummel
We found that the odor identification scores are significantly higher on the left-side nostril than the right-side nostril in the older group, which is in line with findings of previous research [12]. These asymmetries can be interpreted as a reflection of the hemispheric specialization in terms of language. Besides, olfactory information is largely processed ipsilaterally to the stimulated nostril which is different from vision and hearing [13], which processed oppositely to the stimulations in the brain. Classical anatomical studies also showed that the olfactory nerve projects ipsilaterally to the olfactory bulb, which in turn projects to ipsilateral olfactory cortical areas [13]. Thus, right-handers may have a better performance on odor identification in the left-side nostril than in the right-side nostril, which is supported by the current result.