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The Invisible Problem: The Incidence of Olfactory Impairment following Traumatic Brain Injury

Published online by Cambridge University Press:  25 November 2015

Melanie Drummond ,
Jacinta Douglas  and
John Olver
Melanie Drummond*
Affiliation:
College of Science, Health and Engineering, La Trobe University, Victoria, Australia Epworth Monash Rehabilitation Medicine Unit, Melbourne, Victoria, Australia Epworth Rehabilitation, Epworth Health Care, Melbourne, Victoria, Australia
Jacinta Douglas
Affiliation:
College of Science, Health and Engineering, La Trobe University, Victoria, Australia NHMRC Clinical Centre of Research Excellence in Brain Recovery, Melbourne, Victoria, Australia Summer Foundation, Melbourne, Victoria, Australia
John Olver
Affiliation:
Epworth Monash Rehabilitation Medicine Unit, Melbourne, Victoria, Australia Epworth Rehabilitation, Epworth Health Care, Melbourne, Victoria, Australia
*
Address for Correspondence: Melanie Drummond, Speech Pathologist/Project Coordinator, Epworth Rehabilitation Executive Team, 25 Burwood Road, Hawthorn, Victoria, 3122, Australia. E-mail: [email protected]. Phone: +011 61 039415 5733; Fax: +011 61 039415 5603.
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Abstract

Background and aims: As many as 50–60% of patients with traumatic brain injury (TBI) admitted to rehabilitation facilities may have olfactory impairment (OI). These incidence estimates are derived from studies conducted internationally and there is no comparable data available in the Australian context. The primary aim of this study was to identify the incidence of OI following TBI in a consecutive sample of adults admitted to the Epworth Hospital Brain Injury Rehabilitation Program in Victoria, Australia. A secondary aim was to investigate whether age, duration of posttraumatic amnesia (PTA) and presence of facial fractures made a significant contribution to the prediction of severity of OI.

Method: The sample comprised 134 adults (mean age 39.09 years, SD 18.36), the majority of whom had sustained moderate to severe injury (PTA mean 21.57 days, SD 18.78). OI was measured using the Pocket Smell Test (PST) and the University of Pennsylvania Smell Identification Test (UPSIT).

Results: Seventy-three participants (54.48%) demonstrated OI on the PST whereas 89 (66.42%) demonstrated OI on the UPSIT. Age, PTA duration, and presence of facial fractures predicted 10.3% of the variance in severity of OI.

Conclusion: A substantial proportion of adults admitted for rehabilitation following TBI has OI. Accurate assessment and appropriate management of post-traumatic OI must be incorporated into rehabilitation programs.

Keywords

traumatic brain injurysmellolfactionrehabilitation
Type
Articles
Information
Brain Impairment , Volume 16 , Issue 3 , December 2015 , pp. 196 - 204
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2015 

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References

Access Economics. (ed.) (2008). The economic cost of spinal cord injury and traumatic brain injury in Australia. Melbourne: Victorian Neurotrauma Institute.Google Scholar
AIHW. (2007). Disability prevalence and trends. Disability series, AIHW Bulletin 55, Dec.Google Scholar
Bert, P.H., Menco, M., & Morrison, E.E. (2003). Morphology of the mammalian olfactory epithelium: form, fine structure, function and pathology. In Doty, R.L. (Ed.), Handbook of olfaction and gustation. (pp. 17–49). Haddon Heights, NJ: Sensonics Inc.Google Scholar
Blomquist, E., Bramerson, A., Stjarne, P., & Nordin, S. (2004). Consequences of olfactory loss and adopted coping strategies. Rhinology, 42, 189–194.Google Scholar
Bromley, S. (2000). Smell and taste disorders: a primary care approach. American Family Physician, 61, 427–436.Google ScholarPubMed
Callahan, C., & Hinkebein, J. (1999). Neuropsychological significance of anosmia following traumatic brain injury. Journal of Head Trauma Rehabilitation, 14, 581–587.CrossRefGoogle ScholarPubMed
Callahan, C.D., & Hinkebein, J. (2002). Assessment of anosmia after traumatic brain injury: performance characteristics of the university of Pennsylvania smell identification test. Journal of Head Trauma Rehabilitation, 17 (3), 251–256.CrossRefGoogle ScholarPubMed
Constanzo, R.M., & Zasler, N.D. (1991). Head trauma. In Getchell, T.V., Doty, R.L., Bartoshuk, L.M., & Snow, J.B. Jr. (Eds.), Smell and taste in health and disease. (pp. 711–730). New York, NY: Raven Press.Google Scholar
Croy, I., Nordin, S., & Hummel, T. (2014). Olfactory disorders and quality of life – an updated review. Chemical Senses, 39, 185–194.CrossRefGoogle ScholarPubMed
Davidson, T.M., Murphy, C., & Jalowayskii, A.A. (1995). Smell impairment. Can it be reversed? Postgraduate Medicine, 98 (1), 107–118.CrossRefGoogle ScholarPubMed
Deems, D.A., Doty, R.L., Settle, G., Moore-Gillon, V., Sharman, P., Mester, A.F., . . . Snow, J.B. (1991). Smell and taste disorders, a study of 750 patients from the university of Pennsylvania smell and taste center. Archives of Otolaryngology Head and Neck Surgery, 117, 519–528.CrossRefGoogle ScholarPubMed
Doty, R., Shaman, P., & Dann, M. (1984). Development of the university of Pennsylvania smell identification test: a standardized microenscapulated test of olfactory function (UPSIT). Physiology and Behaviour, 32, 489–502.CrossRefGoogle Scholar
Doty, R., Yousem, D., Pham, L., Kreshak, A., Geckle, R., & Lee, W. (1997). Olfactory dysfunction in patients with head trauma. Archives of Neurology, 54, 1131–1140.CrossRefGoogle ScholarPubMed
Drummond, M., Douglas, J., & Olver, J. (2007). Anosmia after traumatic brain injury: a clinical update. Brain Impairment, 8, 31–40.CrossRefGoogle Scholar
Drummond, M., Douglas, J., & Olver, J. (2013). ‘If I haven't got any smell. . . . .I’m out of work’. Consequences of anosmia following traumatic brain injury. Brain Injury, 27 (3), 332–345.CrossRefGoogle Scholar
Eslinger, P., Damasio, A., & Van Hoesen, G. (1982). Olfactory dysfunction in man: anatomical and behavioural aspects. Brain and Cognition, 1, 259–285.CrossRefGoogle Scholar
Haxel, B.R., Grant, L., & Mackay-Sim, A. (2008). Olfactory dysfunction after head injury. Journal of Head Trauma Rehabilitation, 23 (6), 407–413.CrossRefGoogle ScholarPubMed
Hummel, T., & Nordin, S. (2005). Olfactory disorders and their consequences for quality of life. Acta Otolaryngologica, 125, 116–121.CrossRefGoogle ScholarPubMed
Jennett, B., & Teasdale, G. (1981). Management of head injuries. Contemporary neurology series. Philadelphia: FA Davis Company.Google Scholar
Kamath, V., & Doty, R. (2014). The influence of age on olfaction: a review. Frontiers in Psychology, 5, 1–20.Google Scholar
Levin, H.S., High, W.M., & Eisenberg, H.M. (1985). Impairment of olfactory recognition after closed head injury. Brain, 108, 579–591.CrossRefGoogle ScholarPubMed
Marosszeky, N.E.V., Ryan, L., Shores, E.A., Batchelor, J., & Marosszeky, J.E. (1997). The PTA protocol: Guidelines for using the westmead post-traumatic amnesia (PTA) scale. Sydney: Wild & Wooley.Google Scholar
Mueller, C.A., & Hummel, T. (2009). Recovery of olfactory function after nine years of post-traumatic anosmia: a case report. Journal of Medical Case Reports, 3, 9283.CrossRefGoogle ScholarPubMed
Reiter, E., DiNardo, L., & Costanzo, R. (2004). Effects of head injury on olfaction and taste. Otolaryngologic Clinics of North America, 37, 1167–1184.CrossRefGoogle ScholarPubMed
Renzi, G., Carboni, A., Gasparini, G., Perugini, M., & Becelli, R. (2002). Taste and olfactory disturbances after upper and middle third facial fractures: a preliminary study. Annals of Plastic Surgery, 48, 355–358.CrossRefGoogle ScholarPubMed
Santos, D., Reiter, E., DiNardo, L., & Costanzo, R. (2004). Hazardous events associated with impaired olfactory function. Archives of Otolaryngology Head and Neck Surgery, 130, 317–319.CrossRefGoogle ScholarPubMed
Schofield, P.W., Moore, T.M., & Gardner, A. (2014). Traumatic brain injury and olfaction: a systematic review. Frontiers in Neurology, 5, 5. Doi: 10.3389/fneur.2014.00005.CrossRefGoogle ScholarPubMed
Sensonics, Inc. (1995). The pocket smell test. Haddon Heights, NJ: Sensonics, Inc.Google Scholar
Temmel, A., Quint, C., Schickinger-Fischer, B., Klimek, L., Stoller, E., & Hummel, T. (2002). Characteristics of olfactory disorders in relation to major causes of olfactory loss. Archives of Otolaryngology Head and Neck Surgery, 128, 635–641.CrossRefGoogle ScholarPubMed
Trewin, D., & Pink, B. (2006). Australian and New Zealand standard classification of occupations (1st ed.). Canberra: Australian Bureau of Statistics.Google Scholar
Varney, N., Pinkston, J., & Wu, J. (2001). Quantitative PET findings in patients with posttraumatic anosmia. Journal of Head Trauma Rehabilitation, 16, 253–259.CrossRefGoogle ScholarPubMed
Yousem, D., Geckle, R., Bilker, W., McKeown, D., & Doty, R. (1996). Posttraumatic olfactory dysfunction: MR and clinical evaluation. American Journal of Neuroradiology, 17, 1171–1179.Google ScholarPubMed