The Trauma of the Olfactory Structures

Objective: We have 26-year (1992–2018) experiences with open skull base fracture surgery reconstruction and prospective study of skull base trauma treated by conservative. During surgery reconstruction of anterior skull base, we protected olfactory structures. We described on surgery of 40 cases of traumatic pathology of olfactory structures.

Methods: We have more than 400 patients: the anterior skull base, middle, and posterior open trauma. During anterior skull base reconstruction, we protected the olfactory structures in 91%. Mortality rate of our series is 1.7%, morbidity posttraumatic 17%, postoperative 0.6%. Follow-up in this series is 25 years. Concurrently with timing surgery study of open skull base fracture we have constituted group non-surgery treatment open skull base fracture. Our study group have together 116 cases, which come into being first 5 years. We have follow-up of the group 25 years. We were all eyes on complications, which developing during 15 to 25 years under different diagnosis: meningitis, meningoencephalitis, abscessus cerebri, liquorrhea, pneumocephalus, Pott’s tumor, mucocele, meningoencephalocele, “polyps of paranasal sinuses,” “polyps of middle ear,” “cholesteatoma of middle ear.”

Results: We study different pathological problems of posttraumatic on olfactory structures—destruction or contusion or hematoma into olfactory bulb, destruction of olfactory tract, and destruction or contusions in olfactory trigonum. We described different traumatic pathology of olfactory structures during surgery. The pathology of olfactory structures: contusion of olfactory bulb 16 (45%), hematoma of olfactory bulb 2 (5%), destruction of olfactory tract uni 20 (50%), bil. 14 (35%), and destruction of olfactory trigonum 4 (10%). A total of 40 cases were included. In four cases, we reimplanted olfactory bulb into cribriform plate, a partial effect of recovering smell. The area of lamina cribrosa is very important from the aspect of intracranial functional study, especially in relation to resorption problem of cerebrospinal fluid. The lamina cribrosa and olfactory structures are very important with regard to function—smelling, tasting, and sexual behavioral functions.

Conclusion: The traumas of olfactory structures have influenced to smell and taste as well as sexual behavioral system. Reimplantation of olfactory bulb into cribriform plate has only partial effect to recovery functions.

Keywords: anatomy, olfactory structures, reimplantation, trauma