Olfactory dysfunction: A sequela of pediatric blunt head trauma

Objective: To evaluate olfactory function in children with blunt head trauma. Methods: Eligible subjects were consecutive children presenting at San Diego Children's Hospital Emergency Department or Trauma Service with blunt head trauma. Thirty-seven head injured children mean age 10.11 +/- 2.74 were evaluated; 36 healthy age and gender matched community children, mean age 10.08 +/- 2.99, served as controls. The medical record was reviewed for clinical measures related to head injury (HI). All children underwent olfactory assessment with the San Diego Children's Odor Identification Test (SDOIT). Olfactory event-related potentials were recorded on a subset of head injured and control children. Results: Three of 37 head injured children had olfactory dysfunction. The head injured hyposmics had signs of more severe head injury represented by lower Glasgow Coma Scores (GCS), 10.33 +/- 5.51, when compared to their normosmic counterparts with mean GCS of 14.06 +/- 2.82. When stratifying the head injured children by clinical measures, lower Glasgow Coma Score, and abnormalities on head CT scan were associated with poorer olfactory performance. Conclusion: Children with blunt head injury may suffer post-traumatic olfactory impairment. More severe head injuries are more likely to produce olfactory deficits. In cases of significant head injury, cranial nerve I evaluation is imperative. (C) 2005 Elsevier Ireland Ltd. All rights reserved.