Inflammatory Obstruction of the Olfactory Clefts and Olfactory Loss in Humans: A New Syndrome?

• Published in: Chemical senses Vol. 32; no. 3; pp. 285 - 292
• Main Authors: Trotier, Didier, Bensimon, Jean Loup, Herman, Philippe, Tran Ba Huy, Patrice, Døving, Kjell B., Eloit, Corinne
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.03.2007; Oxford Publishing Limited (England); Oxford University Press (OUP)
• Subjects: Adult; anosmia; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Female; Fundamental and applied biological sciences. Psychology; human olfaction; Humans; Life Sciences; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurobiology; Neurology; Neurons and Cognition; Nose; Nose - anatomy & histology; Nose - physiology; Nose Diseases; Nose Diseases - complications; Nose Diseases - diagnosis; Nose Diseases - physiopathology; Olfaction Disorders; Olfaction Disorders - etiology; Olfaction Disorders - physiopathology; Olfaction. Taste; olfactory bulb; olfactory clefts; olfactory test; Perception; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Reference Values; Rhinitis; Rhinitis - physiopathology; Smell; Syndrome; Tomography, X-Ray Computed; olfactory bulb; olfactory test; olfactory clefts; human olfaction; anosmia; Human; Nervous system diseases; Stomatology; Central nervous system; Anosmia; Congenital cleft; Congenital disease; Encephalon; Olfactory pathway; Malformation; Olfaction; Olfactory bulb; Perception; Olfactory disorder; Neurological disorder
• ISSN: 0379-864X; 1464-3553
• DOI: 10.1093/chemse/bjl057

The first step in the olfactory perception is the activation by odorants of sensory neurones in the olfactory epithelium. In humans, this sensory epithelium is located at 2 narrow passages, the olfactory clefts, at the upper part of the nasal cavities. Little is known about the physiology of these clefts. We examined, in 34 patients, the impact of obstructed clefts upon detection and postlearning identification of 5 odorants. The location and extension of the obstructions were assessed using endoscopy, CT scans, and MRI. The inflammatory obstruction was usually bilateral, extending anteroposteriorly, and confined to the clefts, with no sign of obstruction or any inflammatory disease in the rest of the nasal cavities and sinuses. When tested with 5 odorants, these patients showed greatly impaired olfaction compared with a group of 73 normosmic subjects. The majority of these 34 patients had sensory deficits equivalent to that found in another group of 41 congenital anosmic patients, where inspection with MRI indicated the lack of olfactory bulbs. This study demonstrates that the olfactory clefts, in human, function as an entity that is different from other regions of the nasal cavity and is the target for local inflammatory events that are apparently not responding to corticoid and antibiotic treatments.