Olfactory mucosa of patients with olfactory disturbance following head trauma.

The olfactory mucosa in 7 patients with olfactory disturbance following head trauma were sampled for biopsy with special biopsy forceps and examined by immunohistochemical staining with anti-neuron-specific enolase (NSE) and S-100 protein (S-100) antibodies. The residual olfactory receptor cells and nerve bundles were counted, and the degree of degeneration was determined. In 5 patients, olfactory receptor cells that reacted with anti-NSE antiserum remained, although the number varied with the patient, and in 2 patients the receptor cells disappeared. In the lamina propria, the S-100-immunoreactive olfactory nerves were retained in 6 patients. The outcome was poor in all cases regardless of the number of residual receptor cells and nerve bundles. These results indicate that the degree of impairment of the peripheral olfactory region after head trauma differs from case to case, and that even if the receptor cells and nerve bundles remain, it is difficult to improve the condition, although some cases of malingering may be contained.