He had edematous, moderately enlarged turbinates right-greater-than-left, but no masses, lesions, or foreign bodies were noted. On exam, the patient was a well-developed, healthy-appearing male, who was unable to smell an alcohol pad. His birth history was also uncomplicated, being full-term, passing newborn screens, without prolonged stay in neonatal intensive care unit (NICU). He had no other past medical or surgical history. He noted moderate right-greater-than-left nasal obstruction and snoring for which he was given over-the-counter antihistamines. He denied head trauma, headaches, or vision changes. He could taste sweets, but denied sensation of fragrant or pungent smells. Olfaction, Magnetic resonance imaging, Anosmia, HyposmiaĪ 9-year-old male presents to the Ear, Nose, and Throat clinic of a tertiary referral hospital on the recommendation of his pediatrician for anosmia beginning at least 5 years prior. An MRI Brain with and without contrast was ordered, demonstrating left OBT hypoplasia and right OBT aplasia, and these findings are discussed. Physical exam and endoscopic examination were unremarkable. We present the case of an otherwise healthy 9-year-old male who presented to the Ear, Nose, and Throat clinic for evaluation of longstanding anosmia.
Anosmia is associated with relatively reduced olfactory bulb and tract (OBT) volumes on MRI in a variety of clinical settings, but congenitally anosmic patients will characteristically have olfactory nerve aplasia or hypoplasia. Magnetic resonance imaging (MRI) is commonly ordered in the workup of the anosmic patient. Clinical Image: Olfactory Bulb and Tract Aplasia/Hypoplasia on MRI