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Sinusitis - The Olfactory Nerve

 

NIH Guide

Volume 21

Number 42

10-20-1992

 

The olfactory nerve provides a direct anatomic conduit between the

 

 

external chemical environment and the brain. This location puts the

 

 

olfactory system at risk for damage from environmental toxicants and

 

 

pathogens. These toxic agents comprise the major health hazard to

 

 

human olfaction. However, the direct and indirect effects of these

 

 

agents on the peripheral and central olfactory system are poorly

 

 

understood. The purpose of this Program Announcement (PA) is to

foster

 

 

investigator-initiated research fundamental to understanding the

impact

 

 

of environmental toxicants and pathogens on the olfactory system. A

 

 

broad range of studies extending from the molecular to the behavioral

 

 

areas of basic and clinical research is applicable to this PA. The

 

 

scope of these areas encompasses the transport of toxic substances

into

 

 

the brain through the olfactory nerve; olfactory mucosal defense

 

 

mechanisms; neurogenesis; the relation of neurodegenerative diseases,

 

 

such as Alzheimer's disease, to olfactory abnormalities induced by

 

 

toxic agents; and the vulnerability of an aged olfactory system to

 

 

toxic agents.

 

----

 

Assessing Cranial Nerves I

 

1. Cranial nerve function and neuroforamina # CRANIAL NERVE FUNCTION

APERTURE I OlfactorySpecial sensory (olfaction) Cribriform plate II

OpticSpecial sensory (vision) Optic canal III OculomotorMotor

(superior inferior and medial rectus, inferior oblique) Visceral

motor

(parasympathetic: pupillary constrictor muscles) Superior orbital

fissure IV TrochlearMotor (superior oblique) Superior orbital fissure

V TrigeminalMotor (muscles of mastication) Sensory (head and neck,

sinuses and meninges, tympanic membrane) V1: Superior orbital fissure

V2: foramen rotundum V3: foramen ovale VI AbducensMotor (lateral

rectus muscle). Superior orbital fissure CRANIAL NERVE IThe first two

cranial nerves are actually projections of the telencephalon

(olfactory nerve) and diencephalon (optic nerve), and may thus be

affected by the same diseases which affect the brain. They subserve

the special senses of smell and taste, respectively. From the

olfactory epithelium in the superior aspect of the nasal vault,

olfactory nerve fibers ascend into the cranium via perforations

within

the cribriform plate. Some of these fibers synapse at the mitral and

tufted cells within the olfactory bulb, others pass directly through

to the olfactory nerve. The nerve is situated within the olfactory

groove, interposed between the gyrus rectus and the medial

orbitofrontal gyrus. Just ventral to the anterior perforated

substance, the olfactory nerve trifurcates into medial, intermediate

and lateral striae. Most of the axons travel in the lateral olfactory

stria to the uncus and the entorhinal cortex at the anterior aspect

of the hippocampal gyrus. The medial fibers travel to the medial

olfactory area, which is subjacent to the genu of the corpus

callosum. These neurons interface with the limbic system, and are

thought to mediate the emotional response to olfactory stimulation.

The 3 olfactory areas are interconnected by the diagonal band of

Broca. Pathology located anywhere along the olfactory pathway can

affect this special sense (Table 2). Upper respiratory infections,

usually viral in origin, are a fairly common cause of anosmia. An

obstructed nasal cavity prevents access of aromatic molecules to the

olfactory mucosa, causing anosmia. Both benign and malignant

conditions such as polyposis and tumors may obstruct the nasal vault.

In young patients, rhabdomyosarcoma must be considered if an

aggressive mass is present.

The incidence of esthesioneuroblastoma peaks in the second decade,

with a second peak in older adults. In adolescent

males, juvenile angiofibroma may result in complete obstruction of

the superior nasal vault. Although this lesion is histologically

benign, it frequently presents as a very large, vascular and

aggressive mass.Other sinonasal tumors may produce similar symptoms.

Finally, trauma may cause transection of the olfactory fibers which

traverse the skull base at the level of the cribriform plate,

resulting in acute post- traumatic anosmia. Alternatively, delayed

post-traumatic anosmia may result from cicatrization, or scar

formation, caused by dural tears at this location. Lesions such as

gliomas or infection involving the medial temporal lobes may give

rise to olfactory hallucinations and other symptoms, but they usually

do not cause anosmia

 

***Inflammatory Upper respiratory infection (viral), sinusitis,***

 

mucocele, meningitis, polyposis Neoplasm Meningioma, sinonasal

tumors,

nasopharyngeal tumors, Trauma Direct nerve bundle injury, scar

formation (delayed injury)

 

----

 

Excerpts

HSV-1 brain infection by the olfactory nerve route and virus latency

and reactivation may cause learning and behavioral deficiencies and

violence in children and adults: A point of view

 

Journal Virus Genes

Publisher Springer Netherlands

ISSN 0920-8569 (Print) 1572-994X (Online)

Issue Volume 10, Number 3 / October, 1995

DOI 10.1007/BF01701811

Pages 217-226

Subject Collection Biomedical and Life Sciences

SpringerLink Date Monday, June 13, 2005

 

HSV-1 brain infection by the olfactory nerve route and virus latency

and reactivation may cause learning and behavioral deficiencies and

violence in children and adults: A point of view

Yechiel Becker1

 

 

(1) Department of Molecular Virology, Institute of Microbiology,

Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem,

Israel

Received: 5 February 1995 Accepted: 5 February 1995

 

Abstract

Two recent studies provided new evidence on the latency of

HSV-1 DNA in 15.5% of olfactory bulbs and in 72.5% of trigeminal

nerves from human corpses at forensic postmortems (1) and in 35% of

40

autopsied human brains (2). In the latter brains, latent HSV-1 DNA

was

found in the olfactory bulbs, amygdala, hippocampus, brain stem, and

trigeminal ganglia. Although in these studies it is not known by

which

route HSV-1 entered the olfactory bulbs and brain, experimental

studies in mice (3) revealed that injection of HSV-1 into the

olfactory bulbs leads to virus migration into the brain amygdala and

hippocampus via the olfactory nerve and locus coeruleus. If the

olfactory ciliary nerve epithelium is the port of entry of HSV-1 into

the olfactory bulbs and brain in humans as well, protection of the

nose against HSV-1 infection may be needed to prevent virus latency

in

neurons in the amygdala and hippocampus (3). Infection of humans by

HSV-1 was estimated to increase from 18.2% in the 0-20 year

population

group to 100% in persons older than 60 years (1),

 

***indicating that worldwide human populations at all ages are at

risk of brain infection by the olfactory nerve route.***

 

In addition, both primary infection and reactivation of latent DNA in

the brain may lead to damage of neurons in the brain involved in

memory, learning, and behavior, as observed in infected,

acyclovirtreated mice (3). The current introduction of a live

apathogenic varicella-zoster virus (VZV) vaccine to immunize children

against chickenpox (4) may suggest that the time is ripe for

immunization of children and adults against HSV-1 infections,

especially infections by the olfactory nerve route, to prevent

potential brain damage.

Key words HSV-1 - olfactory nerve - brain amygdala and hippocampus -

infection of serotonergic neurons - behavior deficit in children -

learning deficit in children - HSV-1 latency in brain - virus

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Sinusitis - The Olfactory Nerve

Bacterial/Viral/Fungal

 

Excerpt

NIH Guide

Volume 21

Number 42

10-20-1992

 

The olfactory nerve provides a direct anatomic conduit between the

 

 

external chemical environment and the brain. This location puts the

 

 

olfactory system at risk for damage from environmental toxicants and

 

 

pathogens. These toxic agents comprise the major health hazard to

 

 

human olfaction. However, the direct and indirect effects of these

 

 

agents on the peripheral and central olfactory system are poorly

 

 

understood. The purpose of this Program Announcement (PA) is to

 

 

foster investigator-initiated research fundamental to understanding

 

 

the impact of environmental toxicants and pathogens on the

 

 

olfactory system. A broad range of studies extending from

 

 

the molecular to the behavioral areas of basic and clinical

 

 

research is applicable to this PA. The scope of these areas

 

 

encompasses the transport of toxic substances

 

 

into the brain through the olfactory nerve; olfactory

 

 

mucosal defense mechanisms; neurogenesis; the relation of

 

 

neurodegenerative diseases, such as Alzheimer's disease,

 

 

to olfactory abnormalities induced by toxic agents; and the

 

 

vulnerability of an aged olfactory system to toxic agents.

 

---

 

Excerpts

HSV-1 brain infection by the olfactory nerve route and virus latency

and reactivation may cause learning and behavioral deficiencies and

violence in children and adults: A point of view

 

Journal Virus Genes

Publisher Springer Netherlands

ISSN 0920-8569 (Print) 1572-994X (Online)

Issue Volume 10, Number 3 / October, 1995

DOI 10.1007/BF01701811

Pages 217-226

Subject Collection Biomedical and Life Sciences

SpringerLink Date Monday, June 13, 2005

 

HSV-1 brain infection by the olfactory nerve route and virus latency

and reactivation may cause learning and behavioral deficiencies and

violence in children and adults: A point of view

Yechiel Becker1

 

 

(1) Department of Molecular Virology, Institute of Microbiology,

Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem,

Israel

Received: 5 February 1995 Accepted: 5 February 1995

 

Abstract

Two recent studies provided new evidence on the latency of

HSV-1 DNA in 15.5% of olfactory bulbs and in 72.5% of trigeminal

nerves from human corpses at forensic postmortems (1) and in 35% of

40 autopsied human brains (2). In the latter brains, latent HSV-1 DNA

was found in the olfactory bulbs, amygdala, hippocampus, brain stem,

and trigeminal ganglia. Although in these studies it is not known by

which route HSV-1 entered the olfactory bulbs and brain, experimental

studies in mice (3) revealed that injection of HSV-1 into the

olfactory bulbs leads to virus migration into the brain amygdala and

hippocampus via the olfactory nerve and locus coeruleus. If the

olfactory ciliary nerve epithelium is the port of entry of HSV-1 into

the olfactory bulbs and brain in humans as well, protection of the

nose against HSV-1 infection may be needed to prevent virus latency

in neurons in the amygdala and hippocampus (3). Infection of humans by

HSV-1 was estimated to increase from 18.2% in the 0-20 year

population group to 100% in persons older than 60 years (1),

 

***indicating that worldwide human populations at all ages are at

risk of brain infection by the olfactory nerve route.***

 

In addition, both primary infection and reactivation of latent DNA in

the brain may lead to damage of neurons in the brain involved in

memory, learning, and behavior, as observed in infected,

acyclovirtreated mice (3). The current introduction of a live

apathogenic varicella-zoster virus (VZV) vaccine to immunize children

against chickenpox (4) may suggest that the time is ripe for

immunization of children and adults against HSV-1 infections,

especially infections by the olfactory nerve route, to prevent

potential brain damage.

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