Surgical approaches to stimulate the olfactory bulb in terms of an "olfactory implant”

Introduction Technological achievements allow an "olfactory implant" to come into the near future. In particular, stimulation in the area of the olfactory bulb seems to be promising for this purpose. However, the surgical approach for electrical stimulation in the olfactory system is unclear.

Methods A human anatomical cadaver study was performed to investigate different endoscopic approaches for electrical stimulation at the level of the olfactory bulb based on the following considerations (1) minimally invasive surgical procedure, (2) good surgical feasibility for experienced ENT surgeons, and (3) close positioning of the electrode to the olfactory bulb.

Results The endoscopic approach to the olfactory bulb via a widened ostium of the fila olfactoria or a Draf IIb demonstrated a close electrode positioning to the olfactory bulb, maintaining manageable potential invasiveness and good surgical feasibility. An endoscopic intranasal electrode positioning showed the least invasiveness and also a low surgical difficulty, but a bigger distance to the olfactory bulb. By combining the external and endonasal approach, an electrode could be positioned close to the olfactory bulb at the expense of higher invasiveness.

Discussion Intra- and extracranial approaches provide good options for positioning an electrode at the olfactory bulb. Currently, a widened ostium of the fila olfactoria or a Draf IIb seems to be promising.

Publication History

Article published online:
12 May 2023