The cribriform plate represents a transition from the base of the skull to the face at the upper aspect of the nose. The cribriform plate plays a role in the passage of olfactory nerves and disruption of this can lead to partial or total anosmia. A review of the incidence and factors involved in this sensory loss caused by trauma has been summarized.10 It is therefore intuitive to understand that disruption of the sensory fibers passing through this region can lead to permanent smell alteration. Fig. 5 demonstrates a Lefort II fracture whereby the nasal bone separated from the cranial base and was displaced 1-cm posteriorly as the maxilla-nasal complex rotated up and back as a single unit. This patient had resultant permanent anosmia.

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