Olfactory dysfunction in patients with head trauma
Olfactory dysfunction in patients with head trauma
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DOI：
10.1001/archneur.1997.00550210061014
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发表时间：
1997-09-01
影响因子：
--
通讯作者：
Lee, WW
中科院分区：
文献类型：
--
作者：
Doty, RL;Yousem, DM;Lee, WW
背景：头部创伤（HT）通常会改变嗅觉能力。然而，这种改变的性质，患病率，预后和病因知之甚少。目的：要定量确定HT相关的chemosensory投诉患者的嗅觉功能的程度，并研究年龄，性别，HT的严重程度，时间HT，和其他变量对这种功能的影响。此外，使用定量磁共振成像（MRI），以建立是否以及在何种程度上损害嗅球和束，额叶，颞叶happening.Patients和方法：二百六十八名患者与HT从宾夕法尼亚大学和味觉中心，费城，进行了定量气味识别测试，抑郁症清单，和病史问卷调查; 66人在1个月至13年的个别重测期后进行了重测。结果：179例（66.8%）患者有嗅觉缺失，55例（20.5%）有微小嗅觉，34例（12.7%）嗅觉正常。正面碰撞比背面或侧面碰撞产生的功能障碍少。在66例重新测试的患者中，24例（36%）略有改善，30例（45%）无变化，12例（18%）恶化;只有3例患者恢复了正常的嗅觉功能，这些患者最初都没有嗅觉丧失。在嗅觉减退患者中，创伤严重程度与嗅觉测试分数相关。嗅觉异常患病率从41.1%下降到15.4%，在一个g年的创伤后时期。嗅球和男性，但不是女性，HT患者的道体积大大减少相对于controls.Conclusions卷：患者抱怨HT相关的嗅觉功能障碍通常有嗅觉缺失，很少恢复正常的嗅觉能力，嗅觉异常患病率随着时间的推移降低，在这样的患者，嗅觉相关的脑结构的损害，可以观察到在大多数这样的患者使用适当的MRI协议。
Background: The ability to smell is commonly altered by head trauma (HT). However, the nature, prevalence, prognosis, and etiology of such alterations are poorly understood.Objectives: To quantitatively determine the degree of olfactory function in patients with HT-related chemosensory complaints and to examine the influences of age, sex, HT severity, time since HT, and other variables on such function. Also, to use quantitative magnetic resonance imaging (MRI) to establish whether and to what degree damage to the olfactory bulbs and tracts, frontal lobes, and temporal lobes occurs.Patients and Methods: Two hundred sixty-eight patients with HT from the University of Pennsylvania Smell and Taste Center, Philadelphia, were administered a quantitative odor identification test, a depression inventory, and a medical history questionnaire; 66 were retested after individual test-retest periods ranging from 1 month to 13 years. The volume of olfactory-related brain structures was determined in 15 patients and 15 controls using MRI.Results: One hundred seventy-nine patients (66.8%) had anosmia, 55 (20.5%) had microsmia, and 34 (12.7%) had normosmia. Frontal impacts produced less dysfunction than back or side impacts. Of the 66 retested patients, 24 (36%) improved slightly, 30 (45%) had no change, and 12 (18%) worsened; only 3 patients, none of whom initially had anosmia, regained normal olfactory function. Trauma severity was related to olfactory test scores in patients with microsmia. Parosmia prevalence decreased from 41.1% to 15.4% over an g-year posttrauma period. Olfactory bulb and tract volumes of male, but not female, patients with HT were greatly reduced relative to volumes of controls.Conclusions: Patients complaining of HT-related olfactory dysfunction typically have anosmia and rarely regain normal olfactory ability, parosmia prevalence decreases over time in such patients, and damage to olfaction-related brain structures can be observed in most such patients using an appropriate MRI protocol.