Relation between CT scan findings and human sense of smell
Relation between CT scan findings and human sense of smell
复制标题
DOI：
10.1016/s0194-5998(98)80008-9
复制
发表时间：
1998-02-01
影响因子：
3.4
通讯作者：
Zinreich, SJ
中科院分区：
文献类型：
--
作者：
Hong, SC;Leopold, DA;Zinreich, SJ
在约翰霍普金斯门诊中心，106名患者在接受鼻和鼻窦计算机断层扫描前立即进行症状问卷调查。由两名耳鼻喉科医生和三名神经放射科医生使用36个解剖区域的大小和不透明度的半客观评级系统对他们的扫描进行分析。患者估计他们自己的左右嗅觉是极好的，减弱的，或没有。结果表明：（1）嗅觉能力与鼻腔和鼻窦结构的大小无关。（2）一般情况下，只有左侧解剖结构的混浊与左右嗅觉均相关（p < 0.01）。这表明我们的受试者优先使用左侧嗅觉感受器，而不是右侧嗅觉感受器;（3）左侧嗅裂、额隐窝或筛漏斗的全部而非部分混浊与嗅觉下降相关。这表明嗅裂区域的这些前部结构确实影响气流，但需要完全阻塞这些空间。对鼻窦混浊对嗅觉影响的可能解释包括：（1）鼻窦中存在液体或增厚的粘膜可能通过改变鼻腔气流模式或气味物质进入受体而干扰感知嗅觉能力;（2）鼻窦内可能存在嗅觉受体;（3）鼻窦中的三叉神经受体与嗅觉系统之间可能存在关系。
Symptom questionnaires were obtained from 106 patients immediately before nasal and sinus computed tomography scans at the Johns Hopkins Outpatient Center. Their scans were analyzed by two otolaryngologists and three neuroradiologists by using a semiobjective rating system of the size and opacity of 36 anatomic areas. Patients estimated their own left and right sense of smell as excellent, diminished, or absent. Results of the data are as follows: (1) There is no correlation between smell ability and size of the nasal and sinus structures. This indicates that there is no gross effect of the bulging of sinuses into the nasal airway; (2) As a rule, opacity of only left-sided anatomic structures was correlated with both left and right sense of smell (p < 0.01). This suggests that our subjects were using their left smell receptors preferentially, to the exclusion of and in place of the right smell receptors; and (3) Total, not partial, opacity of the left olfactory cleft, frontal recess, or ethmoidal infundibulum was correlated with decreased sense of smell. This suggests that these anterior structures in the region of the olfactory cleft do affect airflow, but complete obstruction of these spaces is needed. Possible explanations for the effect of opacified sinuses on the sense of smell include (1) The presence of fluid or thickened mucosa in the sinuses may interfere with perceived olfactory ability by changing nasal airflow patterns or odorant access to receptors; (2) There may be olfactory receptors inside the sinuses; and (3) There may be a relation between the trigeminal receptors in the sinuses and the olfactory system.