Local and systemic administration of corticosteroids in the treatment of olfactory loss
Local and systemic administration of corticosteroids in the treatment of olfactory loss
复制标题
DOI：
10.1177/194589240401800107
复制
发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Hummel, T
中科院分区：
文献类型：
--
作者：
Heilmann, S;Huettenbrink, KB;Hummel, T
背景资料：本研究的目的是评估嗅觉功能障碍患者的利益前局部（A组）或全身（组B）给药的皮质类固醇激素。方法：这揭盲研究进行了嗅觉和味觉门诊诊所的机构转诊中心。包括上呼吸道感染后嗅觉丧失的患者、明显的鼻窦疾病患者和患有“特发性”嗅觉丧失的患者。本文报告莫米松鼻喷雾剂治疗37例慢性鼻窦炎的疗效。此外，在55名患者中分析了口服泼尼松龙的效果，这些患者从40 mg剂量开始，在21天内接受递减剂量。治疗前后的嗅觉功能measured.Results：虽然气味识别分数往往增加（p = 0.05），莫米松鼻喷雾剂并没有显着改善嗅觉功能，当看着整个组的患者或单独分析的三个诊断类别时。相反，在全身给予皮质类固醇后，在所有诊断类别中均观察到嗅觉功能的改善（p < 0.001）。有趣的是，上呼吸道感染后诊断为嗅觉丧失的患者（p = 0.05）和最初诊断为嗅觉丧失的患者的嗅觉功能也有所改善。结论：在许多患者中，局部应用皮质类固醇似乎对嗅觉功能障碍几乎没有或没有积极影响，特别是考虑到长期变化时。病程、患者的年龄/性别或嗅觉异常的存在似乎不能预测皮质类固醇治疗的反应。
Background: The aim of this study was to evaluate the benefit of patients with olfactory dysfunction front local (group A) or systemic (group B) administration of corticosteroids.Methods: This unblinded study was conducted at a smell and taste outpatient clinic of an institutional referral center. Patients with olfactory loss after infections of the upper respiratory tract, patients with apparent sinonasal disease, and patients suffering from "idiopathic" smell loss were included. Effects of mometasone nasal spray, administered for 1-3 months, were studied in 3 7 patients. In addition, effects of oral prednisolone were analyzed in 55 patients who received decreasing doses over 21 days, starting with a dose of 40 mg. Olfactory function before and after treatment was measured.Results: Although odor identification scores tended to increase (p = 0.05), mometasone nasal spray did not significantly improve olfactory function, when looking at the entire group of patients or when analyzing the three diagnostic categories separately. In contrast, after systemic administration of corticosteroids, improvement of olfactory function was seen over all diagnostic categories (p < 0.001). Interestingly, olfactory function also improved in patients diagnosed with olfactory loss after upper respiratory tract infection (p = 0.05) and in patients initially diagnosed with. "idiopathic" olfactory dysfunction (p = 0.008).Conclusion: In many patients, local application of corticosteroids appears to have little or no positive effect on olfactory dysfunction, especially when considering long-term changes. Duration of disease, the patient's age/sex, or the presence of parosmia does not appear to predict the response to therapy with corticosteroids.