Retronasal olfactory function in nasal polyposis
Retronasal olfactory function in nasal polyposis
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DOI：
10.1097/00005537-200311000-00026
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发表时间：
2003-11-01
期刊：
影响因子：
2.6
通讯作者：
Lacroix, JS
中科院分区：
文献类型：
--
作者：
Landis, BN;Giger, R;Lacroix, JS
目的：探讨慢性鼻窦炎合并鼻息肉病（NP）患者与健康对照者鼻后嗅觉功能是否存在差异。这个问题是基于临床观察，即许多患者出现嗅觉丧失，但没有抱怨对食物的鉴赏能力丧失。研究设计：开放前瞻性研究，将有症状的患者与健康对照进行比较。方法：对56名健康志愿者和42名NP患者进行了鼻前和鼻后气味识别测试。所有受试者均接受详细的鼻内窥镜检查； NP 根据 Malm 分类进行分期。患者根据视觉模拟量表评价他们的嗅觉功能。使用“Sniffin' Sticks”测试套件进行口鼻测试。使用应用于口腔的加味粉末来评估鼻后测试。在这两项测试中，受试者都被要求使用强制选择范式来识别 10 个项目。结果：总体而言，与 NP 患者相比，对照组的气味识别能力更好 (P < .001)。尽管对照组在鼻前和鼻后嗅觉之间没有表现出差异（P = .26），但在 NP 患者中，通过鼻后途径施加气味时，嗅觉功能明显更好（P < .001）。 NP 患者的一般嗅觉能力评级与鼻后和鼻前嗅觉功能相关 (P < .001)，但在健康对照中则不然 (P = .34) 结论：鼻后嗅觉功能优于鼻前嗅觉功能似乎与嗅裂前部存在机械性阻塞有关。反过来，这些数据表明 NP 的嗅觉丧失似乎是由局部机械或炎症因素引起的。
Objective: To investigate the question of whether there is a difference in retronasal olfactory function between patients suffering from chronic rhinosinusitis with nasal polyposis (NP) and healthy controls. This question was based on the clinical observation that many of these patients present with smell loss without complaining about loss of the appreciation of foods. Study Design: Open prospective study comparing symptomatic patients with healthy controls. Methods: A total of 56 healthy volunteers and 42 NP patients were tested for orthonasal and retronasal odor identification. All subjects received detailed nasal endoscopy; NP was staged according to the Malm classification. Patients rated their olfactory function on visual analogue scales. Orthonasal testing was performed using the "Sniffin' Sticks" test kit. Retronasal testing was evaluated with odorized powders applied to the oral cavity. In both tests, subjects were asked to identify 10 items using a forced choice paradigm. Results: Overall, odor identification was better in controls compared with NP patients (P < .001). Although controls exhibited no difference between orthonasal and retronasal smelling (P = .26), in NP patients, olfactory function was significantly better when odors were applied through the retronasal route (P < .001). Ratings of general olfactory abilities correlated with retronasal and orthonasal olfactory function in NP patients (P < .001) but not in healthy controls (P = .34) Conclusion: Better retronasal than orthonasal olfactory function seems to be associated with the presence of mechanical obstruction in the anterior portion of the olfactory cleft. In turn, these data indicate that olfactory loss in NP seems to be caused by regional mechanical or inflammatory factors.