Olfactory function after functional endoscopic sinus surgery for chronic sinusitis.
Olfactory function after functional endoscopic sinus surgery for chronic sinusitis.
复制标题
慢性鼻窦炎功能性内窥镜鼻窦手术后的嗅觉功能。
作者：
Delank Kw;W. Stoll
对115名慢性鼻窦炎患者进行观察，分析嗅觉功能障碍的发生情况及FESS的影响。术前问卷还通过嗅觉阈值和辨别力检查进行补充。术前，58% 的人意识到或抱怨有嗅觉缺陷。然而，嗅觉测试表明，52% 的人嗅觉减退，31% 的人嗅觉缺失。百分之八的嗅觉减退患者辨别气味的能力个别下降。 70% 的患者术后情况有所改善。 25% 的嗅觉减退患者术后恢复正常嗅觉，但只有 5% 的嗅觉丧失患者恢复正常。 FESS 后 8% 的人嗅觉变差。因此，慢性鼻窦炎术前嗅觉功能障碍的发生率较高，且改善率低于一般假设。通过鼻内息肉病的程度来衡量鼻窦疾病的程度与嗅觉功能障碍相关。由于嗅丝受损或嗅裂内正常空气动力学模式的改变，中鼻甲切除可能对嗅觉产生负面影响。然而，这一假设是基于一些观察，需要通过进一步的调查来验证。
One hundred and fifteen patients suffering from chronic sinusitis were observed to analyse the prevalence of olfactory dysfunction and the influence of FESS. Pre-operative questionnaires were supplemented by examination of olfactory thresholds and discrimination. Pre-operatively, 58% of the collective were aware or complained of any olfactory deficit. However, the olfactory tests demonstrated that of the collective 52% were hyposmic and 31% anosmic. Eight per cent of the hyposmic patients presented with an isolated reduction of their ability to discriminate odours. Post-operative improvements were found in 70%. Normosmia was post-operatively achieved in 25% of the hyposmic patients, but only in 5% of the anosmic patients. Olfaction changed to the worse in 8% after FESS. Therefore, the prevalence of olfactory dysfunction in chronic sinusitis is pre-operatively higher, and the rate of improvement is lower than generally assumed. The extent of sinus disease as measured by the degree of intranasal polyposis correlates with olfactory dysfunction. Resections of the middle turbinate may have a negative effect on olfaction, due to damage to the olfactory fila or alteration of the normal aerodynamic pattern within the olfactory cleft. However, this hypothesis is based on a few observations and needs to be verified by further investigations.