Objective evaluation of conductive olfactory losses & nasal obstruction symptoms

传导性嗅觉损失的客观评估

• 批准号: 9118609
• 负责人: KAI ZHAO
• 金额: $ 14.91万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2018-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9118609
• 关键词: Acoustic Rhinometry; Adult; Affect; Afferent Pathways; Aftercare; Air; Animals; Anterior; Chronic; Clinical; Computer Simulation; Data; Decongestants; Detection; Diagnostic; Dilator; Disease; Disease Management; Epithelial; Evaluation; Facial Pain; Fiber; Future; Heat Losses; Hypertrophy; Inferior nasal concha; Inflammation; Inflammatory; Liquid substance; Measurement; Measures; Medical; Menthol; Modeling; Mucous Membrane; Nasal Decongestants; Nasal Polyps; Nasal obstruction present finding; Nasal turbinate bone structure; Nose; Obstruction; Odors; Olfactory Epithelium; Operative Surgical Procedures; Outcomes Research; Pathway interactions; Patients; Perception; Population; Property; Recovery; Rhinomanometry; Sensory; Sinus; Site; Skin; Smell Perception; Subgroup; Swelling; Symptoms; Techniques; Testing; Translating; Trigeminal System; Variant; X-Ray Computed Tomography; absorption; base; chronic rhinosinusitis; cohort; effective therapy; food flavor; indexing; loss of function; neuromechanism; novel; olfactory threshold; polyposis; pressure; response; sensory feedback; tool

Project Summary Nasal sinus disease is one of the most common medical conditions in the US, affecting an estimated 13% of adults, or more than 29 million people. Nasal obstruction and smell loss are two of the major symptoms of the disease; however, the field currently lacks a clear, objective understanding to the mechanisms causing these symptoms, which limits effective disease management. For example, patients' complaints of nasal obstruction correlate poorly or inconsistently with objective measurements of actual physical obstruction. Olfactory loss has been widely believed to be induced in part by airflow blockage; however, no tool has been able to quantify or predict such a mechanism. We propose to develop and validate a novel objective diagnostic tool for nasal obstructive symptoms, based on two hypotheses (a) that perception of nasal obstruction (lack of patency) is due to lack of nasal cooling caused by physical nasal conditions, and/or inadequate sensory feedback, and (b) that insufficient conduction of air/odorant flow specifically to the olfactory region contributes to olfactory losses. To test these hypotheses and pursue a clinical tool, we will conduct a study and focus on three aims. In Aim 1, we will use individualized computational fluid dynamics (CFD) nasal models based on patient CT scans to assess insufficient mucosal cooling due to existing airway abnormalities, and determine if this correlates with patient symptom ratings. We will further perturb patients' nasal airway temporarily with a nasal dilator and decongestant and test whether our approach can predict perceptual symptom changes. In Aim 2, we will broadly assess the trigeminal cool sensitivity of patients with the symptom of nasal obstruction, and determine whether abnormal trigeminal cool sensitivity (including the TRPM8 pathway) contributes to symptoms. TRPM8 is a major component of the cool afferent pathway that is also activated chemically, which offers a unique dual investigatory tool and potentially broadens our understanding of chemosensory functions in nasal inflammatory disease. In Aim 3, we will specifically target nasal polyp patients with olfactory losses, track their treatment progress, and determine if the CFD-predicted air transport and odorant sorption rate to the olfactory region correlate with olfactory function losses and recovery. The outcomes from this research may validate how to combine one or several measurements into an effective clinical tool to differentiate the causal factors leading to a patient's conductive symptoms, to potentially identify the site that most affects the symptom, and to guide move effective treatment or surgery in the future.

项目概要 鼻窦疾病是美国最常见的疾病之一，影响着人们 据估计，有 13% 的成年人，即超过 2900 万人。鼻塞和嗅觉丧失是 该疾病的两个主要症状；然而，该领域目前缺乏明确、客观的 了解导致这些症状的机制，这限制了有效的疾病 管理。例如，患者对鼻塞的抱怨相关性较差或 与实际物理障碍的客观测量不一致。嗅觉丧失有 人们普遍认为部分是由气流阻塞引起的；然而，没有工具能够 量化或预测这种机制。 我们建议开发并验证一种新颖的鼻阻塞客观诊断工具 症状，基于两个假设 (a) 鼻塞（缺乏通畅）的感觉是 由于鼻腔物理状况导致鼻腔冷却不足和/或感觉不足 反馈，以及 (b) 空气/气味流向嗅觉的传导不足 该区域会导致嗅觉丧失。为了检验这些假设并寻求临床工具，我们 将进行一项研究，重点关注三个目标。在目标 1 中，我们将使用个性化计算 基于患者 CT 扫描的流体动力学 (CFD) 鼻模型，以评估粘膜不足 由于现有气道异常而导致的降温，并确定这是否与患者相关 症状评级。我们将用鼻扩张器进一步暂时扰乱患者的鼻腔气道 和减充血剂并测试我们的方法是否可以预测感知症状的变化。在 目标2，我们将广泛评估具有以下症状的患者的三叉神经冷敏感性 鼻塞，并判断三叉神经冷敏感是否异常（包括 TRPM8 通路）会导致症状。 TRPM8 是冷传入的主要组成部分 途径也被化学激活，提供了独特的双重研究工具和 可能拓宽我们对鼻腔炎症化学感应功能的理解 疾病。在目标 3 中，我们将专门针对嗅觉丧失的鼻息肉患者，追踪 他们的治疗进展，并确定 CFD 预测的空气传输和气味吸附是否 嗅觉区域的速率与嗅觉功能的丧失和恢复相关。 这项研究的结果可能会验证如何结合一个或多个 将测量结果转化为有效的临床工具，以区分导致疾病的原因 患者的传导症状，以潜在地识别对症状影响最大的部位， 并指导今后采取有效的治疗或手术。