Apter A J, Mott A E, Cain W S, Spiro J D, Barwick M C
Department of Medicine, University of Connecticut Health Center, Farmington 06030.
J Allergy Clin Immunol. 1992 Oct;90(4 Pt 1):670-80. doi: 10.1016/0091-6749(92)90141-n.
Olfactory loss is of importance for allergists to investigate in their patients, because if it is due to either allergic rhinitis or nonallergic rhinitis, it is potentially reversible. One should be sure to consider nasal polyposis and inflammation from chronic sinusitis, especially of the ethmoidal sinuses. Simple screening in the office can be achieved with an odor identification test of widely available substances as described above. Should there be no response to treatment or if the patient has a history of chronic sinusitis, recalcitrant nasal polyposis, or previous otolaryngologic procedures, further evaluation including rhinoscopy may be required. Recent olfactory loss in the absence of nasal symptoms and in the absence of abnormalities in the nasal cavity should suggest further investigation to look for a more central process. Morphologic investigation with electron microscopy of the olfactory epithelium and the superior nasal cavity is just beginning. The impact of inflammation in this area awaits investigation.
嗅觉丧失对于过敏症专科医生而言，在其患者中进行调查很重要，因为如果嗅觉丧失是由变应性鼻炎或非变应性鼻炎引起的，那么它有可能是可逆的。必须要考虑鼻息肉以及慢性鼻窦炎（尤其是筛窦炎）引发的炎症。如上文所述，在诊室里通过对广泛可得物质进行气味识别测试即可实现简单筛查。如果对治疗无反应，或者患者有慢性鼻窦炎病史、难治性鼻息肉或既往耳鼻喉科手术史，则可能需要进一步评估，包括鼻镜检查。近期在无鼻部症状且鼻腔无异常的情况下出现嗅觉丧失，应提示进行进一步检查以寻找更中枢性的病因。对嗅觉上皮和鼻腔上部进行电子显微镜形态学研究才刚刚开始。该区域炎症的影响有待研究。
