Rombaux Philippe, Mouraux André, Bertrand Bernard, Nicolas Georges, Duprez Thierry, Hummel Thomas
Department of Otorhinolaryngology, Cliniques Universitaires Saint Luc, Brussels, Belgium.
Laryngoscope. 2006 Jun;116(6):901-5. doi: 10.1097/01.mlg.0000217533.60311.e7.
The aims of this study were to evaluate olfactory function with orthonasal and retronasal testing in patients with posttraumatic olfactory loss and to investigate the relation between residual olfactory function and olfactory bulb (OB) volume.
A retrospective study of 25 patients with posttraumatic olfactory loss was performed. Orthonasal olfactory function was assessed with the Sniffin' Sticks test kit; retronasal olfactory function was assessed with intraorally applied odors. Magnetic resonance imaging was used to determine OB volume and cortical damage in the frontal and temporal areas.
The main outcomes of the present study were the demonstration of a correlation between olfactory function and OB volume, which was more pronounced for retronasal than for orthonasal olfactory function; retronasal olfactory function was most affected in the patients with the most extensive cerebral damage and was least compromised in patients without such damage; OB volumes were smaller in patients with parosmia compared with those without; and the presence of parosmia was clearly associated with the presence of cerebral damage.
The data confirm that OB volume is an indicator of olfactory function but, interestingly, in this study, it is largely determined by retronasal olfactory sensitivity. In addition, these results emphasize the role of higher cortical centers in olfactory function, and especially in parosmia, which may, at least in some cases, be related to lesions in the fronto-orbital and anterior temporal cortices. It would be of interest to investigate OB volume further in relation to the prognosis of the disorder.
本研究旨在通过前鼻和后鼻测试评估创伤后嗅觉丧失患者的嗅觉功能，并探讨残余嗅觉功能与嗅球（OB）体积之间的关系。
对25例创伤后嗅觉丧失患者进行回顾性研究。使用嗅棒测试试剂盒评估前鼻嗅觉功能；通过口腔内施加气味评估后鼻嗅觉功能。利用磁共振成像确定OB体积以及额叶和颞叶区域的皮质损伤情况。
本研究的主要结果表明，嗅觉功能与OB体积之间存在相关性，后鼻嗅觉功能的相关性比前鼻嗅觉功能更明显；后鼻嗅觉功能在脑损伤最广泛的患者中受影响最大，在无此类损伤的患者中受影响最小；嗅觉倒错患者的OB体积比无嗅觉倒错患者小；嗅觉倒错的存在与脑损伤的存在明显相关。
数据证实OB体积是嗅觉功能的一个指标，但有趣的是，在本研究中，它很大程度上由后鼻嗅觉敏感性决定。此外，这些结果强调了高级皮质中枢在嗅觉功能中的作用，尤其是在嗅觉倒错中，嗅觉倒错至少在某些情况下可能与额眶和颞前皮质的病变有关。进一步研究OB体积与该疾病预后的关系将很有意义。
