Guss Joel, Doghramji Laurel, Reger Christine, Chiu Alexander G
Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.
ORL J Otorhinolaryngol Relat Spec. 2009;71(5):268-72. doi: 10.1159/000242429. Epub 2009 Sep 30.
Olfactory dysfunction in patients with allergic rhinitis has long been thought to be secondary to coexisting chronic rhinosinusitis and polyposis with obstruction of airflow over the olfactory epithelium. Recent evidence suggests that the allergic inflammatory infiltrate may itself affect olfaction in the absence of mucosal hypertrophy.
We undertook a study to determine olfactory function in patients with allergic rhinitis in the presence and absence of chronic sinusitis.
Fifty-one subjects with symptoms of rhinitis who presented for allergy testing were administered the University of Pennsylvania Smell Identification Test. In addition each patient underwent computed tomography (CT) scanning of the sinuses.
Eighty percent of subjects were allergic. Subjects with allergic rhinitis and no evidence of sinusitis scored on average in the 30th percentile (95% CI 20-40th percentile) on objective olfactory testing compared to age- and gender-specific norms. Half the allergic patients were classified as normosmic, while half had some degree of hyposmia.
Our study demonstrates that even in the absence of mucosal disease on CT scan, a significant subset of patients with allergic rhinitis will exhibit hyposmia, mostly to a mild or moderate degree. The pathophysiology and potential treatments for olfactory loss in these patients should be further explored.
长期以来，变应性鼻炎患者的嗅觉功能障碍一直被认为是继发于并存的慢性鼻-鼻窦炎和鼻息肉，导致气流阻塞嗅觉上皮。最近的证据表明，在没有黏膜肥大的情况下，变应性炎症浸润本身可能会影响嗅觉。
我们进行了一项研究，以确定有无慢性鼻窦炎的变应性鼻炎患者的嗅觉功能。
对51名因鼻炎症状前来进行变应原检测的受试者进行宾夕法尼亚大学嗅觉识别测试。此外，每位患者均接受鼻窦计算机断层扫描（CT）。
80%的受试者为变应性体质。与年龄和性别特异性标准相比，变应性鼻炎且无鼻窦炎证据的受试者在客观嗅觉测试中的平均得分处于第30百分位（95%可信区间为第20至40百分位）。一半的变应性患者被归类为嗅觉正常，而另一半有一定程度的嗅觉减退。
我们的研究表明，即使CT扫描未显示黏膜疾病，相当一部分变应性鼻炎患者仍会出现嗅觉减退，大多为轻度或中度。这些患者嗅觉丧失的病理生理学和潜在治疗方法应进一步探索。
