Hellings P W, Rombaux P
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
B-ENT. 2009;5 Suppl 13:71-5.
Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in different nasal inflammatory conditions like common cold, allergic rhinitis, and acute and chronic rhinosinusitis with and without nasal polyps (NP). The mechanism underlying olfactory impairment in inflammatory sinonasal disease relates to either the obstruction of the olfactory cleft due to congestion of the nasal mucosa, the presence of secretions or polyps inside the nasal cavity, or to dysfunction of the sensory mucosa of the olfactory bulb resulting from local inflammation. The reduction of smell capacity in nasal inflammatory conditions may have an acute or gradual onset, often with resolution of smell dysfunction after adequate medical treatment or surgery. In contrast to the well documented effects of surgery for rhinosinusitis on smell dysfunction, the available information about the effects of medical treatment is limited. Most studies have looked at corticosteroids, evaluating the restoration of olfactory capacity as a primary or secondary study outcome parameter. Both nasal and systemic corticosteroids have a beneficial effect on olfactory dysfunction, with systemic treatment being the most powerful. This review aims to provide an overview of current knowledge about medical treatment for rhinosinusitis and its effects on smell.
嗅觉功能障碍被认为是导致多种鼻腔炎性疾病（如普通感冒、过敏性鼻炎以及伴有或不伴有鼻息肉的急慢性鼻-鼻窦炎）患者生活质量下降的重要因素。炎性鼻窦疾病导致嗅觉减退的机制，要么是由于鼻黏膜充血致使嗅裂阻塞，鼻腔内存在分泌物或息肉，要么是局部炎症导致嗅球感觉黏膜功能障碍。鼻腔炎性疾病中嗅觉能力的降低可能急性发作，也可能逐渐出现，通常在经过适当的药物治疗或手术后嗅觉功能障碍会得到缓解。与鼻窦炎手术对嗅觉功能障碍的影响已有充分记录不同，关于药物治疗效果的现有信息有限。大多数研究关注的是皮质类固醇，将嗅觉能力的恢复作为主要或次要研究结果参数进行评估。鼻用和全身性皮质类固醇对嗅觉功能障碍均有有益作用，其中全身治疗效果最为显著。本综述旨在概述目前关于鼻窦炎药物治疗及其对嗅觉影响的相关知识。
