Collet S, Grulois V, Bertrand B, Rombaux P
Department of Otorhinolaryngology -Head & Neck Surgery, Université Catholique de Louvain, Mont-Godinne, Yvoir, Belgium.
B-ENT. 2009;5 Suppl 13:97-107.
Post-traumatic olfactory loss (PTOL) is the third most common aetiology for olfactory disorders. Mechanisms that lead to post-traumatic olfactory disorders include sinonasal affections, damage to the olfactory nerve and lesions of the cerebral olfactory centres. The purpose of this review is to present an update of this condition and to present a cohort study of 90 patients.
A review of the literature was made on Medline Pubmed up to May 2009 and a review was also conducted of patients with post-traumatic olfactory loss.
The degree of olfactory impairment was related to the severity of head trauma and was particularly frequent in cases of occipital impact. Typically, patients experienced a sudden onset of olfactory symptoms and were more severely affected than in other aetiologies. Results from orthonasal and retronasal testing, chemosensory event-related potentials and olfactory bulb (OB) volume confirmed previous findings: patients are usually anosmic, OB volume correlates with the degree of olfactory loss (better correlation with retronasal scores than with orthonasal scores) and olfactory event-related potentials were recorded in only 18 patients.
Accuracy in the evaluation of PTOL patients is based on the expertise and the time spent by the clinician on defining the complaint. Failing treatment, complete evaluation of the PTOL patients may help in counselling for the recovery prognosis, and appropriate counselling must be given to secure the environment and alimentation.
创伤后嗅觉丧失（PTOL）是嗅觉障碍的第三大常见病因。导致创伤后嗅觉障碍的机制包括鼻旁窦病变、嗅神经损伤和大脑嗅觉中枢病变。本综述的目的是介绍这种疾病的最新情况，并展示一项对90例患者的队列研究。
截至2009年5月，在Medline Pubmed上对文献进行了综述，并对创伤后嗅觉丧失患者进行了回顾。
嗅觉损害程度与头部创伤的严重程度相关，在枕部撞击的病例中尤为常见。通常，患者嗅觉症状突然发作，且比其他病因的患者受影响更严重。前鼻和后鼻测试、化学感觉事件相关电位和嗅球（OB）体积的结果证实了先前的发现：患者通常嗅觉缺失，OB体积与嗅觉丧失程度相关（与后鼻评分的相关性优于前鼻评分），仅18例患者记录到嗅觉事件相关电位。
对PTOL患者评估的准确性基于临床医生在定义主诉方面的专业知识和花费的时间。如果治疗失败，对PTOL患者进行全面评估可能有助于对恢复预后进行咨询，并且必须给予适当的咨询以确保环境和营养。
