Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.
Eur Arch Otorhinolaryngol. 2010 Oct;267(10):1563-7. doi: 10.1007/s00405-010-1240-0. Epub 2010 Apr 9.
The objective of this study was to treat posttraumatic anosmia with oral steroid and evaluate its effect. One-hundred sixteen posttraumatic patients whose olfactory thresholds were -1.0 by the phenyl ethyl alcohol threshold test assembled in our department. They were treated with a course of high-dose steroid, and followed up for at least 3 months. During the latter period of this study, magnetic resonance imaging was performed to measure the volumes of olfactory bulbs and to detect subfrontal lobe damage. Among them, 19 (16.4%) patients' olfactory thresholds improved after steroid treatment, but the other 97 patients' thresholds did not change. The incidences of loss of consciousness and intracranial hemorrhage after head injury, the ratios of admission and craniotomy, the intervals between head injury and steroid treatment, the volumes of olfactory bulbs, and the incidences of subfrontal lobe damage were not significantly different between patients whose thresholds improved and those whose thresholds did not improve. However, patients with olfactory improvement were significantly younger than those who remained unchanged. Our study showed that oral steroid treatment might improve olfactory acuity in some patients with posttraumatic anosmia, but the possibility of spontaneous recovery cannot be ruled out.
本研究旨在通过口服类固醇治疗创伤后嗅觉缺失，并评估其疗效。我们科室共收治了 116 例创伤后嗅觉阈值为-1.0 的患者，他们接受了一个疗程的高剂量类固醇治疗，并至少随访了 3 个月。在此研究的后期，我们进行了磁共振成像，以测量嗅球体积并检测额叶下损伤。其中，19 例（16.4%）患者的嗅觉阈值在类固醇治疗后得到改善，但其余 97 例患者的阈值没有变化。在改善和未改善嗅觉阈值的患者之间，受伤后意识丧失和颅内出血的发生率、入院和开颅手术的比例、头部受伤和类固醇治疗之间的时间间隔、嗅球体积以及额叶下损伤的发生率没有显著差异。然而，嗅觉改善的患者明显比嗅觉未改善的患者年轻。我们的研究表明，口服类固醇治疗可能会改善一些创伤后嗅觉缺失患者的嗅觉敏锐度，但不能排除自发恢复的可能性。
