Rózańska-Kudelska Małgorzata, Sieśkiewicz Andrzej, Rogowski Marek, Godlewska-Zoładkowska Katarzyna
Klinika Otolaryngologii Uniwersytetu Medycznego w Białymstoku.
Pol Merkur Lekarski. 2010 Apr;28(166):273-6.
One of the most common symptoms of chronic rhinosinusitis with polyps is smell deterioration. Polypectomy and mechanical restoration of patency of the nose not always and not to the same degree leads to the sense of smell improvement. THE AIM OF STUDY was to assess the sense of smell and nasal patency in patients with chronic rhinosinusitis with polyps treated endoscopically during the healing period and the process of functional normalization of the nasal mucosa.
30 patients suffering from chronic rhinosinusitis with polyps treated endoscopically were included in the study. Nasal resistance (anterior rhinomanometry), smell (smell threshold and identification tests) and rhinoscopic findings were assessed and analyzed 1, 3, 6 and 12 months postoperatively.
The most conspicuous decrease of mean nasal resistance was observed in the first control examination (1 month postoperatively) and then further slight improvement continued until sixth postoperative month. Restoration of the patency of the nose yielded only inconsiderable improvement of smell in first postoperative month. Significant improvement of smell could be detected as late as in third and sixth month after the operation. In the twelfth postoperative month slight deterioration of the mean results of smell and nasal patency tests was noted. At the same time control endoscopic examination revealed recurrent polyposis in 26.6% of patients whereas the improvement in mean smell test result in comparison to preoperative results was observed in over 66.6% of patients.
The smell improvement in patients with rhinosinusitis with polyps after endoscopic surgery occurs later than the nasal patency improvement what may be attributed to the process of healing and functional normalization of the nasal mucosa. On average after a year in some patients first clinical symptoms of recurrent disease emerges. Taking in to the consideration chronic and complex nature of the disease it seems reasonable to assess nasal resistance and smell during longer follow up period.
伴有鼻息肉的慢性鼻-鼻窦炎最常见的症状之一是嗅觉减退。息肉切除术以及鼻腔通畅性的机械恢复并不总能且不能同等程度地改善嗅觉。本研究的目的是评估在内镜治疗后愈合期以及鼻黏膜功能正常化过程中,伴有鼻息肉的慢性鼻-鼻窦炎患者的嗅觉和鼻腔通畅性。
本研究纳入了30例接受内镜治疗的伴有鼻息肉的慢性鼻-鼻窦炎患者。在术后1、3、6和12个月评估并分析鼻阻力(前鼻测压法)、嗅觉(嗅觉阈值和识别测试)以及鼻镜检查结果。
在首次对照检查(术后1个月)时观察到平均鼻阻力最显著下降,随后直到术后第6个月持续有轻微改善。鼻腔通畅性的恢复仅在术后第1个月使嗅觉有微不足道的改善。直到术后第3个月和第6个月才能检测到嗅觉有显著改善。在术后第12个月,嗅觉和鼻腔通畅性测试的平均结果出现轻微恶化。与此同时,对照鼻内镜检查显示26.6%的患者有复发性息肉形成,而超过66.6%的患者与术前结果相比,嗅觉测试平均结果有所改善。
内镜手术后伴有鼻息肉的鼻-鼻窦炎患者的嗅觉改善比鼻腔通畅性改善出现得晚,这可能归因于鼻黏膜的愈合和功能正常化过程。平均一年后,一些患者出现复发性疾病的首批临床症状。考虑到该疾病的慢性和复杂性,在更长的随访期内评估鼻阻力和嗅觉似乎是合理的。