Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology - Head & Neck Surgery, Hospital Clínic i Universitari de Barcelona, Barcelona, Spain.
Respir Med. 2011 Jan;105(1):44-9. doi: 10.1016/j.rmed.2010.10.019.
The aim of the study was to evaluate the sense of smell in patients with bronchiectasis.
Prospective controlled study was performed on 91 patients with bronchiectasis. Bronchiectasis patients were sub-classified depending on: the presence of chronic rhinosinusitis, with or without nasal polyps, and the bronchiectasis ethiology. Olfactory function was evaluated by means of the Barcelona Smell Test (BAST-24) olfactometry for detection, identification, and forced choice for the first and fifth cranial nerve dependent odours in comparison to a group of 120 healthy volunteers.
Most patients with bronchiectasis (80.2%) satisfied EP(3)OS criteria of chronic rhinosinusitis (CRS), and 26.4% presented nasal polyps (NP). Smell detection, identification, and forced choice tests were significantly (p < 0.001) worse in bronchiectasis patients than healthy controls for both the 1st and 5th CN. Among subgroups, patients with CRS presented a significant (p < 0.05) reduction in smell detection compared to both healthy controls and patients without CRS. Patients with both CRS and NP presented a significant (p < 0.01) reduction in both smell detection and forced choice compared to patients with CRS and without NP. Patients with bronchiectasis and primary humoral immunodeficiency had a poorer smell detection (p < 0.001) and forced choice (p < 0.001) compared with post-infective and idiopathic bronchiectasis patients.
Patients with bronchiectasis have a moderate loss of smell with a higher impairment in patients with CRS, being maximal in patients with NP. Patients with immunodeficiency bronchiectasis showed high prevalence of CRS, and therefore marked impairment on the sense of smell. The mechanism could be explained through a mixed ethiology (obstruction/inflammation).
本研究旨在评估支气管扩张症患者的嗅觉。
对 91 例支气管扩张症患者进行前瞻性对照研究。根据慢性鼻-鼻窦炎（CRS）的存在情况，有无鼻息肉，以及支气管扩张症的病因，对支气管扩张症患者进行分类。采用巴塞罗那嗅觉测试（BAST-24）嗅觉仪评估嗅觉功能，比较两组患者：一组为 120 名健康志愿者，检测、识别和选择第一和第五颅神经依赖的气味。
大多数支气管扩张症患者（80.2%）符合慢性鼻-鼻窦炎（CRS）的 EP(3)OS 标准，26.4%有鼻息肉（NP）。与健康对照组相比，支气管扩张症患者的嗅觉检测、识别和强制选择测试均显著（p<0.001）下降，第一和第五颅神经均如此。在亚组中，CRS 患者的嗅觉检测明显（p<0.05）低于健康对照组和无 CRS 患者。同时患有 CRS 和 NP 的患者，嗅觉检测和强制选择均明显（p<0.01）低于仅患有 CRS 且无 NP 的患者。与感染后和特发性支气管扩张症患者相比，患有原发性体液免疫缺陷的支气管扩张症患者的嗅觉检测（p<0.001）和强制选择（p<0.001）能力更差。
支气管扩张症患者嗅觉丧失程度中等，CRS 患者嗅觉损害程度更高，NP 患者损害程度最大。免疫缺陷性支气管扩张症患者 CRS 发病率高，因此嗅觉严重受损。其机制可能是由于混合病因（阻塞/炎症）所致。
