Goektas Oender, Lau Larissa, Olze Heidi
Department of Otolaryngology-Head and Neck Surgery, University of Berlin, Charité Campus Mitte, Smell and Taste Consultation Service, Berlin, Germany.
Indian J Otolaryngol Head Neck Surg. 2013 Aug;65(Suppl 2):402-5. doi: 10.1007/s12070-013-0625-y. Epub 2013 Feb 15.
Chronic rhinosinusitis may cause olfactory dysfunction and affects quality of life in patients. In a prospective study we investigated the effect of topical application of corticosteroids through pressure-pulsed inhalation as treatment option of chronic rhinosinusitis with olfactory disorder. Patients with sinonasal olfactory disorder according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) were allocated to the new nasal inhalation therapy or a systemic corticosteroid therapy, each receiving a corticosteroid course of 12 days. 18 patients received topical corticosteroid pressure-pulsed inhalation (AMSA, Schumacher, Dausenau) and 15 systemic corticosteroid. Olfactory function was measured before and after treatment using the Threshold Discrimination Identification score (TDI score) and visual analogue scales. Lund Mackay score (LMS) was measured before starting treatment. Olfactory function (OF) increased from 17.5 ± 6.4 to 21 ± 7.9 TDI points (p < 0.0005) after 2 months. OF decreased again to 19.5 ± 6.0 after 6 months (p = 0.007). OF increased from 17.0 ± 8.9 to 22.0 ± 9.5 points (p = 0.002) with systemic treatment after 2 months. In the follow-up period of 6 months, the mean TDI score dropped to 20.0 ± 9.2 points (p = 0.01). There was no correlation between LMS and TDI. Treatment of chronic rhinosinusitis with pressure-pulsed inhalation was demonstrated to be effective. Multicenter investigations with large participant numbers are needed.
慢性鼻窦炎可能导致嗅觉功能障碍，并影响患者的生活质量。在一项前瞻性研究中，我们调查了通过压力脉冲吸入局部应用皮质类固醇作为慢性鼻窦炎伴嗅觉障碍治疗方案的效果。根据欧洲鼻窦炎和鼻息肉立场文件（EP3OS）诊断为鼻窦嗅觉障碍的患者被分配接受新的鼻腔吸入疗法或全身皮质类固醇疗法，每种疗法均接受为期12天的皮质类固醇疗程。18例患者接受局部皮质类固醇压力脉冲吸入（AMSA、舒马赫、道塞纳），15例接受全身皮质类固醇治疗。治疗前后使用阈值辨别识别评分（TDI评分）和视觉模拟量表测量嗅觉功能。在开始治疗前测量Lund Mackay评分（LMS）。2个月后，嗅觉功能（OF）从17.5±6.4 TDI点增加到21±7.9 TDI点（p<0.0005）。6个月后，OF再次降至19.5±6.0（p=0.007）。全身治疗2个月后，OF从17.0±8.9分增加到22.0±9.5分（p=0.002）。在6个月的随访期内，平均TDI评分降至20.0±9.2分（p=0.01）。LMS与TDI之间无相关性。压力脉冲吸入治疗慢性鼻窦炎被证明是有效的。需要进行有大量参与者的多中心研究。
