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对在术前和术后接受腺样体扁桃体切除术的儿童进行嗅觉功能的临床评估。

Clinical assessment of olfactory functions in children who underwent adenotonsillectomy during pre- and post-operative period.

作者信息

Altundag Aytug, Salihoglu Murat, Cayonu Melih, Tekeli Hakan

机构信息

Istanbul Surgery Hospital, Division of Otorhinolaryngology, Sisli, Istanbul 34365, Turkey.

Gulhane Military Medical Academy Haydarpaşa Training Hospital, Department of Otorhinolaryngology, Uskudar, Istanbul 34668, Turkey.

出版信息

Int J Pediatr Otorhinolaryngol. 2014 Jul;78(7):1138-42. doi: 10.1016/j.ijporl.2014.04.032. Epub 2014 May 2.

Abstract

OBJECTIVE

The aim of this study was to investigate the changes of both ortho- and retronasal olfactory function in children who underwent adenotonsillectomy (AT) operation due to infectious and/or obstructive adenotonsillar disease.

MATERIAL AND METHODS

A total of 25 children with adenotonsillar disease are included in the study; the children were followed for 6 months in the conducted clinics and underwent AT operation. An age- and sex-matched control group was constituted with 25 healthy children free of adenotonsillar disease. Adenoid and tonsillar hypertrophy was graded according to the subjective size scales. Each subject's orthonasal and retronasal olfactory functions were assessed using odor identification test and retronasal olfactory testing. These tests were performed once, at the beginning of the study, for the control group and performed twice, at the beginning of the study and the third month follow-up, for the disease group. Parents of children in the adenotonsillar disease group filled out a visual analog scale to evaluate the children's appetite at the same time with olfactory testing.

RESULTS

The current investigation produced four major findings: (1) both ortho- and retronasal olfactory abilities of participants were improving following AT operation, (2) adenoid hypertrophy had a significant negative effect on both ortho- and retronasal olfaction, whereas tonsil hypertrophy had significant negative effect only on the retronasal olfactory score, (3) retronasal olfaction was found to be more affected by the adenoid size than the orthonasal, as shown with correlation analysis, and (4) the increase in appetite of children after AT operation had been specified by parents.

CONCLUSIONS

Children with adenotonsillar disease have increased olfaction abilities, namely ortho- and retronasal olfactory function following AT operation. In addition, retronasal olfactory function, an important component of flavor, seems to be more affected than orthonasal function. These results also explain the increased appetite of operated children.

摘要

目的

本研究旨在调查因感染性和/或阻塞性腺样体扁桃体疾病接受腺样体扁桃体切除术(AT)的儿童的前鼻和后鼻嗅觉功能变化。

材料与方法

本研究共纳入25例腺样体扁桃体疾病患儿;这些患儿在相关诊所接受了6个月的随访并接受了AT手术。选取25名无腺样体扁桃体疾病的健康儿童组成年龄和性别匹配的对照组。根据主观大小量表对腺样体和扁桃体肥大进行分级。使用气味识别测试和后鼻嗅觉测试评估每个受试者的前鼻和后鼻嗅觉功能。对照组在研究开始时进行一次这些测试,疾病组在研究开始时和第三个月随访时各进行一次。腺样体扁桃体疾病组患儿的家长在进行嗅觉测试的同时填写视觉模拟量表以评估患儿的食欲。

结果

本次调查产生了四个主要发现:(1)AT手术后参与者的前鼻和后鼻嗅觉能力均有所改善,(2)腺样体肥大对前鼻和后鼻嗅觉均有显著负面影响,而扁桃体肥大仅对后鼻嗅觉评分有显著负面影响,(3)相关性分析表明,后鼻嗅觉比前鼻嗅觉受腺样体大小的影响更大,(4)家长指出AT手术后患儿的食欲有所增加。

结论

患有腺样体扁桃体疾病的儿童在AT手术后嗅觉能力增强,即前鼻和后鼻嗅觉功能增强。此外,作为风味重要组成部分的后鼻嗅觉功能似乎比前鼻功能受影响更大。这些结果也解释了手术患儿食欲增加的原因。

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