Özkiriş Mahmut, Gencer Zeliha Kapusuz, Aydin Reha, Açikgöz Mustafa, Saydam Levent
*Department of Otolaryngology, Head and Neck Surgery, Bozok University Medical Faculty†Neurology Department of Yozgat State Hospital‡Department of Psychiatry, Bozok University Medical Faculty, Yozgat, Turkey.
J Craniofac Surg. 2017 May;28(3):e203-e207. doi: 10.1097/SCS.0000000000003436.
The olfactory bulb (OB) plays a pivotal role in the processing of olfactory information. The aim of this study was to investigate the OB volume changes and its possible associations with nasal septal deviation.
Cross-sectional study.
Otolaryngology Department of Bozok University School of Medicine and Neurology Department of Yozgat State Hospital.
Ninety patient's cranial magnetic resonance imaging (MRI) studies (46 males and 44 females, mean age 36 ± 13.4 years; range 18-56 years) with isolated nasal septal deviations were recruited for the study. Olfactory bulb volumes in all study subjects were evaluated in T2-weighted coronal MRI images by planimetric manual contouring.
Nasal septal deviation angles were found to range between 5° and 23.21° (mean 13.6° ± 3.58°). The right-sided deviations included 17 mild (<9°, Group I), 20 moderate (9°-15°, Group II), and 16 severe (15° and up, Group III) patients. The left-sided deviations included 14 mild (<9°, Group I), 13 moderate (9°-15°, Group II), and 10 severe (15° and up, Group III) subjects. Olfactory bulb volumes were calculated in both right- and left-sided deviation groups. In the patients with left-sided septal deviations of Groups I, II, and III, the left OB volumes of Groups I, II, and III were 46.49 ± 3.87, 47.46 ± 3.36, and 60.68 ± 5.65 mm and the right OB volumes were 53.37 ± 3.76, 56.47 ± 4.43, and 76.69 ± 6.84 mm, respectively. The statistical evaluation of the right OB volumes did not produce significant difference between Groups I and II (P = 0.73). The authors demonstrated statistically significant differences in comparison of Groups I to III and Groups II to III (P = 0.002 and P = 0.016, respectively). In the right septal deviation group for Groups I, II, and III, mean volumes of right OB volumes were 45.59 ± 4.46, 48.63 ± 3.78, and 61.35 ± 5.84 mm, respectively, and the left OB volumes were 54.67 ± 4.73, 57.65 ± 4.53, and 75.84 ± 7.67 mm, respectively. There was no statistically significant difference between Groups I and II (P = 0.95) left OB volumes in the right-sided deviation group, but statistically significant difference was demonstrated in Groups I to III and Groups II to III compartments (P = 0.002 and P = 0.003).
In our study, while mild and moderate septal deviations lacked any significant affect on OB volumes, severe deviations were found to have significant impact on these parameter. Additionally the contralateral OB volumes in the severe septum deviation group were significantly bigger when compared to the ipsilateral OB volumes. Further multidisciplinary studies are required to evaluate the clinical significance of OB volume changes in diagnosis and follow-up of several otolaryngologic or nonotolaryngologic diseases.
嗅球（OB）在嗅觉信息处理中起关键作用。本研究旨在调查嗅球体积变化及其与鼻中隔偏曲的可能关联。
横断面研究。
博佐克大学医学院耳鼻喉科及约兹加特州立医院神经科。
招募90例孤立性鼻中隔偏曲患者的头颅磁共振成像（MRI）研究资料（46例男性和44例女性，平均年龄36±13.4岁；范围18 - 56岁）。通过平面手动勾勒轮廓，在T2加权冠状位MRI图像上评估所有研究对象的嗅球体积。
发现鼻中隔偏曲角度在5°至23.21°之间（平均13.6°±3.58°）。右侧偏曲包括17例轻度（<9°，I组）、20例中度（9° - 15°，II组）和16例重度（15°及以上，III组）患者。左侧偏曲包括14例轻度（<9°，I组）、13例中度（9° - 15°，II组）和10例重度（15°及以上，III组）受试者。计算了左右侧偏曲组的嗅球体积。在I、II、III组左侧鼻中隔偏曲患者中，I、II和III组的左侧嗅球体积分别为46.49±3.87、47.46±3.36和60.68±5.65mm，右侧嗅球体积分别为53.37±3.76、56.47±4.43和76.69±6.84mm。右侧嗅球体积的统计学评估显示I组和II组之间无显著差异（P = 0.73）。作者在I组与III组以及II组与III组的比较中显示出统计学显著差异（分别为P = 0.002和P = 0.016）。在I、II、III组右侧鼻中隔偏曲组中，右侧嗅球平均体积分别为45.59±4.46、48.63±3.78和61.35±5.84mm，左侧嗅球体积分别为54.67±4.73、57.65±4.53和75.84±7.67mm。右侧偏曲组中I组和II组的左侧嗅球体积无统计学显著差异（P = 0.95），但I组至III组以及II组至III组各部分有统计学显著差异（P = 0.002和P = 0.003）。
在我们的研究中，轻度和中度鼻中隔偏曲对嗅球体积没有显著影响，而重度偏曲对这些参数有显著影响。此外，重度鼻中隔偏曲组中对侧嗅球体积与同侧嗅球体积相比明显更大。需要进一步开展多学科研究，以评估嗅球体积变化在多种耳鼻喉科或非耳鼻喉科疾病诊断和随访中的临床意义。
