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全喉切除术后的嗅觉和味觉障碍

Smell and Taste Impairment After Total Laryngectomy.

作者信息

Riva Giuseppe, Sensini Matteo, Corvino Andrea, Pecorari Giancarlo, Garzaro Massimiliano

机构信息

1 ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.

出版信息

Ann Otol Rhinol Laryngol. 2017 Jul;126(7):548-554. doi: 10.1177/0003489417709794. Epub 2017 May 16.

Abstract

OBJECTIVE

Aim of this observational study is the evaluation of olfactory and gustatory impairments in laryngectomized long-term survivors compared to control subjects. Correlation between smell and taste alterations, age, and previous adjuvant treatments in laryngectomees was investigated.

METHODS

Fifty control subjects and 50 patients who underwent total laryngectomy for advanced laryngeal carcinoma were evaluated. All subjects underwent symptoms evaluation, oropharyngeal exam, endoscopic fiberoptic nasal examination, and Taste Strips and Sniffin' Sticks tests.

RESULTS

Hyposmia was reported by all laryngectomees and hypogeusia by 54% of patients. Sniffin' Sticks and Taste Strips tests demonstrated a statistically significant difference between controls and laryngectomees regarding olfactory threshold, odor discrimination and identification, Threshold Discrimination Identification (TDI) score, and sour, salty, and gustatory Total Taste score ( P < .05). Multivariate analysis for Total Taste score in laryngectomees showed a statistically significant correlation with aging, having an odds ratio of 0.127 for age ≥65 years, but not with TDI score, radiotherapy, and follow-up time, whereas multivariate analysis for TDI score demonstrated no correlation with radiotherapy, age, and follow-up time.

CONCLUSIONS

Total laryngectomy determines olfactory and gustatory impairments that should be taken into account in clinical practice. Relationships between sensorial alterations, aging, follow-up period, and adjuvant treatments should be further evaluated in prospective studies.

摘要

目的

本观察性研究旨在评估喉切除术后长期存活者与对照受试者相比的嗅觉和味觉障碍。研究了喉切除患者嗅觉和味觉改变、年龄及既往辅助治疗之间的相关性。

方法

对50名对照受试者和50名因晚期喉癌接受全喉切除术的患者进行评估。所有受试者均接受症状评估、口咽检查、鼻纤维内镜检查以及味觉试纸和嗅觉棒测试。

结果

所有喉切除患者均报告有嗅觉减退,54%的患者有味觉减退。嗅觉棒和味觉试纸测试显示,对照者与喉切除患者在嗅觉阈值、气味辨别和识别、阈值辨别识别(TDI)评分以及酸味、咸味和味觉总评分方面存在统计学显著差异(P < .05)。对喉切除患者味觉总评分的多因素分析显示,与年龄存在统计学显著相关性,年龄≥65岁的优势比为0.127,但与TDI评分、放疗及随访时间无关;而对TDI评分的多因素分析表明,与放疗、年龄及随访时间均无相关性。

结论

全喉切除术会导致嗅觉和味觉障碍,临床实践中应予以考虑。感觉改变、年龄、随访期及辅助治疗之间的关系应在前瞻性研究中进一步评估。

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