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经鼻内镜经筛板入路切除嗅沟脑膜瘤后的幻嗅和味觉障碍

Phantosmia and Dysgeusia following Endoscopic Transcribriform Approaches to Olfactory Groove Meningiomas.

作者信息

Venteicher Andrew S, Kumar Jay I, Murphy Emma A, Gray Stacey T, Holbrook Eric H, Curry William T

机构信息

Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States.

出版信息

J Neurol Surg B Skull Base. 2017 Jun;78(3):245-250. doi: 10.1055/s-0036-1597925. Epub 2017 Jan 18.

Abstract

The endoscopic, endonasal transcribriform approach (EETA) is an important technique used to directly access the anterior skull base and is increasingly being used in the management of olfactory groove meningiomas (OGMs). As this approach requires removal of the cribriform plate and olfactory epithelium en route to the tumor, patients are anosmic postoperatively. Here, we report the development of phantosmia and dysgeusia in two patients who underwent EETAs for OGMs, which has not yet been reported in the literature. We hypothesize that phantosmia and dysgeusia may result from aberrant neuronal signals or misinterpretation centrally from the remaining distal portions of the olfactory and taste pathways. Since EETAs are newer than traditional open craniotomy-based techniques, reporting these outcomes will be important to appropriately counsel patients preoperatively.

摘要

鼻内镜经筛板入路(EETA)是一种用于直接进入前颅底的重要技术,越来越多地应用于嗅沟脑膜瘤(OGM)的治疗。由于该入路在到达肿瘤的途中需要切除筛板和嗅上皮,患者术后会出现嗅觉丧失。在此,我们报告了两名因OGM接受EETA手术的患者出现嗅觉幻觉和味觉障碍的情况,这在文献中尚未见报道。我们推测,嗅觉幻觉和味觉障碍可能是由于嗅觉和味觉通路剩余远端部分的异常神经元信号或中枢的错误解读所致。由于EETA比传统的基于开颅手术的技术更新,报告这些结果对于术前适当地向患者提供咨询非常重要。

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本文引用的文献

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Risk factors for hazardous events in olfactory-impaired patients.嗅觉障碍患者发生危险事件的危险因素。
JAMA Otolaryngol Head Neck Surg. 2014 Oct;140(10):951-5. doi: 10.1001/jamaoto.2014.1675.
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