GATA Haydarpasa Training Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
GATA Haydarpasa Training Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
Braz J Otorhinolaryngol. 2018 Sep-Oct;84(5):630-637. doi: 10.1016/j.bjorl.2017.07.009. Epub 2017 Aug 24.
Idiopathic hypogonadotrophic hypogonadism with an olfactory deficit is defined as Kallmann syndrome and is distinct from normosmic idiopathic hypogonadotrophic hypogonadism.
Because olfactory perception not only consists of orthonasally gained impressions but also involves retronasal olfactory function, in this study we decided to comprehensively evaluate both retronasal and orthonasal olfaction in patients with idiopathic hypogonadotrophic hypogonadism.
This case-control study included 31 controls and 45 idiopathic hypogonadotrophic hypogonadism patients. All participants whose olfactory and taste functions were evaluated with orthonasal olfaction (discrimination, identification and threshold), retronasal olfaction, taste function and olfactory bulb volume measurement. The patients were separated into three groups according to orthonasal olfaction: anosmic idiopathic hypogonadotrophic hypogonadism, hyposmic idiopathic hypogonadotrophic hypogonadism and normosmic idiopathic hypogonadotrophic hypogonadism.
Discrimination, identification and threshold scores of patients with Kallmann syndrome were significantly lower than controls. Threshold scores of patients with normosmic idiopathic hypogonadotrophic hypogonadism. were significantly lower than those of controls, but discrimination and identification scores were not significantly different. Retronasal olfaction was reduced only in the anosmic idiopathic hypogonadotrophic hypogonadism group compared to controls. Identification of bitter, sweet, sour, and salty tastes was not significantly different when compared between the anosmic, hyposmic, and normosmic idiopathic hypogonadotrophic hypogonadism groups and controls. Olfactory bulb volume was lower bilaterally in all patient groups when compared with controls. The olfactory bulb volume of both sides was found to be significantly correlated with threshold, discrimination and identification scores in idiopathic hypogonadotrophic hypogonadism patients.
嗅觉缺陷伴特发性低促性腺激素性性腺功能减退症被定义为卡尔曼综合征，与正常嗅觉特发性低促性腺激素性性腺功能减退症不同。
由于嗅觉感知不仅包括鼻前获得的印象，还包括鼻后嗅觉功能，因此在这项研究中，我们决定全面评估特发性低促性腺激素性性腺功能减退症患者的鼻后和鼻前嗅觉。
这项病例对照研究包括 31 名对照者和 45 名特发性低促性腺激素性性腺功能减退症患者。所有参与者均接受了鼻前嗅觉（辨别力、识别力和阈值）、鼻后嗅觉、味觉功能和嗅球体积测量。根据鼻前嗅觉，将患者分为三组：嗅觉丧失性特发性低促性腺激素性性腺功能减退症、嗅觉减退性特发性低促性腺激素性性腺功能减退症和正常嗅觉性特发性低促性腺激素性性腺功能减退症。
卡尔曼综合征患者的辨别力、识别力和阈值评分明显低于对照组。正常嗅觉性特发性低促性腺激素性性腺功能减退症患者的阈值评分明显低于对照组，但辨别力和识别力评分无显著差异。与对照组相比，仅嗅觉丧失性特发性低促性腺激素性性腺功能减退症患者的鼻后嗅觉减退。与对照组相比，嗅觉丧失、嗅觉减退和正常嗅觉的特发性低促性腺激素性性腺功能减退症患者对苦、甜、酸、咸味道的识别没有显著差异。与对照组相比，所有患者组的双侧嗅球体积均降低。在特发性低促性腺激素性性腺功能减退症患者中，双侧嗅球体积与阈值、辨别力和识别力评分显著相关。
1）对照组和特发性低促性腺激素性性腺功能减退症患者的味觉功能无显著差异；2）仅嗅觉丧失患者的鼻后嗅觉减退，而鼻前嗅觉减退的参与者没有，可能表明存在有效的代偿机制；3）嗅球体积与低促性腺激素性性腺功能减退症组的嗅觉评分高度相关。目前的结果表明，特发性低促性腺激素性性腺功能减退症患者从嗅觉丧失到嗅觉正常存在一个连续体。
