慢性鼻-鼻窦炎中的鼻后嗅觉
Retronasal olfaction in chronic rhinosinusitis.
作者信息
Othieno Florence, Schlosser Rodney J, Storck Kristina A, Rowan Nicholas R, Smith Timothy L, Soler Zachary M
机构信息
Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina.
Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, South Carolina.
出版信息
Laryngoscope. 2018 Nov;128(11):2437-2442. doi: 10.1002/lary.27187. Epub 2018 Apr 10.
OBJECTIVE
The goals of this study were to assess retronasal olfaction in patients with chronic rhinosinusitis (CRS) and describe clinical factors that influence retronasal olfaction. This study sought to investigate the influence of retronasal olfaction on patient-perceived outcomes and examine the relationship between retronasal and orthonasal olfaction.
METHODS
Retronasal olfactory function was tested using odorized powders in the oral cavity, whereas Sniffin' Sticks test (Burghart Instruments, Wedel, Germany) were used to assess orthonasal function prospectively in 69 adult CRS patients. Endoscopic evaluation of the olfactory cleft was scored using the Olfactory Cleft Endoscopy Scale (OCES). Several quality-of-life (QOL) instruments relating to sinonasal, olfactory, and chemosensory functions were used to assess the interactions between patient-reported outcome measures and retronasal olfaction.
RESULTS
There was strong correlation between retronasal and total orthonasal olfaction scores (r = 0.77, P < 0.001) as well as retronasal scores with orthonasal subscores. Retronasal scores were worse in patients with nasal polyposis (P = 0.002), asthma (P = 0.04), and aspirin-exacerbated respiratory disease (AERD) (P = 0.02), whereas OCES was the only independent predictor of retronasal olfaction (r = -0.42, P < 0.001). Significant correlation existed between retronasal olfaction and olfactory-specific QOL and chemosensory smell scores.
CONCLUSION
Few studies have examined retronasal olfaction in CRS patients. In this cohort, CRS patients demonstrated deficits in retronasal olfaction, with worse scores in patients with nasal polyposis, asthma, and AERD. Retronasal olfaction scores correlate with degree of inflammation of the olfactory cleft. Retronasal olfaction correlated strongly with orthonasal olfaction and patient-reported smell and taste metrics, although orthonasal olfaction may have a stronger correlation with these metrics.
LEVEL OF EVIDENCE
NA. Laryngoscope, 2437-2442, 2018.
目的
本研究的目的是评估慢性鼻-鼻窦炎（CRS）患者的鼻后嗅觉，并描述影响鼻后嗅觉的临床因素。本研究旨在调查鼻后嗅觉对患者主观感受结果的影响，并探讨鼻后嗅觉与鼻前嗅觉之间的关系。
方法
使用口腔内的嗅味粉末测试鼻后嗅觉功能，而使用Sniffin' Sticks测试（德国韦德尔的Burghart仪器公司）对69例成年CRS患者进行前瞻性鼻前嗅觉功能评估。使用嗅觉裂内镜评分量表（OCES）对嗅觉裂进行内镜评估评分。使用几种与鼻窦、嗅觉和化学感觉功能相关的生活质量（QOL）工具来评估患者报告的结局指标与鼻后嗅觉之间的相互作用。
结果
鼻后嗅觉总分与鼻前嗅觉总分之间存在强相关性（r = 0.77，P < 0.001），鼻后嗅觉评分与鼻前嗅觉各分项评分之间也存在强相关性。鼻息肉患者（P = 0.002）、哮喘患者（P = 0.04）和阿司匹林诱发的呼吸道疾病（AERD）患者（P = 0.02）的鼻后嗅觉评分较差，而OCES是鼻后嗅觉的唯一独立预测因素（r = -0.42，P < 0.001）。鼻后嗅觉与嗅觉特异性QOL及化学感觉嗅觉评分之间存在显著相关性。
结论
很少有研究对CRS患者的鼻后嗅觉进行研究。在这个队列中，CRS患者表现出鼻后嗅觉功能缺陷，鼻息肉、哮喘和AERD患者的评分更差。鼻后嗅觉评分与嗅觉裂的炎症程度相关。鼻后嗅觉与鼻前嗅觉以及患者报告的嗅觉和味觉指标密切相关，尽管鼻前嗅觉可能与这些指标的相关性更强。
证据水平
NA。《喉镜》，2018年，第2437 - 2442页。
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