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鼻中隔偏曲矫正术后患者的嗅觉和生活质量。

Olfaction and quality of life in patients with nasal septal deviation treated with septoplasty.

机构信息

1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

出版信息

Am J Otolaryngol. 2019 Sep-Oct;40(5):747-754. doi: 10.1016/j.amjoto.2019.07.008. Epub 2019 Jul 16.

Abstract

OBJECTIVE

Patients with septal deviation-induced nasal obstruction may experience olfactory impairment. This study aimed to evaluate septoplasty-related changes in olfactory function and their effect on patients' quality of life (QoL).

METHODS

Prospective study of sixty patients with nasal obstruction and septal deviation and 25 healthy controls. Objective measurements were performed for the evaluation of nasal patency and "Sniffin' sticks" tests were used for quantitative assessment of lateralized and bilateral olfactory performance. All participants self-assessed their smell using a visual analog scale and completed validated questionnaires for nasal obstruction (Nasal Obstruction Symptom Evaluation: NOSE), for nasal symptoms QoL (SinoNasal Outcome Test-22: SNOT-22), for olfaction-associated QoL (Questionnaire of Olfactory Deficits: QOD) preoperatively and six months after septoplasty and reported personal benefit after surgery (Glasgow Benefit Inventory: GBI), six months postoperatively.

RESULTS

Smell was significantly compromised due to septal deviation especially in the more obstructed nasal cavity side. Smell improved significantly after septoplasty (subjective report and olfactory measurements), along with increased nasal patency. Increased nasal cavity volume was significantly correlated with olfactory thresholds but not with suprathreshold measurements. Subjective hyposmia and lateralized olfaction were significantly reduced postoperatively. Postoperatively, normosmic patients reported higher personal benefit from surgery than patients with olfactory disorders. The patients' QoL improved significantly, but it remained lower than the controls' group. Olfaction-associated QoL was not significantly different between patients and controls before and after septoplasty.

CONCLUSION

Septoplasty leads to improvement in smell perception, and patients with improved smell report greater personal benefit from septoplasty than patients with remaining olfactory deficits.

摘要

目的

鼻中隔偏曲引起的鼻阻塞患者可能会出现嗅觉障碍。本研究旨在评估鼻中隔成形术相关的嗅觉功能变化及其对患者生活质量(QoL)的影响。

方法

前瞻性研究了 60 例鼻塞和鼻中隔偏曲患者和 25 例健康对照者。客观测量用于评估鼻腔通畅度,“Sniffin' sticks”测试用于定量评估单侧和双侧嗅觉功能。所有参与者使用视觉模拟量表自我评估嗅觉,并在术前和鼻中隔成形术后 6 个月完成了针对鼻塞的鼻腔阻塞症状评估(NOSE)、针对鼻部症状的生活质量(SNOT-22)、针对嗅觉相关的生活质量(QOD)的调查问卷,并报告了术后 6 个月的个人受益(Glasgow 受益量表:GBI)。

结果

鼻中隔偏曲导致嗅觉明显受损,尤其是在阻塞更严重的鼻腔侧。鼻中隔成形术后嗅觉明显改善(主观报告和嗅觉测量),同时鼻腔通畅度增加。鼻腔容积增加与嗅觉阈值显著相关,但与阈上测量无关。术后主观嗅觉减退和单侧嗅觉明显减少。术后,嗅觉正常的患者报告手术带来的个人受益高于嗅觉障碍患者。患者的生活质量显著改善,但仍低于对照组。嗅觉相关的生活质量在鼻中隔成形术前和术后与患者和对照组之间没有显著差异。

结论

鼻中隔成形术可改善嗅觉感知,嗅觉改善的患者报告鼻中隔成形术带来的个人受益大于仍存在嗅觉缺陷的患者。

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