嗅裂及窦口鼻道复合体阻塞对慢性鼻-鼻窦炎嗅觉的影响不同。
Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
出版信息
Laryngoscope. 2020 Oct;130(10):2311-2318. doi: 10.1002/lary.28332. Epub 2019 Oct 11.
OBJECTIVES
Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opacification, sinus opacification, and olfactory function in patients with CRS.
METHODS
One hundred and forty-eight patients with CRS were prospectively enrolled across five institutions. Olfactory function was evaluated using the Sniffin' Sticks tests (Burghardt, Wedel, Germany) and the 17-item Questionnaire of Olfactory Disorders (QOD-NS). Computed tomography (CT) scans for each patient were acquired and Lund-Mackay scores recorded. Opacification of the OC was determined using OsiriX MD (Pixmeo, Bernex, Switzerland) and correlated with olfaction scores.
RESULTS
A total of 148 CRS patients, 73 CRS without nasal polyps (CRSsNP) and 75 CRS with nasal polyps (CRSwNP), as well as 30 control subjects were enrolled. Overall OC opacification averaged 63.7% in CRS patients and 47.1% in control subjects (P < 0.001). In the overall cohort, OC opacification significantly correlated with threshold, discrimination, and identification (TDI) (r = -0.520; P < 0.001) and QOD-NS scores (r = 0.374; P < 0.001). CRSwNP patients demonstrated a significant correlation between OC opacification and TDI scores (r = -0.464; P < 0.001) but not the CRSsNP group (r = -0.143; P = 0.229). Lund-Mackay score correlated with TDI in both the CRSsNP (r = -0.300; P = 0.010) and CRSwNP (r = -0.271; P = 0.019) groups.
CONCLUSION
CT opacification is associated with olfactory dysfunction differentially based on nasal polyp status. Smell loss in CRSwNP correlated with both OC opacification and Lund-Mackay score, whereas CRSsNP correlated only with Lund-Mackay score, indicating different relationships between olfactory function and local inflammatory processes in these disorders.
LEVEL OF EVIDENCE
2 Laryngoscope, 130:2311-2318, 2020.
目的
先前的研究表明，在慢性鼻-鼻窦炎（CRS）患者中，嗅裂（OC）混浊与嗅觉相关。然而，在没有息肉的患者中，结果尚不清楚。本研究旨在进一步探讨 CRS 患者 OC 混浊、窦腔混浊与嗅觉功能之间的关系。
方法
前瞻性纳入来自五家机构的 148 例 CRS 患者。使用嗅觉测试棒（Burghardt、Wedel、德国）和嗅觉障碍 17 项问卷（QOD-NS）评估嗅觉功能。对每位患者进行计算机断层扫描（CT）扫描并记录 Lund-Mackay 评分。使用 OsiriX MD（Pixmeo、Bernex、瑞士）确定 OC 混浊程度，并与嗅觉评分相关联。
结果
共纳入 148 例 CRS 患者，73 例 CRS 无鼻息肉（CRSsNP）和 75 例 CRS 伴鼻息肉（CRSwNP），以及 30 例对照。CRS 患者的 OC 混浊平均为 63.7%，对照组为 47.1%（P<0.001）。在整个队列中，OC 混浊与阈值、辨别力和识别力（TDI）（r=-0.520；P<0.001）和 QOD-NS 评分（r=0.374；P<0.001）显著相关。CRSwNP 患者的 OC 混浊与 TDI 评分之间存在显著相关性（r=-0.464；P<0.001），而 CRSsNP 组无相关性（r=-0.143；P=0.229）。Lund-Mackay 评分与 CRSsNP（r=-0.300；P=0.010）和 CRSwNP（r=-0.271；P=0.019）组的 TDI 相关。
结论
基于鼻息肉状态，CT 混浊与嗅觉功能障碍呈不同相关性。CRSwNP 的嗅觉丧失与 OC 混浊和 Lund-Mackay 评分均相关，而 CRSsNP 仅与 Lund-Mackay 评分相关，表明在这些疾病中，嗅觉功能与局部炎症过程之间存在不同的关系。
证据等级
2 级 Laryngoscope，130：2311-2318，2020。
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