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嗅觉功能障碍对鼻塞及鼻中隔偏曲患者心理状态和生活质量的影响

The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation.

作者信息

Valsamidis Konstantinos, Printza Athanasia, Constantinidis Jannis, Triaridis Stefanos

机构信息

1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece.

出版信息

Int Arch Otorhinolaryngol. 2020 Apr;24(2):e237-e246. doi: 10.1055/s-0040-1701269. Epub 2020 Feb 27.

Abstract

Olfactory dysfunction may be present in patients with nasal obstruction and septal deviation. The impact of olfactory dysfunction on the psychological profile and quality of life (QoL) of these patients remains unexplored.  The present study aimed to investigate the emotional status and QoL of patients with olfactory dysfunction and septal deviation and to identify predictors associated with clinically significant improvement of psychological status and QoL, focusing mainly on the role of olfactory recovery after septoplasty.  The olfactory function was quantitatively assessed using the ''Sniffin' sticks'' test (Burghart Messtechnik GmbH, Wedel, Germany) in 60 patients and 25 controls enrolled in this prospective study. The participants completed validated questionnaires specific for general health (Short Form-36), nasal-symptom related QoL (SinoNasal Outcome Test-22), olfaction-associated QoL (Questionnaire of Olfactory Deficits) and for assessing their psychological state (Short Anxiety Screening Test and Beck Depression Inventory) preoperatively and 6 months postoperatively. The patients used the Glasgow Benefit Inventory to evaluate their personal benefit after septoplasty with.  Septoplasty led to significantly improved olfactory function. Patients with olfactory impairment had significantly lower nasal-symptom related QoL, higher stress levels, and more depressive mood compared with normosmics and controls before and after septoplasty. Postoperatively, personal benefit from surgery was higher in normosmic patients. Improvement of nasal-symptom related QoL was significantly associated with higher likelihood of clinically significant improvement of patients' psychological profile and more personal benefit from surgery. Olfactory dysfunction was negatively correlated with the emotional status of the patients.  Olfactory dysfunction appears to significantly affect the psychological status of patients with nasal obstruction, and olfactory recovery improves the patients' perception of personal benefit from septoplasty.

摘要

嗅觉功能障碍可能存在于鼻塞和鼻中隔偏曲的患者中。嗅觉功能障碍对这些患者心理状况和生活质量(QoL)的影响仍未得到探索。

本研究旨在调查嗅觉功能障碍和鼻中隔偏曲患者的情绪状态和生活质量,并确定与心理状态和生活质量临床显著改善相关的预测因素,主要关注鼻中隔成形术后嗅觉恢复的作用。

在这项前瞻性研究中,使用“嗅觉棒”测试(德国韦德尔市布尔哈特测量技术有限公司)对60例患者和25名对照者进行嗅觉功能的定量评估。参与者在术前和术后6个月完成了针对一般健康状况(简短健康调查问卷-36)、鼻症状相关生活质量(鼻鼻窦结局测试-22)、嗅觉相关生活质量(嗅觉缺陷问卷)以及评估其心理状态(简短焦虑筛查测试和贝克抑郁量表)的有效问卷。患者使用格拉斯哥效益量表评估鼻中隔成形术后的个人获益情况。

鼻中隔成形术使嗅觉功能显著改善。与鼻中隔成形术前和术后的嗅觉正常者及对照者相比,嗅觉受损患者的鼻症状相关生活质量显著更低,压力水平更高,抑郁情绪更严重。术后,嗅觉正常患者从手术中获得的个人获益更高。鼻症状相关生活质量的改善与患者心理状况临床显著改善的可能性更高以及从手术中获得更多个人获益显著相关。嗅觉功能障碍与患者的情绪状态呈负相关。

嗅觉功能障碍似乎显著影响鼻塞患者的心理状态,而嗅觉恢复可改善患者对鼻中隔成形术个人获益的感知。

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