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成人轻度头部外伤嗅觉功能障碍的预后因素。

Prognostic Factors for Olfactory Dysfunction in Adult Mild Head Trauma.

机构信息

Department of Neurosurgery, College of Medicine, Mansoura University, Mansoura, Egypt.

Department of Otorhinolaryngology, College of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

World Neurosurg. 2020 Sep;141:e545-e552. doi: 10.1016/j.wneu.2020.05.232. Epub 2020 May 31.

Abstract

BACKGROUND

Although posttraumatic olfactory disturbances are frequent, they have a poor prognosis. Our study aimed to investigate the impact of clinical factors on the progress of these olfactory disturbances.

METHODS

Among patients admitted with evidence of head trauma, only suspected cases of posttraumatic olfactory disturbances were included. Patients were examined by the Sniffin'Sticks test, early posttraumatic and then later after recovery. Such factors as age, sex, olfactory bulb status, and observation period were enrolled in logistic regression analysis, because they are considered to have a possible influence on olfactory function improvements. Amelioration of olfaction was expressed as an alteration in olfactory function to a better level.

RESULTS

A total of 70 patients were involved, with a mean age of 38 years. The mean duration of follow-up was 6 months. Twelve patients (17.1%) had olfactory function improvements. In univariate and multivariate analyses, no clinical factors had an impact on olfactory recovery (all P > 0.05) except olfactory bulb integrity, which appears to influence improvement in olfactory function (P = 0.0327 and 0.0293).

CONCLUSIONS

Olfactory bulb integrity, probably the sole prognostic factor for posttraumatic olfactory recovery, where frank damage to such a structure carries a prognosis of poor posttraumatic olfactory function.

摘要

背景

尽管创伤后嗅觉障碍很常见,但预后较差。我们的研究旨在探讨临床因素对这些嗅觉障碍进展的影响。

方法

在因头部创伤而住院的患者中,仅纳入疑似创伤后嗅觉障碍的病例。通过嗅觉测试(Sniffin'Sticks 测试)对患者进行检查,在创伤后早期和恢复后进行检查。年龄、性别、嗅球状况和观察期等因素被纳入逻辑回归分析,因为这些因素被认为可能对嗅觉功能的改善有影响。嗅觉改善表示嗅觉功能向更好水平的变化。

结果

共纳入 70 例患者,平均年龄为 38 岁。平均随访时间为 6 个月。12 例患者(17.1%)嗅觉功能改善。在单因素和多因素分析中,除嗅球完整性外,没有临床因素对嗅觉恢复有影响(均 P>0.05)(P=0.0327 和 0.0293)。

结论

嗅球完整性可能是创伤后嗅觉恢复的唯一预后因素,嗅球结构的明显损伤预示着创伤后嗅觉功能不佳。

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