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嗅觉障碍的自我报告病程决定了伴有嗅觉丧失的鼻息肉患者手术干预成功的结果。

Self-reported course of olfactory impairment determines outcome for successful surgical intervention in nasal polyps with anosmia.

机构信息

Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.

Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.

出版信息

Acta Otolaryngol. 2020 Dec;140(12):1021-1027. doi: 10.1080/00016489.2020.1805508. Epub 2020 Aug 18.

Abstract

BACKGROUND

Olfactory impairment is one of important symptoms of Chronic rhinosinusitis with nasal polyps (CRSwNP). However, the relationship between course of olfactory impairment and postoperative symptom improvement was still unclear.

OBJECTIVE

The aim of this study was to assess the relationship between the self-reported course of olfactory loss and the degree of improvement in olfaction to determine the timing for successful surgical intervention in improving olfaction in patients with CRSwNP.

MATERIALS AND METHODS

A total of 86 CRSwNP patients with loss of smell and undergoing functional endoscopic sinus surgery (FESS) were recruited consecutively. The self-reported course of smell lose before treatment was recorded. Olfactory function was recorded before and after FESS using T&T Olfactometry.

RESULTS

Fifty-seven patients demonstrated recovery of olfaction and 29 patients no-recovery. The average recovery time of smell loss in the study was 2.6 weeks. The course of smell loss showed moderate accuracy as a marker for determining the timing for successful FESS; with up to 4.5 years of self-reported smell loss being the cut-off point for recovery of smell following FESS.

CONCLUSION

This study suggests that FESS in CRSwNP patients with self-reported significant olfactory impairment for less than 4.5 years may lead to improvement in olfaction.

SIGNIFICANCE

FESS in CRSwNP patients with self-reported significant olfactory impairment persisting for less than 4.5 years may lead to considerable improvement in olfaction in these patients.

摘要

背景

嗅觉障碍是慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)的重要症状之一。然而,嗅觉障碍的病程与术后症状改善之间的关系仍不清楚。

目的

本研究旨在评估自我报告的嗅觉丧失病程与嗅觉改善程度之间的关系,以确定在 CRSwNP 患者中成功手术干预改善嗅觉的时机。

材料和方法

连续招募了 86 例有嗅觉丧失并接受功能性内镜鼻窦手术(FESS)的 CRSwNP 患者。记录治疗前自我报告的嗅觉丧失病程。使用 T&T 嗅觉计在 FESS 前后记录嗅觉功能。

结果

57 例患者嗅觉恢复,29 例患者嗅觉未恢复。研究中嗅觉丧失的平均恢复时间为 2.6 周。嗅觉丧失的病程作为确定 FESS 成功时机的标志物具有中等准确性;自我报告的嗅觉丧失长达 4.5 年是 FESS 后嗅觉恢复的截止点。

结论

本研究表明,对于自我报告有明显嗅觉障碍且持续时间少于 4.5 年的 CRSwNP 患者,FESS 可能会改善嗅觉。

意义

对于自我报告有明显嗅觉障碍且持续时间少于 4.5 年的 CRSwNP 患者,FESS 可能会导致这些患者的嗅觉有相当大的改善。

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