European Academy Facial Plastic Surgery Fellow, University Hospital Lewisham, London, UK.
ENT Department, James Paget University Hospital NHS Foundation Trust, UK.
Clin Otolaryngol. 2022 Nov;47(6):656-663. doi: 10.1111/coa.13968. Epub 2022 Aug 19.
Olfactory dysfunction (OD) is a common but underreported problem that can significantly impact a patient's quality of life. OD is prevalent in over 5% of the adult population and can be broadly categorised into conductive and sensorineural causes. Magnetic Resonance Imaging (MRI) can form part of the diagnostic work up, although its exact role is often debated.
The aim of this study was to evaluate the value of MRI in managing patients with OD.
DESIGN/METHOD: A retrospective analysis of the records of patients presenting to a national smell and taste clinic over a 5-year period was performed. Variables included demographics, endoscopic findings, final diagnosis, psychophysical smell test and imaging results.
A total of 409 patients, with an age range of 10-93 years, underwent clinical assessment and smell testing, of which 172 patients (42%) had MRI scans. Imaging in younger age-groups was associated with a higher rate of positive findings, however identifiable causes for OD were recorded across the range. MRI provided both diagnostic and prognostic information in those with idiopathic, traumatic and congenital causes of OD. For example, MRI provided information on the extent or absence of gliosis in those with a head trauma history allowing further treatment and prognosis.
We recommend the adjunct use of MRI in patients with a clear history and examination findings of head injury, congenital cases and in apparent idiopathic cases. MRI should be requested to compliment clinical findings with a view to aiding decision-making on treatment and prognosis independent of patient's age.
嗅觉障碍（OD）是一种常见但未被充分报告的问题，可显著影响患者的生活质量。OD 在超过 5%的成年人群中普遍存在，可广泛分为传导性和感觉神经性原因。磁共振成像（MRI）可作为诊断工作的一部分，尽管其确切作用经常存在争议。
本研究旨在评估 MRI 在管理 OD 患者中的价值。
设计/方法：对 5 年内到国家嗅觉味觉诊所就诊的患者记录进行回顾性分析。变量包括人口统计学、内窥镜检查结果、最终诊断、心理物理学嗅觉测试和影像学结果。
共 409 例年龄 10-93 岁的患者接受了临床评估和嗅觉测试，其中 172 例（42%）进行了 MRI 扫描。年轻患者组的影像学阳性率较高，但在整个年龄段均记录到可识别的 OD 原因。MRI 为特发性、创伤性和先天性 OD 患者提供了诊断和预后信息。例如，MRI 提供了头部外伤史患者神经胶质增生的程度或缺失信息，从而进一步进行治疗和预后评估。
我们建议在有明确头部外伤史、先天性病例和明显特发性病例的患者中辅助使用 MRI。应根据临床发现请求 MRI，以帮助独立于患者年龄做出关于治疗和预后的决策。
