Schwartz D N, Mozell M M, Youngentob S L, Leopold D L, Sheehe P R
Department of Physiology, SUNY Health Science Center, Syracuse 13210.
Laryngoscope. 1987 Nov;97(11):1280-6. doi: 10.1288/00005537-198711000-00006.
Hyposmia following laryngectomy is an often recognized phenomenon. A larynx bypass device was used to determine whether this olfactory deficit could be reversed simply by restoring nasal airflow. Odorant detection thresholds and confusion matrix identification tests were administered to laryngectomy and normal comparison groups. Data on nasal airflow characteristics with and without the bypass were also analyzed. The results suggested that restoration of nasal airflow completely reversed the hyposmia for trigeminal nerve stimuli. However, the reversal of hyposmia was not complete for those odorants which primarily, if not exclusively, stimulate the olfactory nerve. This suggested that other factors may contribute to laryngectomy-induced hyposmia for olfatory nerve stimuli. Additionally, nasal airflow analysis revealed that confusion matrix identification scores were depedent upon inspiratory sniff flow rates with and without the larynx bypass. It is argued that rehabilitation for the laryngectomee should include efforts to restore and maintain preoperative olfactory acuity.
喉切除术后嗅觉减退是一种常见的现象。使用一种喉旁路装置来确定这种嗅觉缺陷是否可以通过恢复鼻腔气流而简单地得到逆转。对喉切除组和正常对照组进行了气味检测阈值和混淆矩阵识别测试。还分析了有无旁路时的鼻腔气流特征数据。结果表明,鼻腔气流的恢复完全逆转了三叉神经刺激引起的嗅觉减退。然而,对于那些主要(如果不是唯一)刺激嗅神经的气味剂,嗅觉减退并未完全逆转。这表明其他因素可能导致喉切除术后嗅神经刺激引起的嗅觉减退。此外,鼻腔气流分析显示,混淆矩阵识别分数取决于有无喉旁路时的吸气嗅气流速。有人认为,对喉切除患者的康复治疗应包括努力恢复和维持术前嗅觉敏锐度。