Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Department of Otorhinolaryngology, Ludwig-Maximillian University Hospital (LMU), Munich, Germany.
Eur Arch Otorhinolaryngol. 2023 Sep;280(9):4111-4119. doi: 10.1007/s00405-023-07967-1. Epub 2023 May 9.
This study investigates the impact of etiology on the epidemiologic profile, disease severity, type of treatment and therapy outcome in smell and taste disorders.
This is a retrospective analysis of 270 patients that presented with a smell or taste disorder in a specialized, tertiary care center. An established questionnaire was used to collect data from patients and physicians. Olfactometry was performed with the Sniffin' Sticks test kit, while gustometry was performed by taste strips.
Post-traumatic etiology was associated with young age (median 46 years) and male sex, and showed the most severe degrees of smell loss compared to other etiologies (64.3% anosmia). Postinfectious causes occurred more frequently in females (77.3%) and correlated with a history of pharyngeal surgery, suggesting a vulnerability for virally mediated sensory dysfunction following adenoid/tonsil removal. Parosmia also correlated with both postinfectious etiology (62.5%) and female sex. In sinunasal etiology, the presence of nasal polyps worsened the overall olfactory test score by approximately 50%. In particular, smell threshold and discrimination were reduced, while smell identification was not significantly impacted by nasal polyp obstruction. Sinunasal dysfunction was the only etiology to show significant improvement after therapy (73.9% improved). Finally, we could establish good correlations between the subjective impairment and objective dysfunction for each sensory modality.
Each etiology of chemosensory dysfunction shows particular distributions of variables like sex, age, comorbidities and operations, disease severity, sensory threshold, discrimination and identification. This paper offers a detailed account of the correlations between the cause and the characteristics of smell and taste loss.
本研究旨在探讨病因对嗅觉和味觉障碍的流行病学特征、疾病严重程度、治疗类型和治疗效果的影响。
这是一项对在专门的三级护理中心就诊的 270 名嗅觉或味觉障碍患者的回顾性分析。采用已建立的问卷从患者和医生收集数据。嗅觉测试使用 Sniffin' Sticks 测试试剂盒进行,味觉测试使用味觉条进行。
创伤后病因与年轻(中位数 46 岁)和男性有关,与其他病因相比,嗅觉丧失程度最严重(64.3%的患者为嗅觉丧失)。感染后病因更常见于女性(77.3%),与咽部手术史相关,提示在腺样体/扁桃体切除术后易发生病毒介导的感觉功能障碍。幻嗅也与感染后病因(62.5%)和女性有关。在鼻窦病因中,鼻息肉的存在使总体嗅觉测试评分恶化约 50%。特别是,嗅觉阈值和辨别力降低,而嗅觉识别不受鼻息肉阻塞的显著影响。鼻窦功能障碍是唯一一种在治疗后显示出显著改善的病因(73.9%的患者改善)。最后,我们可以为每种感觉模式的主观障碍和客观功能障碍建立良好的相关性。
每种化学感觉功能障碍的病因都表现出特定的变量分布,如性别、年龄、合并症和手术、疾病严重程度、感觉阈值、辨别力和识别力。本文详细描述了病因与嗅觉和味觉丧失特征之间的相关性。