Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology Head and Neck Surgery, The Affiliated Children's Hospital, Capital Institute of Pediatrics, Yabao Road 2, Beijing, 100020, China.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6477-6483. doi: 10.1007/s00405-024-08945-x. Epub 2024 Sep 6.
Smell ability is associated with nasopharyngeal obstruction. Herein, we evaluated the effect of nasopharyngeal obstruction by adenoid hypertrophy on the olfactory bulb (OB) volume and olfactory sulcus (OS) depth in children.
A total of 135 children who were candidates for brain magnetic resonance imagining scanning were enrolled in the study. The olfactory disorder-negative statements questionnaire was utilized to assess the patient-reported olfactory status. A validated sleep questionnaire was used to assess sleeping status. According to the adenoidal/nasopharyngeal (A/N) ratio, the children were divided into two groups: those with an A/N ratio ≤ 0.5 (n = 70) and those with an A/N ratio > 0.5 (n = 65). OB volume and OS depth measurements were performed on coronal T2-weighted images using planimetric manual contouring. The mean OB volumes and OS depths on the right and left sides were used for the evaluation.
The mean OB volume of the group with an A/N ratio > 0.5 was significantly lower than that of the group with an A/N ratio ≤ 0.5 (P = 0.003), while there was no difference in the mean OS depth between groups (P = 0.061). In those with an A/N ratio > 0.5, the mean OB volume in older children (aged 9-12 years) was significantly lower than that in younger children (aged 5-8 years) (P = 0.012). In terms of laterality, the OS depth on the right side was significantly larger than that on the left side in both groups (P = 0.039 and P = 0.001). In the group with an A/N ratio ≤ 0.5, the OB volume on the right side was also significantly larger than that on the left side (P = 0.040); however, no such difference was observed in the group with an A/N ratio > 0.5 (P = 0.630). No sex-based differences were evident for any variable.
Children with nasopharyngeal obstruction greater than 50% have a significantly smaller OB volume. Our results suggest that morphological alterations in OB may contribute to the pathogenic mechanism of olfactory dysfunction related to nasopharyngeal obstruction.
嗅觉能力与鼻咽阻塞有关。在此，我们评估了腺样体肥大引起的鼻咽阻塞对儿童嗅球（OB）体积和嗅沟（OS）深度的影响。
共有 135 名候选行脑部磁共振成像扫描的儿童被纳入本研究。采用嗅觉障碍阴性陈述问卷评估患者的嗅觉状况。使用经过验证的睡眠问卷评估睡眠状况。根据腺样体/鼻咽（A/N）比值，将儿童分为两组：A/N 比值≤0.5（n=70）和 A/N 比值>0.5（n=65）。使用冠状 T2 加权图像上的平面手动轮廓测量 OB 体积和 OS 深度。评估右侧和左侧的平均 OB 体积和 OS 深度。
A/N 比值>0.5 组的平均 OB 体积明显低于 A/N 比值≤0.5 组（P=0.003），而两组间的平均 OS 深度无差异（P=0.061）。在 A/N 比值>0.5 的儿童中，9-12 岁的大龄儿童的平均 OB 体积明显低于 5-8 岁的儿童（P=0.012）。就侧别而言，两组中右侧 OS 深度明显大于左侧（P=0.039 和 P=0.001）。在 A/N 比值≤0.5 的组中，右侧 OB 体积也明显大于左侧（P=0.040）；然而，在 A/N 比值>0.5 的组中则未见差异（P=0.630）。任何变量均无性别差异。
鼻咽阻塞超过 50%的儿童 OB 体积明显较小。我们的结果表明，OB 的形态改变可能有助于解释与鼻咽阻塞相关的嗅觉功能障碍的发病机制。
