Davidson T M, Murphy C, Jalowayski A A
Division of Otolaryngology--Head and Neck Surgery, University of California, School of Medicine, San Diego, USA.
Postgrad Med. 1995 Jul;98(1):107-9, 112-8.
Patients who have lost the sense of smell usually come to a doctor on their own, reporting loss of the sense of taste. Inflammation (often due to allergy), viral infection, and head trauma are common causes of olfactory disturbance. History taking may provide clues to these and other problems (eg, toxin exposure, congenital dysosmia). Workup should not begin until a standardized test has been given that established impairment of the sense of smell. The only truly reversible cause is inflammation, which is confirmed when smell returns after a course of corticosteroid. Sinus computed tomography is necessary to view the olfactory cleft; lack of obstruction indicates that smell impairment is nonreversible. Patients deserve an explanation for their disorder and a prognosis. If restoration of their sense of smell is unlikely, patients should be cautioned to take steps to ensure safety in regard to such dangers as gas leaks, smoke, and spoiled foods.
嗅觉丧失的患者通常会自行前来就医，诉说味觉丧失。炎症（通常由过敏引起）、病毒感染和头部外伤是嗅觉障碍的常见原因。病史采集可能会为这些及其他问题（如接触毒素、先天性嗅觉障碍）提供线索。在进行标准化测试确定嗅觉受损之前，不应开始检查。唯一真正可逆转的原因是炎症，当使用一个疗程的皮质类固醇后嗅觉恢复时即可确诊。鼻窦计算机断层扫描对于观察嗅裂是必要的；没有阻塞表明嗅觉障碍是不可逆的。患者有权了解其病情及预后。如果嗅觉不太可能恢复，应告诫患者采取措施确保在诸如煤气泄漏、烟雾和变质食物等危险情况下的安全。
