Downey L L, Jacobs J B, Lebowitz R A
Department of Otolaryngology, New York University School of Medicine, NY 10016, USA.
Otolaryngol Head Neck Surg. 1996 Jul;115(1):24-8. doi: 10.1016/S0194-5998(96)70131-6.
Chronic sinus disease associated with progressive mucosal disease is often a cause for anosmia. Despite aggressive allergic, medical, and surgical intervention, long-term relief of anosmia has been difficult to document. Fifty patients sought treatment for subjective anosmia and symptoms of progressive sinusitis and underwent endoscopic sinus surgery. After surgery 52% maintained significant improvement in smell by subjective measures that correlated with objective olfactory University of Pennsylvania Small Identification test ("UPSIT") results. Of the remaining patients, some had intermittent improvement, but most remained hyposmic or anosmic despite clinically well-healed ethmoid surgical beds. Of the preoperative and postoperative historical, clinical, and radiological data analyzed, severity of the presenting sinus disease (defined as stage II In the Kennedy staging criteria or disease extending beyond the ethmoids on preoperative computed tomography scan) and persistent mucosal disease in the surgical bed are associated with persistent anosmia (p = 0.005).
与进行性黏膜疾病相关的慢性鼻窦疾病常常是嗅觉丧失的一个原因。尽管采取了积极的抗过敏、药物及手术干预措施，但嗅觉丧失的长期缓解情况仍难以得到证实。50例因主观嗅觉丧失及进行性鼻窦炎症状而寻求治疗的患者接受了鼻内镜鼻窦手术。术后，通过与客观嗅觉宾夕法尼亚大学嗅觉识别测试（“UPSIT”）结果相关的主观测量方法，52%的患者嗅觉保持显著改善。其余患者中，一些有间歇性改善，但大多数尽管筛窦手术创面在临床上已愈合良好，仍存在嗅觉减退或嗅觉丧失。在所分析的术前及术后的病史、临床及放射学数据中，所呈现的鼻窦疾病的严重程度（根据肯尼迪分期标准定义为II期，或术前计算机断层扫描显示疾病超出筛窦范围）及手术创面持续存在的黏膜疾病与持续性嗅觉丧失相关（p = 0.005）。
