改良嗅觉训练结合糖皮质激素治疗上呼吸道感染后嗅觉障碍的临床初步观察

目的 观察改良嗅觉训练结合糖皮质激素治疗上呼吸道感染后嗅觉功能障碍的效果.方法 纳入47例湖州市中心医院耳鼻咽喉科门诊诊断为上呼吸道感染后嗅觉障碍患者,随机分为口服糖皮质激素结合嗅觉训练组和单纯口服糖皮质激素组.口服糖皮质激素结合嗅觉训练组先给予甲泼尼龙片口服14 d疗程,然后运用嗅觉试剂:土耳其玫瑰、马达加斯加柠檬尤...     

上呼吸道感染后嗅觉障碍的治疗进展

上呼吸道感染是嗅觉障碍最常见的原因之一。一般认为上呼吸道感染后嗅觉障碍主要是由病毒损伤嗅觉通路引起,故又称病毒感染后嗅觉障碍（post-viral olfactory dysfunction,PVOD）。由于PVOD的发病机制尚不明确,到目前为止没有确切的方法可治愈该病,但一些药物和补充疗法已经使用。本文针对该病治疗的研究现状做一综述。     

普米克令舒治疗上呼吸道感染后嗅觉障碍的疗效观察

目的 探讨普米克令舒鼻腔雾化治疗上呼吸道感染后嗅觉障碍的疗效.方法 对照组41例,治疗组42例,均口服VitA、VitE、ATP、甲钴铵等治疗;治疗组加用普米克令舒1mg+生理盐水10ml鼻腔雾化.结果 治疗组总有效率78.6％,对照组总有效率58.5％,两组比较差异有统计学意义(P＜0.05).结论 普米克令舒鼻腔雾化治疗上呼吸道感染后嗅觉障碍有较好疗效.     

慢性鼻窦炎与嗅觉障碍

鼻 鼻窦炎性病变是引起嗅觉障碍的最常见原因之一〔1〕。基础研究表明 ,鼻窦慢性炎症可对嗅觉功能产生直接或间接的不良影响。而在临床治疗方面 ,鼻内窥镜外科 (ｅｎｄｏｓｃｏｐｉｃｓｉｎｕｓｓｕｒｇｅｒｙ ,ＥＳＳ)技术的应用为慢性鼻窦炎患者嗅觉障碍的改善创造了良好条件     

嗅觉训练治疗嗅觉障碍的研究进展

嗅觉障碍是一种可对患者的生活质量产生严重影响的疾病,同时也被证明与多种疾病存在一定的相关性。传统的嗅觉障碍治疗手段主要包括通过手术治疗和应用药物治疗,但往往有时并不能取得期待的效果。近年来嗅觉训练作为一种全新的治疗嗅觉障碍的手段得到了众多专家及学者的关注。本文综述了应用嗅觉训练治疗嗅觉障碍的最新研究进展,为其基础研究与临床应用提供一定的参考。     

上呼吸道感染后嗅觉障碍的相关研究

嗅觉障碍是耳鼻咽喉科常见症状,包括嗅觉减退、嗅觉丧失、嗅觉过敏、嗅觉倒错和幻嗅,临床上以前两者多见.造成嗅觉障碍的原因很多,包括上呼吸道感染、鼻和鼻窦疾病、外伤、先天和遗传因素、有害气体及放射线损伤等.     

鼻窦炎鼻息肉术后嗅觉障碍的原因分析及治疗

鼻窦炎鼻息肉是嗅觉障碍的常见原因,但临床往往重视鼻窦炎鼻息肉的治疗而忽视嗅觉障碍的存在,我院2000-01—2007—12收治的80例（149侧）鼻窦炎鼻息肉患者术后嗅觉障碍不能恢复,现就原因及治疗进行探讨。     

嗅觉训练治疗嗅觉障碍的临床观察

目的初步探讨复杂香味进行嗅觉训练对外伤或上呼吸道感染引起的嗅觉障碍的疗效。方法2016年12月~2018年3月于中国医科大学附属第一医院门诊收治的外伤及上呼吸道感染后嗅觉障碍患者36例,其中男12例,女24例;年龄20~80岁,平均年龄（47.61±16.68）岁,病程3~60个月,平均病程（13.58±13.51）个月。分别按病因分为上呼吸道感染组（19例）和外伤组（17例）,按嗅觉下降程度分为嗅觉下降组（18例）和嗅觉丧失组（18例）。均采用患者自行购买的4种味道明显不同的香水进行嗅觉训练,治疗前后进行嗅觉综合VAS评分,并分别对香味、臭味进行嗅觉评分。用Fisher确切概率法进行统计学分析。结果所有患者均完成治疗方案,总有效率为55.56%（20/36）。嗅觉下降组有效率77.78%（14/18）,嗅觉丧失组有效率33.33%（6/18）,经比较差异具有统计学意义（P<0.05）。上呼吸道感染后嗅觉障碍组有效率73.68%（14/19）,外伤后嗅觉障碍组有效率35.29%（6/17）,经比较差异具有统计学意义（P<0.05）。治疗有效患者中50.00%（10/20）对香味感知的恢复明显优于臭味,经比较差异具有统计学意义（P<0.05）。结论本研究所采用的嗅觉训练方案具有简便易行、灵活度高、患者负担轻、患者依从度高的特点,对嗅觉障碍患者有一定的疗效,其中对有残余嗅觉的患者疗效更显著,上呼吸道感染引起的嗅觉障碍比外伤后的嗅觉障碍更易于恢复。另外,嗅觉训练通常采用香味嗅剂,因而有重要警示作用的臭味嗅觉恢复明显落后于香味,应该受到重视。     

上呼吸道感染后嗅觉障碍预后因素分析

目的:分析上呼吸道感染后嗅觉障碍(PVOD)患者主客观嗅觉功能测试结果,评估预后因素,为临床诊疗提供依据.方法:回顾性分析就诊于首都医科大学附属北京安贞医院门诊的PVOD患者,给予嗅觉训练治疗4个月,对患者治疗前后进行Sniffin'Sticks嗅觉测试,根据嗅觉功能改善情况分为嗅觉功能改善组和嗅觉功能无改善组,分析患...     

嗅觉障碍和嗅觉功能检查

嗅觉是一个很重要的感觉 ,但与视觉、听觉相比其研究显著滞后。主要表现在对嗅觉的中枢解剖通路、嗅觉机制、嗅觉障碍机制和治疗了解甚少 ,缺乏准确行嗅觉功能定性和定量检查的客观方法。另外 ,嗅觉功能有Ⅴ、Ⅸ、Ⅹ脑神经的参与 ,还受心理因素的影响 ,增加了嗅觉功能研究的难度。嗅觉在人类生命活动中起着非常重要的作用 ,其不仅有报警作用 ,还和生活质量密切相关 ,而且一些疾病的早期表现为嗅觉的改变。 2 0世纪 70年代美国国家神经和交流障碍与中风咨询委员会估计有 2 0 0万美国人有味觉或嗅觉障碍。晚近统计 ,国家地球协会和Monell化学…     

Infiltration of India ink from subarachnoid space to nasal mucosa along olfactory nerves in rabbits

The mode of the transportation of India ink to the nasal cavity was studied when it was given to the subarachnoid space chiefly through facial nerve sheath and partly by cisterna magna injection. From subarachnoid space India ink infiltrated through perineurium, epineurium and perineural space of the fila olfactoria and of olfactory nerve fibers to lamina propria of the olfactory mucosa and spread also to the respiratory mucosa. It was further taken into lymphatic vessels and accumulated in bilateral cervical lymph nodes. In normal rabbits, India ink didn't penetrate the basement membrane into the epithelial layer at all, but in rabbits with chronic rhinitis showing edema, degeneration and destruction of mucosa, India ink was found to pass easily through the basement membrane into the epithelial layer and further to leak into the nasal cavity in all cases. It was a new finding that in cases with rhinitis large particles like India ink could infiltrate from the subarachnoid space to the nasal cavity passing through the nasal mucosa, and was considered to be a possible cause of idiopathic cerebrospinal fluid rhinorrhea.     

鼻腔嗅神经母细胞瘤6例报告

目的探讨鼻腔嗅神经母细胞瘤的临床表现、病理、诊断、鉴别诊断及治疗.方法诊治鼻腔嗅神经母细胞瘤6例,B期4例,C期2例,均行手术加放射治疗.结果B期患者2年生存率50%,3年生存率25%.C期患者2年生存率50%,5年生存率50%.结论鼻腔嗅神经母细胞瘤B、C期患者手术加放疗是最佳的治疗方案.     

Respiratory epithelial adenomatoid hamartoma of bilateral olfactory clefts associated with nasal polyposis: Three cases report and literature review

We report three cases of patients with respiratory epithelial adenomatoid hamartoma (REAH) of bilateral olfactory clefts associated with nasal polyposis. REAH is a kind of rare lesion which commonly occurs in nasal cavity, paranasal sinuses, and nasopharynx. Our cases were all localized in bilateral olfactory clefts which is very rare since the most common site reported in the past in nasal cavity is the posterior nasal septum and unilateral. Furthermore, our presented cases all associated with nasal polyposis which can provide greater evidence that inflammation can induce REAH development. Although REAH is benign lesion it can probably continue developing after operation if REAH was not completely resected. So during endoscopic sinus surgery (ESS), complete resection of the lesions is key point in successfully treatment of REAH. Although REAH arising from the rhinosinusal region is very rare rhinolaryngologists should know this entity thoroughly in order to differentiate it from inverted papilloma and adenocarcinoma since misinterpretation of this lesion may result in aggressive surgery for a benign lesion which could greatly affect patient's quality of life after operation.     

鼻内镜治疗慢性鼻窦炎嗅觉障碍的临床病理学研究

目的探讨鼻内镜治疗慢性鼻窦炎嗅觉障碍的临床疗效与嗅黏膜病理学变化的关系。方法对52例(104侧)嗅觉障碍病人行功能性鼻内镜手术(FESS),同时辅助药物治疗,并对治疗前后嗅黏膜进行了组织学观察及统计学分析。结果104侧嗅黏膜术前均发现有病理组织学的改变,以嗅细胞的减少占首位,为73%(73/100);其次是嗅上皮萎缩,为49%(49/100);4侧呼吸上皮化生。Ⅰ型与Ⅱ型相比术前嗅细胞减少、嗅上皮萎缩,差异有统计学意义(P<0.05)。术后随访6个月,嗅觉恢复66.3%,嗅觉改善23.1%,为嗅上皮正常或轻中度病变者;嗅觉无变化10.6%,为嗅上皮中重度病变和呼吸上皮化生者。各临床分型于术前、术后在嗅细胞减少、嗅上皮萎缩,差异有统计学意义(P<0.01)。结论慢性鼻窦炎分型与嗅上皮病理学变化明显相关,嗅细胞减少、嗅上皮萎缩是嗅觉障碍的病理学基础,鼻内镜技术是治疗嗅觉障碍的有效方法,药物治疗明显提高疗效。     

Hazardous events associated with impaired olfactory function

OBJECTIVE: To evaluate the risk of olfactory-related hazardous events in patients with impaired olfactory function. DESIGN: Retrospective cohort study. SETTING: A university-based clinic for smell and taste disorders. PATIENTS: A total of 445 patients who underwent olfactory testing between 1983 and 2001. INTERVENTIONS: Patient interview, olfactory testing. MAIN OUTCOME MEASURES: (1) Frequency of olfactory-related hazardous events including cooking incidents (ie, burning pots or pans), undetected fires, undetected gas leaks, and ingestion of spoiled foods or toxic substances; (2) level of olfactory function (anosmia; severe, moderate, or mild hyposmia; or normosmia) as determined by olfactory testing. RESULTS: Olfactory testing revealed that 76% of patients had some degree of impairment; 30% had complete anosmia. Thirty-seven percent of patients with olfactory impairment but only 19% of patients without impairment experienced at least 1 olfactory-related hazardous event. Of the hazardous events reported by impaired patients, cooking-related incidents were most common, representing 45%, with ingestion of spoiled food (25%), inability to detect a gas leak (23%), and inability to smell a fire (7%) reported less frequently. There was a significant correlation between frequency of hazardous events and degree of olfactory impairment (Cochran-Armitage trend test, P<.001): at least 1 hazardous event was reported by 45.2% of patients with anosmia, 34.1% with severe hyposmia, 32.8% with moderate hyposmia, 24.2% with mild hyposmia, and 19.0% of patients with with normal olfaction by testing. CONCLUSION: Patients with impaired olfactory function are more likely to experience olfactory-related hazardous events than those with normal olfactory function.