上呼吸道感染后嗅觉障碍患者化学感觉功能评估

目的:观察上呼吸道感染后嗅觉障碍（post-viral olfactory dysfunction,PVOD）患者的嗅觉功能、鼻内三叉神经功能和味觉功能变化,探讨PVOD患者化学感觉功能变化的相关性。方法:回顾性分析2019年1—12月在北京安贞医院耳鼻咽喉头颈外科嗅觉味觉中心就诊的PVOD患者42例,其中男20例,女...     

Impact of antibiotics on smell dysfunction

ObjectiveViral or bacterial respiratory infections can cause long-lasting olfactory dysfunction. Antibiotic therapy is indicated in severe cases; however, it is unclear whether antibiotic use produces a positive, negative, or null effect on olfactory function. This retrospective study sought to determine whether antibiotic use has an influence on odor identification and detection threshold test scores of patients with smell dysfunction secondary to upper respiratory infections (URIs), lower respiratory infections (LRIs), or rhinosinusitis.MethodsData from a total of 288 patients presenting to the University of Pennsylvania Smell and Taste Center were evaluated.ResultsPatients with a URI etiology who had taken bactericidal antibiotics had lower detection thresholds than did patients who had not taken antibiotics (P < 0.023; analysis of covariance with age and time since infection onset as covariates). Moreover, thresholds were lower for bactericidal antibiotic users than for bacteriostatic antibiotic users with either URI (P = 0.023) or rhinosinusitis (P = 0.028) etiologies. No meaningful influences of antibiotics on the odor identification test scores were evident.ConclusionsThese findings, which need to be confirmed in prospective double-blind studies, suggest that bactericidal antibiotic therapy may be beneficial in mitigating, at least to some degree, chronic decrements in smell sensitivity due to URIs and rhinosinusitis.     

Analysis of the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection

Background: Olfactory dysfunction is a common symptom during otolaryngology outpatient service.

Objective: To explore the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection (URTI), and its influence factors.

Material and methods: A total of 60 confirmed cases of URTI-induced olfactory dysfunction were enrolled into the present study. The olfactory training lasted for 24 weeks. These patients were tested using Sniffin’ Sticks and threshold-discrimination-identification (TDI) composite scoring before treatment, and at 1, 3 and 6 months after treatment.

Results: It was found that URTI-induced olfactory dysfunction patients had more evident deterioration in odor identification ability. The effective rates of olfactory training on olfactory dysfunction at 1, 3 and 6 months after treatment were 1.67%, 26.67% and 41.67%, respectively. The TDI scores at the 3rd and 6th months, but not at the 1st month, were significantly higher, when compared to those before treatment. The course of diseases was a significant influence factor on the therapeutic effect of olfactory training (OR = 0.805, 95% CI: 0.696–0.931).

Conclusions: Olfactory training can efficiently cure URTI-induced olfactory dysfunction, and in particular, significantly improve the odor discrimination ability and odor identification ability.

Significance: Providing useful data for further research regarding olfactory dysfunction.     

An explanation for the seasonality of acute upper respiratory tract viral infections

Despite a great increase in our understanding of the molecular biology of the viruses associated with acute upper respiratory tract viral infections (URTIs) there is a remarkable lack of knowledge and ideas about why URTI should exhibit a seasonal incidence. Most publications in this area either acknowledge a complete lack of any explanation for the seasonality of URTI or put forward an explanation relating to an increased "crowding" of susceptible persons in winter. This review will discuss some of the ideas concerning the seasonality of URTI and put forward a new hypothesis for discussion, namely that seasonal exposure to cold air causes an increase in the incidence of URTI due to cooling of the nasal airway. The hypothesis is supported by literature reports demonstrating that inhalation of cold air causes cooling of the nasal epithelium, and that this reduction in nasal temperature is sufficient to inhibit respiratory defences against infection such as mucociliary clearance and the phagocytic activity of leukocytes. A case is also made to suggest that warming of the nasal airway during fever and nasal congestion may help to resolve a current URTI.     

Subpopulation of adenoidal lymphocytes of recurrent infection in the upper respiratory tract

A subpopulation of adenoidal lymphocytes was determined by the E-and EAC-rosetting techniques in order to study an immunological profile of adenoids in 61 children with recurrent otitis media, rhinosinusitis or recurrent tonsillitis.Though there was no significant difference in E- and EAC-rosette forming cells of adenoid tissues from children with recurrent infection in the upper respiratory tract, our results indicated the following. (1) A higher proportion of EAC-rosette forming cells (EAC-RFC) without a change of E-RFC was found in the adenoids of children with recurrent tonsillitis than those without it. (2) The percentage of EAC-RFC appears to increase proportionally to the size of adenoid viewed on the X-ray film. (3) The higher percentage was more remarkable in cases with rhinosinusitis and recurrent otitis media. From the data obtained it is concluded that adenoids may play some part in immunity responses against infection in the upper respiratory tract reflecting adenoidal hypertrophy.     

Surgical treatment of breathing troubles in children's upper respiratory tract

The reaction of child's organism to harmful factors is different than that of an adult. The child's organism has greater possibility of regeneration and is still developing. All this should be considered when planning conservative and especially surgical therapy for a patient of formative age. This paper describes in detail surgical therapy of the nases, especially possible reconstruction of the ala nasi, which in this case is of particular importance. It presents modern principles of the surgery of septum deformation and bone pyramids deformation in the nose. The possibility was demonstrated concerning the reconstruction of cartilage deficit in the nasal septum with specials regard for the growth of middle face. Also described are the present day methods of surgery of choane imperforation. Particular attention was devoted to advantages and disadvantages of the surgery through the nasal cavity or through pallatum. The rules have been described concerning preoperative activities as well as preliminary diagnostics and successive stages of surgery specific to patient in the formative years is most frequent diagnosis of congenital anomalies. The children's most frequent congenital anomalies have been discussed and (in the author's opinion) the best way of the operative treatment has been suggested. On the basis of literature and author's own experience endoscopic surgery of the nose and paranasal sinuses have been presented along with preoperative diagnostic, indications for the surgery, and suitable methods as well as against possible complications.     

Lupus of the upper respiratory tract

Lupus is a form of chronic tuberculous infection which can be differentiated from tuberculosis only on clinical grounds. Lupus is very rarefy found in the present era. A 10 year mule child was diagnosed as a case of lupus on clinical and pathological examination