功能性内窥镜鼻窦手术对嗅觉及嗅粘膜上皮形态的影响

The Influence of Functional Endoscopic Sinus Surgery for Olfaction and Epithelia of Olfactory Mucosae

【目的】评价功能性内窥镜鼻窦手术对嗅觉及嗅粘膜上皮的影响。【方法】对 2 3例慢性鼻窦炎患者的 37侧鼻腔行功能性内窥镜鼻窦手术 ,术前及术后 3个月测试患者察觉阈及识别阈 ,观察其嗅觉变化 ,同时以免疫组化染色检查其嗅粘膜病理结构。【结果】术后 2 9侧鼻腔察觉阈下降 (78% ) ,3侧提高 (8% ) ,5侧未发生变化 (13% )。而识别阈 2 4侧鼻腔下降(6 4% ) ,6侧提高 (16 % ) ,7侧未发生变化 (18% )。手术前后察觉阈和识别阈分别比较 ,差异有显著性 (P <0 .0 5和P <0 0 0 1)。病理上 ,除嗅粘膜严重损伤致鳞状上皮化生外 ,大部分结构得以改善。嗅粘膜Bowman′s腺细胞的表达在手术后明显高于手术前 (P <0 .0 5 )。【结论】功能性内窥镜鼻窦手术有利于慢性鼻窦炎患者嗅觉的改善。

Objective To evaluate the influence of functional endoscopic sinus surgery for olfaction and epithelia of olfactory mucosae. Methods 23 chronic sinusitis patients with 37 sides were treated with functional endoscopic sinus surgery. The patients′ olfactory detection thresholds (DT) and recognition thresholds (RT) were examined and the pathologic change of olfactory mucosae were observed with immunohistochemistry, preoperatively and three months post-operatively. Results Post-operatively, there were 29 sides DT descended (78%), 3 sides DT increased (8%) and 5 sides DT unchanged (13%). With RT, 24 sides descended (64%), 6 sides increased (16%) and 7 sides unchanged (18%). The difference of DT and RT were statistically significant pre- and post-operatively (P<0.05 and P<0.001, respectively). The improvement were observed in the most specimens of olfactory mucosa after operation. The Bowman′s gland cell of olfactory mucosae significantly higher expressed in post-operatively than pre-operatively (P<0.05). Conclusion Functional endoscopic sinus surgery may improve chronic sinusitis patients′ olfaction.