鼻腔良性阻塞性病变嗅功能障碍的处理

Treatment to olfactory abnormity caused by benign obstructive diseases of nose

对筛选出的鼻腔良性阻塞性嗅觉异常的39例（62侧）鼻腔进行CT及鼻内窥镜检查，发现因中鼻甲变异致嗅裂消失者14侧（22.58％），筛泡肥大及中鼻道息肉26侧（41．93％），中鼻道合并嗅裂息肉15侧（24.19％），鼻中隔高位偏曲4侧（6.45％）。鼻中隔代偿性肥厚3侧，经功能性鼻窦内窥镜手术处理后，对其嗅觉变化进行了动态观察，发现术后12周嗅觉治愈率为48．4％（30／62），嗅觉好转为25.8％（16／62），25.8％（16／62）无变化。鼻窦炎越严重者，嗅觉恢复越慢，由此认为嗅觉障碍常与中鼻甲变异，窦口鼻道复合体及嗅裂的阻塞和炎症有关，早期处理上述病变，可使嗅觉有较好的恢复。

: Endoscope and Computer Tomograph were used to examine 62 sides of nose in 39 patients with olfactory abnormity. The occlude of olf actory sulcus was found in most patients. 14-sides (22. 58%)were due to the variation of middle turbinate. 26 sides (41. 93%) were due to the hypertrophy of ethmoidal bulla and middle meatus polyp. 15 sides (24. 19% ) were due to the polyp of middle meatus and olfactory sulcus.4 sides (6. 45% ) were due to high positon deviation of nasal septum. Olfactory changes were dynamically observed after endoscope sinus surgery in 62 sides. The olfaction re covered in 48. 4% (30/62) within 12 weeks and 25. 8% (16/62)improved, those with si nusitis and polyps recovered slowly. It is suggested that olfactory abnormity is usually assciated with the occlude of olfactory sulcus, sinusitis and polyp. Treatment in early stage with endoscope is necessary.