面部轮廓整形后嗅觉障碍的治疗

Treatment of olfactory dysfunction after facial contouring correction

目的 探讨面部轮廓整形术后嗅觉障碍并发症的临床特征和治疗方法。方法回顾性分析了以面部轮廓整形术后嗅觉完全丧失患者12例，对患者的病史、常规口腔检查、鼻腔内镜检查及嗅觉功能检查结果进行分析，2例患者行头颅CT和磁共振成像检查。结果全部患者随访12个月，口内切口无感染，均为I期愈合，面部轮廓均满意。经抗生素＋糖皮质激素＋维生素联合治疗，1例3个月后嗅觉恢复，2例6个月后嗅觉恢复，1例12个月后嗅觉恢复；2例3个月后嗅觉部分改善，6个月后嗅觉完全恢复；2例12个月后嗅觉部分改善；4例嗅觉完全丧失。结论面部轮廓整形术后嗅觉障碍是一种的严重并发症。抗生素、糖皮质激素及维生素治疗对部分患者有效。

Objective To report a new complication of olfactory dysfunction of postfacial con- tour correction and to summarize the clinical characteristics and the effect of therapy. Methods A total of 12 cases of olfactory dysfunction after facial contour correction were reviewed and evaluated by the oral and nasal thorough medical history, routine examination, simple olfactory test, and nasal endoscopy. 2 patients were checked up on sinonasal computerized tomography imaging and magnetic res onance imaging. All patients accepted trial therapy including antibiotics, corticosteroid and vitamin. Results Anosmia was determined in all patients by simple olfactory testing. The bilateral olfactory cleft with a little mueosal red and swollen was seen during endoscopy, no clear obstruction of airway was identified in CT and MRI performed without abnormal findings, and obvious abnormal structure of the olfactory pathway was not found. 12 patients were treated with antibiotics, glucocorticoid and vitamin and were followed up for 12 months. Operative incision of all patients was primarily healing without infections. Facial contour reached the patient requirements and face type pleased. 1 case got olfactory rehabilitation with trial medical therapy after 3 months, the recovery of 2 cases after six months, and one case recovered after one year. Olfactory function were partly improved in 2 cases after 3 months, recovered completely after 6 months; olfactory partial improvement noted in 2 patients after one year; 4 cases had complete loss of smell. Conclusions The olfactory dysfunction of postfacial contouring correction is a severe complication of facial contour correction. Antibiotics, corticosteroids and vitamin therapy are effective for some patients.