摘要
目的研究鼻整形术后嗅觉障碍患者鼻腔通气情况以及鼻腔化学感觉电生理功能的变化。方法回顾性分析2014-2023年期间因鼻整形术后嗅觉障碍就诊于北京安贞医院或中日友好医院的30例患者的临床特征[均为女性,年龄(33±6)岁],匹配30名健康志愿者作为对照组[均为女性,年龄(32±9)岁],对两组受试者分别进行嗅觉心理物理测试(Sniffin′Sticks)、嗅觉诱发电位(olfactory event-related potentials,oERPs)、三叉神经诱发电位(trigeminal event-related potentials,tERPs)和鼻声反射检测。采用SPSS 17.0统计软件比较两组间嗅觉功能和鼻腔通气功能检测结果的差异,分析影响鼻整形术后嗅觉功能的相关因素。结果患者组嗅觉心理物理测试得分显著低于对照组[(10.78±3.90)分比(33.66±2.42)分,t=-23.35,P<0.001]。所有患者均可引出诱发电位波形,与对照组相比,患者oERPs和tERPs的N 1波振幅均显著增加(P值均<0.05),N_(1)波潜伏期和P_(2)波形均无明显变化(P值均>0.05)。患者组鼻腔通气功能与对照组相比差异无统计学意义(P值均>0.05),给予鼻腔减充血剂后,患者组距离前鼻孔6 cm水平处鼻腔横截面积(cross-sectional area,CSA)的黏膜充血状态明显(鼻腔充血指数:40.00%比1.00%,t=2.09,P=0.047)。嗅觉功能与鼻腔容积、鼻阈平面CSA、中鼻甲前端平面CSA相关(P值均<0.05)。结论鼻整形术后患者出现嗅觉障碍可能与鼻腔黏膜局部充血有关,而非鼻腔通气功能的改变或者神经功能损伤导致。
ObjectiveThis study aims to evaluate the nasal structural and electrophysiological features of patients with postoperative olfactory dysfunction following aesthetic rhinoplasty.MethodsWe retrospectively analyzed the clinical features of 30 outpatients(females,aged 33±6 years)from Beijing Anzhen Hospital and China-Japan Friendship Hospital between 2014 and 2023,who complained of olfactory dysfunction following aesthetic rhinoplasty.The control group was 30 healthy females aged 32±9 years.Psychophysical olfactory test(Sniffin′Sticks,SS),olfactory and trigeminal event-related potentials(oERPs and tERPs),and acoustic rhinometry were used for evaluating the olfactory function and nasal structure in patients and healthy controls.SPSS 17.0 software was used to compare the difference in olfactory function and nasal structure between the two groups and to analyze the factors related postoperative olfactory dysfunction.ResultsThere was a significant difference in the scores on psychophysical olfactory test between the patients and controls(10.78±3.90 vs.33.66±2.42,t=-23.35,P<0.001).ERPs could be evoked in all patients and controls.Patients showed higher amplitudes of N_(1) waves in both oERPs and tERPs than controls(P<0.05 for all),but no differences in the latencies of N_(1) and P_(2) waves or in the amplitudes of P_(2) waves were observed between the two groups(P>0.05 for all).There was no difference in nasal structure between the two groups(P>0.05).However,after nasal decongestant,mucosal congestion in the cross-sectional area(CSA)from the nostril to 6 cm level was found more significantly in patients than controls(nasal congestion index 40.00%vs.1.00%,t=2.09,P=0.047).Better olfactory function was associated with increasing nasal volumes,increasing nasal threshold and anterior nasal turbinate plane CSA(P<0.05 for all).ConclusionThe important factor related to olfactory dysfunction following aesthetic rhinoplasty may be attributed to local mucosal congestion,rather than nasal structural alteration or neurophysiologic deficits in the olfactory pathway.
作者
刘佳
占小俊
姚淋尹
高星
胡春华
胡雯
刘剑锋
Liu Jia;Zhan Xiaojun;Yao Linyin;Gao Xing;Hu Chunhua;Hu Wen;Liu Jianfeng(Department of Otorhinolaryngology Head and Neck Surgery,Children′s Hospital,Capital Institute of Pediatrics,Beijing 100020,China;Department of Otorhinolaryngology Head and Neck Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Otorhinolaryngology Head and Neck Surgery,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中华耳鼻咽喉头颈外科杂志》
2025年第2期127-133,共7页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
北京市属医院科研"培育计划"(PX2025047)
北京市自然科学基金(7194259)。
关键词
嗅觉障碍
鼻整形术
嗅觉事件相关电位
鼻声反射
发病机制
Olfaction disorders
Aesthetic rhinoplasty
Olfactory event-related potentials
Acoustic rhinometry
Etiology
