山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (3): 43-49.doi: 10.6040/j.issn.1673-3770.0.2022.041

• 研究进展 • 上一篇    下一篇

慢性鼻窦炎相关嗅觉功能障碍研究进展

王欢1,胡俐1,余洪猛1,2   

  1. 2018RU003), 上海 200030
  • 发布日期:2022-06-15
  • 通讯作者: 余洪猛. E-mail:hongmengyush@163.com
  • 基金资助:
    国家自然科学基金面上项目(81970856);国家自然科学基金青年基金项目(82000953);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-003);上海市科学技术委员会科技创新行动计划基础研究项目(21JC1401100)

Research progress of olfactory dysfunction in chronic rhinosinusitis

WANG Huan1, HU Li1Overview,YU Hongmeng1,2   

  1. 1. Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital Affiliated to Fudan University, Shanghai 200031, China;
    2. Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor(2018RU003), Chinese Academy of Medical Sciences, Shanghai 200031, China
  • Published:2022-06-15

PDF (PC)

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摘要： 嗅觉功能障碍是慢性鼻窦炎患者最主要的临床症状之一,严重影响患者的生活质量。随着经济水平发展和社会进步,慢性鼻窦炎患者对嗅觉功能改善的诉求也有进一步的提升,如何评估慢性鼻窦炎患者嗅觉障碍的严重程度以及选择合适有效的治疗方式成为鼻科医生面对的临床问题。据此,重点阐述慢性鼻窦炎相关嗅觉功能障碍的主客观评估以及治疗方面取得的进展,希冀促进更多鼻科医生关注慢性鼻窦炎患者嗅觉障碍问题,提高嗅觉障碍的诊疗水平。

关键词: 慢性鼻窦炎, 嗅觉障碍, 内镜鼻窦手术, 激素, 生物治疗

Abstract: Olfactory dysfunction, one of the main clinical symptoms in patients with chronic rhinosinusitis, seriously affects patients' quality of life. With improved socio-economic circumstances and social progress, demands for the improvement of olfactory function in patients with chronic rhinosinusitis have increased. Rhinologists, therefore, should be able to assess the severity of anosmia in chronic rhinosinusitis and choose appropriate and effective treatment methods. Accordingly, this article focuses on discussing the evaluation tools and treatment progress that has emerged in recent years to assist rhinologists with improving their diagnosis and treatment of this condition.

Key words: Chronic rhinosinusitis, Olfactory dysfunction, Endoscopic sinus surgery, Steroid, Biologic therapy

中图分类号: 

  • R765.4
[1] Shi JB, Fu QL, Zhang H, et al. Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities[J]. Allergy, 2015, 70(5): 533-539. doi:10.1111/all.12577.
[2] Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe: an underestimated disease. A GA2LEN study[J]. Allergy, 2011, 66(9): 1216-1223. doi:10.1111/j.1398-9995.2011.02646.x.
[3] Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020[J]. Rhinology, 2020, 58(Suppl S29): 1-464. doi:10.4193/Rhin20.600.
[4] Kohli P, Naik AN, Harruff EE, et al. The prevalence of olfactory dysfunction in chronic rhinosinusitis[J]. Laryngoscope, 2017, 127(2): 309-320. doi:10.1002/lary.26316.
[5] Zhao K, Jiang JB, Pribitkin EA, et al. Conductive olfactory losses in chronic rhinosinusitis? A computational fluid dynamics study of 29 patients[J]. Int Forum Allergy Rhinol, 2014, 4(4): 298-308. doi:10.1002/alr.21272.
[6] Doty RL, Mishra A. Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis[J]. Laryngoscope, 2001, 111(3): 409-423. doi:10.1097/00005537-200103000-00008.
[7] 陶丹丹, 董红军, 褚云锋, 等. 慢性鼻-鼻窦炎伴鼻息肉患者组织嗜酸性粒细胞与嗅觉功能障碍的相关性研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 16-20. doi:10.6040/j.issn.1673-3770.0.2019.388. TAO Dandan, DONG Hongjun, CHU Yunfeng, et al. Correlation between eosinophils and olfactory dysfunction in patients with CRSwNP after nasal operation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 16-20. doi:10.6040/j.issn.1673-3770.0.2019.388.
[8] Wu J, Chandra RK, Li P, et al. Olfactory and middle meatal cytokine levels correlate with olfactory function in chronic rhinosinusitis[J]. Laryngoscope, 2018, 128(9): E304-E310. doi:10.1002/lary.27112.
[9] Wu D, Li Y, Bleier BS, Wei Y. Superior turbinate eosinophilia predicts olfactory decline in patients with chronic rhinosinusitis[J]. Ann Allergy Asthma Immunol, 2020, 125(3):304-310. doi: 10.1016/j.anai.2020.04.027.
[10] Yee KK, Pribitkin EA, Cowart BJ, et al. Analysis of the olfactory mucosa in chronic rhinosinusitis[J]. Ann N Y Acad Sci, 2009, 1170(1): 590-595. doi:10.1111/j.1749-6632.2009.04364.x.
[11] Yee KK, Pribitkin EA, Cowart BJ, et al. Neuropathology of the olfactory mucosa in chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2010, 24(2): 110-120. doi:10.2500/ajra.2010.24.3435.
[12] Victores AJ, Chen MF, Smith A, et al. Olfactory loss in chronic rhinosinusitis is associated with neuronal activation of c-Jun N-terminal kinase[J]. Int Forum Allergy Rhinol, 2018, 8(3): 415-420. doi:10.1002/alr.22053.
[13] Kikuta S, Kuboki A, Yamasoba T. Protective effect of insulin in mouse nasal mucus against olfactory epithelium injury[J]. Front Neural Circuits, 2021, 15: 803769. doi:10.3389/fncir.2021.803769.
[14] Rouyar A, Classe M, Gorski R, et al. Type 2/Th2-driven inflammation impairs olfactory sensory neurogenesis in mouse chronic rhinosinusitis model[J]. Allergy, 2019, 74(3): 549-559. doi:10.1111/all.13559.
[15] Han PF, Whitcroft KL, Fischer J, et al. Olfactory brain gray matter volume reduction in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2017, 7(6): 551-556. doi:10.1002/alr.21922.
[16] Shehata EM, Tomoum MO, Amer MA, Alarabawy RA, Eltomey MA. Olfactory bulb neuroplasticity: a prospective cohort study in patients with chronic rhinosinusitis with nasal polyps[J]. Clin Otolaryngol, 2018, 43(6):1528-1534. doi: 10.1111/coa.13202.
[17] Güllmar D, Seeliger T, Gudziol H, et al. Improvement of olfactory function after sinus surgery correlates with white matter properties measured by diffusion tensor imaging[J]. Neuroscience, 2017, 360: 190-196. doi:10.1016/j.neuroscience.2017.07.070.
[18] Ren WW, Wang L, Zhang XJ, et al. Expansion of murine and human olfactory epithelium/mucosa colonies and generation of mature olfactory sensory neurons under chemically defined conditions[J]. Theranostics, 2021, 11(2): 684-699. doi:10.7150/thno.46750.
[19] Frasnelli J, Hummel T. Olfactory dysfunction and daily life[J]. Eur Arch Otorhinolaryngol, 2005, 262(3):231-235. doi: 10.1007/s00405-004-0796-y.
[20] Simopoulos E, Katotomichelakis M, Gouveris H, et al. Olfaction-associated quality of life in chronic rhinosinusitis: adaptation and validation of an olfaction-specific questionnaire[J]. Laryngoscope, 2012, 122(7): 1450-1454. doi:10.1002/lary.23349.
[21] Mattos JL, Bodner TE, Mace JC, et al. Psychometric properties of the brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2021, 11(10): 1436-1442. doi:10.1002/alr.22800.
[22] DeConde AS, Mace JC, Alt JA, et al. Longitudinal improvement and stability of the SNOT-22 survey in the evaluation of surgical management for chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2015, 5(3): 233-239. doi:10.1002/alr.21458.
[23] 金晓峰, 王剑, 李永金, 等. 简体中文版本嗅觉障碍生活质量量表的信度和效度分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(18): 1423-1429. doi:10.13201/j.issn.1001-1781.2016.18.001. JIN Xiaofeng, WANG Jian, LI Yongjin, et al. Reliability and validity analysis of simplified Chinese version of QOL questionnaire of olfactory disorders[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(18): 1423-1429. doi:10.13201/j.issn.1001-1781.2016.18.001.
[24] Lötsch J, Reichmann H, Hummel T. Different odor tests contribute differently to the evaluation of olfactory loss[J]. Chem Senses, 2007, 33(1): 17-21. doi:10.1093/chemse/bjm058.
[25] Soler ZM, Hyer JM, Karnezis TT, et al. The Olfactory Cleft Endoscopy Scale correlates with olfactory metrics in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2016, 6(3): 293-298. doi:10.1002/alr.21655.
[26] Schlosser RJ, Smith TL, Mace JC, et al. The Olfactory Cleft Endoscopy Scale: a multi-institutional validation study in chronic rhinosinusitis[J]. Rhinology, 2021, 59(2): 181-190. doi:10.4193/Rhin20.307.
[27] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 嗅觉障碍诊断和治疗专家共识(2017年)[J]. 中华耳鼻咽喉头颈外科杂志, 2018,53(7): 484-494. doi:10.3760/cma.j.issn.1673-0860.2018.07.002.
[28] Loftus C, Schlosser RJ, Smith TL, et al. Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis[J]. Laryngoscope, 2020, 130(10): 2311-2318. doi:10.1002/lary.28332.
[29] Kohli P, Schlosser RJ, Storck K, et al. Olfactory cleft computed tomography analysis and olfaction in chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2016, 30(6): 402-406. doi:10.2500/ajra.2016.30.4365.
[30] Vandenhende-Szymanski C, Hochet B, Chevalier D, et al. Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis[J]. Rhin, 2015, 53(1): 29-34. doi:10.4193/rhin14.160.
[31] 苗旭涛, 刘佳, 魏永祥. 嗅觉传导通路的MRI评估[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(14): 1093-1096. doi:10.13201/j.issn.1001-1781.2014.14.028. MIAO Xutao, LIU Jia, WEI Yongxiang. MRI evaluation of the olfactory pathway[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(14): 1093-1096. doi:10.13201/j.issn.1001-1781.2014.14.028.
[32] Sadeghi M, Amali A, Ezabadi SR, et al. Evaluation of the olfactory bulb volume and olfactory threshold in patients with nasal polyps and impact of functional endoscopic sinus surgery: a longitudinal study[J]. Int Forum Allergy Rhinol, 2015, 5(4): 356-360. doi:10.1002/alr.21478.
[33] Rombaux P, Potier H, Bertrand B, et al. Olfactory bulb volume in patients with sinonasal disease[J]. Am J Rhinol, 2008, 22(6): 598-601. doi:10.2500/ajr.2008.22.3237.
[34] Whitcroft KL, Fischer J, Han P, et al. Structural plasticity of the primary and secondary olfactory cortices: increased gray matter volume following surgical treatment for chronic rhinosinusitis[J]. Neuroscience, 2018, 395: 22-34. doi:10.1016/j.neuroscience.2018.10.011.
[35] Whitcroft KL, Noltus J, Andrews P, et al. Sinonasal surgery alters brain structure and function: Neuroanatomical correlates of olfactory dysfunction[J]. J Neurosci Res, 2021, 99(9): 2156-2171. doi:10.1002/jnr.24897.
[36] 张丽川, 胡春华, 韩星雨, 等. 鼻息肉患者组织嗜酸粒细胞计数与改良鼻窦CT嗅区评分及嗅觉功能的关系[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(12): 1142-1147. doi:10.13201/j.issn.1001-1781.2019.12.007. ZHANG Lichuan, HU Chunhua, HAN Xingyu, et al. Correlation of tissue eosinophil count and modified CT olfactory cleft score and olfactory function in patients with nasal polyps[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(12): 1142-1147. doi:10.13201/j.issn.1001-1781.2019.12.007.
[37] 张丽川, 孙敬武, 李希平, 等. 内镜鼻窦手术对慢性鼻-鼻窦炎伴鼻息肉患者嗅觉功能转归的影响[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(8): 713-717. doi:10.13201/j.issn.1001-1781.2019.08.008. ZHANG Lichuan, SUN Jingwu, LI Xiping, et al. Effect of endoscopic sinus surgery on olfactory function in patients with chronic rhinosinusitis with nasal polyps[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(8): 713-717. doi:10.13201/j.issn.1001-1781.2019.08.008.
[38] Banglawala SM, Oyer SL, Lohia S, et al. Olfactory outcomes in chronic rhinosinusitis with nasal polyposis after medical treatments: a systematic review and meta-analysis[J]. Int Forum Allergy Rhinol, 2014, 4(12): 986-994. doi:10.1002/alr.21373.
[39] Wu DW, Huang TH, Wei YX. Effects of fluticasone exhalation delivery system in patients with chronic rhinosinusitis with nasal polyps: a systematic review[J]. Am J Rhinol Allergy, 2022, 36(2): 176-184. doi:10.1177/19458924211033214.
[40] Kern RC, Stolovitzky JP, Silvers SL, et al. A phase 3 trial of mometasone furoate sinus implants for chronic sinusitis with recurrent nasal polyps[J]. Int Forum Allergy Rhinol, 2018, 8(4): 471-481. doi:10.1002/alr.22084.
[41] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会小儿学组、鼻科学组. 儿童鼻-鼻窦炎诊断和治疗建议(2012年, 昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(3): 177-179. doi:10.3760/cma.j.issn.1673-0860.2013.03.001.
[42] Lourijsen ES, Reitsma S, Vleming M, et al. Endoscopic sinus surgery with medical therapy versus medical therapy for chronic rhinosinusitis with nasal polyps: a multicentre, randomised, controlled trial[J]. Lancet Respir Med,2022,10(4):337-346. doi: 10.1016/S2213-2600(21)00457-4.
[43] DeConde AS, Mace JC, Alt JA, et al. Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis: a prospective, multi-institutional study[J]. Int Forum Allergy Rhinol, 2014, 4(9): 725-733. doi:10.1002/alr.21350.
[44] Haxel BR. Recovery of olfaction after sinus surgery for chronic rhinosinusitis: a review[J]. Laryngoscope, 2019, 129(5): 1053-1059. doi:10.1002/lary.27764.
[45] Zhao R, Chen K, Tang Y. Olfactory changes after endoscopic sinus surgery for chronic rhinosinusitis: A meta-analysis[J].Clin Otolaryngol,2021,46(1):41-51. doi: 10.1111/coa.13639.
[46] Oka H, Tsuzuki K, Takebayashi H, et al. Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis[J]. Auris Nasus Larynx, 2013, 40(5): 452-457. doi:10.1016/j.anl.2012.12.001.
[47] Minwegen F, Thomas JP, Bernal-Sprekelsen M, et al. Predictive value of disease severity on self-reported rating and quantitative measures of olfactory function outcomes after primary endoscopic sinus surgery. A prospective study[J]. Rhinology, 2014, 52(4): 437-443. doi:10.4193/Rhino14.043.
[48] Szaleniec J, Wróbel A, Strk P, et al. Smell impairment in chronic rhinosinusitis-evaluation of endoscopic sinus surgery results and review of literature concerning olfactory function predictors[J]. Otolaryngol Pol, 2015, 69(1): 33-44. doi:10.5604/00306657.1131143.
[49] Bogdanov V, Walliczek-Dworschak U, Whitcroft KL, et al. Response to glucocorticosteroids predicts olfactory outcome after ESS in chronic rhinosinusitis[J]. Laryngoscope, 2020, 130(7): 1616-1621. doi:10.1002/lary.28233.
[50] Zhang W, Meng YF, Wang CS, et al. Self-reported course of olfactory impairment determines outcome for successful surgical intervention in nasal polyps with anosmia[J]. Acta Otolaryngol, 2020, 140(12): 1021-1027. doi:10.1080/00016489.2020.1805508.
[51] 李华斌, 赖玉婷, 姜文秀. 慢性鼻窦炎的内表型研究进展及精准治疗[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 9-13. doi:10.6040/j.issn.1673-3770.1.2018.043. LI Huabin, LAI Yuting, JIANG Wenxiu. Endotypes and precision medicine in chronic sinusitis treatment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 9-13. doi:10.6040/j.issn.1673-3770.1.2018.043.
[52] Mullol J, Bachert C, Amin N, et al. Olfactory outcomes with dupilumab in chronic rhinosinusitis with nasal polyps[J]. J Allergy Clin Immunol Pract, 2022, 10(4): 1086-1095.e5. doi:10.1016/j.jaip.2021.09.037.
[53] Tsetsos N, Markou K, Konstantinidis I. Effect of monoclonal antibodies on olfactory dysfunction caused by chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis[J]. Int Forum Allergy Rhinol, 2020, 10(7): 893-900. doi:10.1002/alr.22576.
[54] Bachert C, Han JK, Wagenmann M, et al. EUFOREA expert board meeting on uncontrolled severe chronic rhinosinusitis with nasal polyps(CRSwNP)and biologics: definitions and management[J]. J Allergy Clin Immunol, 2021, 147(1): 29-36. doi:10.1016/j.jaci.2020.11.013.
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