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目的通过对上呼吸道感染后嗅觉障碍的患者鼻腔大体及嗅上皮超微结构的研究,从形态学上观察嗅觉减退或丧失的超微结构改变。方法选择上呼吸道感染后嗅觉减退或丧失患者10例,用 T&T 嗅觉测试法测试患者的嗅觉功能。常规前鼻镜、鼻内镜下对鼻腔大体结构进行观察,鼻内镜下钳取嗅区黏膜行透射电镜超微结构观察。结果上呼吸道感染后嗅觉障碍患者嗅黏膜超微结构有以下变化:①嗅上皮结构层次仍能保持,但细胞间隙增宽;②上皮表面嗅泡明显减少,即使嗅泡存在,其末端的纤毛也明显减少,部分嗅泡呈空泡状改变;③微绒毛细胞和支持细胞表面的微绒毛减少或缺失;④支持细胞的细胞核变形或固缩,嗅细胞的树突水肿变形,细胞器减少。结论上呼吸道感染后嗅觉功能障碍与嗅黏膜上皮超微结构的改变密切相关。患者嗅泡及嗅泡内纤毛缺失,微绒毛细胞及支持细胞的微绒毛减少是引起嗅觉减退的主要原因,支持细胞胞核的变形及嗅细胞树突的形态学改变与嗅觉改变相关。
OBJECTIVE: To investigate the ultrastructural changes of olfactory dysfunction or loss of morphology through morphological observation of the nasal general and olfactory epithelium in patients with olfactory dysfunction after upper respiratory tract infection. Methods Ten patients with hypoxia or loss of upper respiratory tract infection were selected and their olfactory function was tested by T & T olfactory test. Conventional anterior nasal endoscopy, nasal endoscopic observation of the general structure of the nasal cavity, nasal endoscopic pliers olfactory mucosa underwent transmission electron microscopy ultrastructural observation. Results The ultrastructure of olfactory mucosa in patients with olfactory dysfunction had the following changes after upper respiratory tract infection: (1) the epithelial structure of olfactory epithelium could be maintained but the cell gap widened; (2) the sniffing of epithelial surface was significantly reduced; Significantly reduced, part of the sniffing bubble was vacuolar changes; microvilli and supporting cells on the surface of microvilli reduced or missing; ④ supporting cell nucleus deformation or pyknosis, dendritic edema of olfactory degeneration, organelles decreased. Conclusion Olfactory dysfunction after upper respiratory tract infection is closely related to the ultrastructural changes of olfactory mucosa epithelium. Sniffing and sniffing in patients with missing cilia, microvilli cells and supporting cells to reduce microvilli is the main reason for hyposmia, supporting the deformation of the cell nucleus and olfactory dendrites morphological changes associated with changes in the sense of smell.