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【目的】评价功能性内窥镜鼻窦手术对嗅觉及嗅粘膜上皮的影响。【方法】对 2 3例慢性鼻窦炎患者的 37侧鼻腔行功能性内窥镜鼻窦手术 ,术前及术后 3个月测试患者察觉阈及识别阈 ,观察其嗅觉变化 ,同时以免疫组化染色检查其嗅粘膜病理结构。【结果】术后 2 9侧鼻腔察觉阈下降 (78% ) ,3侧提高 (8% ) ,5侧未发生变化 (13% )。而识别阈 2 4侧鼻腔下降(6 4% ) ,6侧提高 (16 % ) ,7侧未发生变化 (18% )。手术前后察觉阈和识别阈分别比较 ,差异有显著性 (P <0 .0 5和P <0 0 0 1)。病理上 ,除嗅粘膜严重损伤致鳞状上皮化生外 ,大部分结构得以改善。嗅粘膜Bowman′s腺细胞的表达在手术后明显高于手术前 (P <0 .0 5 )。【结论】功能性内窥镜鼻窦手术有利于慢性鼻窦炎患者嗅觉的改善。
【Objective】 To evaluate the effect of functional endoscopic sinus surgery on olfactory and olfactory mucosal epithelium. 【Methods】 Twenty-three patients with chronic rhinosinusitis underwent nasal endoscopic sinus surgery before operation and at 3 months after operation. The detection threshold and recognition threshold were measured before and after the operation, and the olfactory changes were observed. Immunohistochemistry Staining to check its pathological structure of olfactory mucosa. 【Results】 The nasal sensory threshold decreased (78%), 3 sides increased (8%) and 5 sides changed (13%). However, the nasopharynx decreased (64%), 6 (16%), and 7 (18%) in the recognition threshold. The difference of detection threshold and recognition threshold before and after surgery were significant (P <0.05 and P <0.01). Pathologically, in addition to the severe damage caused by olfactory mucosa squamous metaplasia, most of the structure can be improved. The expression of Bowman’s glandular cells in the olfactory mucosa after operation was significantly higher than that before operation (P <0.05). 【Conclusion】 Functional endoscopic sinus surgery is beneficial to improve olfaction in patients with chronic sinusitis.