1977 年 80 巻 3 号 p. 241-248
For diagnosis and treatment of dysosmia, a useful technique has been developed in our clinic, that is, a macroscopic observation of the olfactory mucous membrane utilizing an endoscope. For this study, an Olympus Selfoscope SES-1711D was used as an endoscope with a diameter of 1.7mm, and it was inserted into the rima olfactoria under non-anesthetic condition.
Thirty-one normal cases and 64 cases of dysosmia were employed, as the subjects.
The normal olfactory mucous membrane was well lubricated as that of the respiratory region, but a slight niche was found on its surface.
The olfactory mucous membrane was light brownish-yellow.
The boundary area of he olfactory mucous membrane was gradually transmuted into the respiratory region.
The olfactory mucous membrane of dysosmia was divided into the following 4 types in this observation.
(i) Swelling type: The olfactory mucous membrane was coated with increased secretion, looked rather pale, and most of the niches were decreased or disappeared, 22 cases. belonged to this type.
(ii) Secretory type: Even niches and the color of the olfactory mucous membrane were similar to normal cases, but the secretion was increased. This is observed in 10 cases.
(iii) No change type: No abnormalities were found on the olfactory mucous membrane in 17 cases.
(iv) Dry type: Secretion of the olfactory mucous membrane appeared to be reduced or dried, and the color was rather brownish. This is shown in 9 cases.
The dry type was further divided into 2 types.
(a) Atrohic type: The niche of the olfactory mucous membrane became deeper; 6 cases.
(b) Hypertrophic type: The niche of the olfactory mucous membrane disappeared or became shallow; 3 cases.
Further, in 6 cases, different observations were obtained in both sides of the nose.
In these, there were no pathology in one side, and in another side, 5 cases were the swelling type and 1 case was the secretory type.
In most cases cf the swelling type and secretory type, the olfactory mucous membrane returned normal, but the cases in the no change type and the dry typf got no remarkable improvement by the treatment. By this method, the olfactory mucous membrane of dysosmic patients was able to be observed directly and the effect of the treatment was easily traced, therefore, more exact diagnosis, treatment, and accurate prognosis could be performed.