内視鏡下鼻副鼻腔手術における嗅覚予後因子

抄録

Endoscopic endonasal sinus surgery was conducted in 92 patients who had chronic sinusitis with moderate or severe olfactory dysfunctions.
Improvements of olfaction in these patients were investigated by employing T & T olfactometry, a standard olfactory test procedure used in Japan, before and after the surgery. In measurements made 6 to 12 months after surgery, 67 had improved olfaction, while 25 showed no improvement. Statistical analysis was performed to identify the factors that may affect the olfaction outcome after endoscopic endonasal sinus surgery.
Factors investigated included age at the time of surgery, complication with allergic rhinitis or bronchial asthma, nasal symptoms (nasal congestion, rhinorrhea, and postnasal drip), results of pre-surgical T & T olfactometry, endoscopic findings of the olfactory cleft, intravenous olfaction test (Alinamine^® injection test), and severity of chronic sinusitis observed by CT.
The following were detected significantly more frequently in the group with no improvement in post-operative olfaction: duration of olfactory dysfunction of 7 or more years, history of surgery of the nose and paranasal sinuses; lack of response to the pre-operative intravenous olfaction test; and the formation of polyps at the olfactory cleft, which was detected during the pre-operative endoscopic examination. We concluded that these factors most markedly affect improvement in olfaction after endoscopic endonasal sinus surgery for chronic sinusitis.