Abstract
The author performed clinical and histopathological studies of the olfactory region particularly in chronic sinusitis. A total of 93 cases (50 males and 43 females) ranging in age from 12 to 70 years, who visited the department of otorhinolaryngology at Jikei University School of Medicine from May 1966 to June 1969 were examined.
Of the 93 cases, 34 complained of anosmia, 27 of hyposmia and the remaining 32 had no olfactory complaints.
The examination included rhinoscopic examination, measurement of the dimensions of the olfactory region, olfactory test, antral mucosal function test, contrast study of the olfactory region and operative findings.
The shape of the olfactory region was classified into 8 types based on the results of contrast studies of the region. Using 12 cadavers, measurements and contrast studies of the olfactory region and contrast studies of the maxillary sinus were performed in an attempt to relate the pathologies of the olfactory region and the maxillary sinus.
Large specimens containing the entire paranasal sinus, base of the skull, and the nasal septum were taken from the cadavers and serial sections of the paranasal sinuses in the frontal plane were prepared.
The specimens were studied with particular interest in the relation between the results of contrast study and pathology of the olfactory region as well as between pathology of the olfactory region and that of paranasal sinuses.
Results of the above studies could be summarized as follows:
1. The shape of olfactory region was classified into 8 different types from the results of contrast study of the region. Of 184 olfactory regions in 92 cases, 71 were classified as Type I, 21 as Type II, 18 as Type III, 3 as Type IV, 9 as Type V, 16 as Type VI, 8 as Type VII, 38 as Type VIII.
2. The filling defect of the olfactory region is not necessarily due to the presence of local inflammation. Narrowing of the region or contact of the opposing structures mainly due to well developed medial wall of the ethmoid sinus often caused filling defect of the area in the absence of local inflammation.
3. Olfactory sense appeared more severely affected by the disease of the ethmoid sinus than any other sinuses. Results of the contrast study of the olfactory region were not necessarily parallel with the pathology of the other paranasal sinuses.
4. Nasal mucous membrane at the olfactory region appears yellowish in color because it is particularly thin in the area and the yellow septal bone can be seen through it. The author concluded that reconstructive surgery of the olfactory region will benefit patients with distrubance of olfactory sense regardless of the presence of chronic sinusitis.
