A comparison was made between the results of surgical treatment (endonasal ethmoidectomy) and conservative treatment (betmaethazore nose drip, orally administered ethylcysteine-HCl and serratiopeptidase or pronase) in patients with chief complaints of olfactory disturbance caused by localized ethmoiditis.
The group receiving surgical treatment contained 8 patients and one receiving conservative treatment contained 14 patients.
The patients given each treatment were observed for 3 months. The effect of each treatment was evaluated at 3 months firstly. The improvementment rate was 62.5% in the surgically-treated group and 50.0% in the group given conservative treatment. There was no statistically significant difference between the two groups.
Secondly the effect was evaluated at 6 and 9 months. As to long-term prognosis, the surgicallytreated group contained half of patients who showed complete improvement and required no further treatment. On the other hand, the patients given conservative treatment showed increased hyposmia with repeated attacks of common cold, so the prognosis was poor.
It is concluded that olfactory disturbance with localized ethmoiditis should be treated surgically and that conservative therapy shoulpbe given over an extended period of time.
In 2 patients in whom biopsy of the olfactory epithelium was performed, the olfactory component (comprised of supporting cells, olfactory cells and basal cells) showed no specific abnormal changes. On the other hand, there was various inflammatory changes in respiratory epithelium near the olfactory epithelium.
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