上呼吸道感染後嗅覺喪失

Olfactory Dysfunction After Upper Respiratory Tract Infection

許孟瑜(Meng-Yu Hsu) ； 梁凱莉(Kai-Li Kiang) ； 江榮山(Rong-San Jiang) ； 蘇茂昌(Mao-Chang Su)

《台灣耳鼻喉頭頸外科雜誌》 48卷1期 (2013/03) Pp. 21-26

https://doi.org/10.6286/2013.48.1.21

摘要

背景：根據國外文獻報告上呼吸道感染是嗅覺喪失常見原因之一，但國內尚未有類似報告。本研究嚐試採討我們處理上呼吸道感染後發生嗅覺喪失的經驗。方法：從2006年1月至2012年4月收集主訴在上呼吸道感染後發現嗅覺功能喪失之病患。這些病患接受酚基乙基乙醇氣味查覺閾值試驗檢查嗅覺功能，並同時接受必要的檢查來排除其他原因導致嗅覺功能喪失之可能性。被診斷因上呼吸道感染後發生嗅覺喪失的病患接受低劑量類固醇治療（10mg prednisolone bid）並再利用酚基乙基乙醇閾值試驗來觀察他們的嗅覺功能是否有進步。結果：在本研究期間共有100名病患被診斷為上呼吸道感染後嗅覺喪失，接受至少兩周口服類固醇治療並回診接受酚基乙基乙醇氣味查覺閾值試驗追蹤嗅覺功能變化的病患有74名。其中嗅覺全失（閾值為-1）病患有47名，追蹤期間發現嗅覺功能有進步有22名（46.8%），從開始接受治療至發現嗅覺功能有進步時間平均52.4天。嗅覺部分喪失（閾值大於-1）病患有27名，追蹤期間發現嗅覺功能有進步有20名（74.1%），從開始接受治療至發現嗅覺功能有進步時間平均26.6天。嗅覺功能進步比率在嗅覺部分喪失病患顯著高於嗅覺全失病患（p=0.042），而且從開始接受治療至發現嗅覺功能有進步的時間在嗅覺部分喪失病患也明顯較快（p=0.032）。治療後嗅覺功能有進步病患共有42名，排除2名發病至治療間隔超過6個月的病患後，平均發病至治療間隔為62.3天；治療後嗅覺功能無進步病患共有32名，排除5名發病至治療間隔超過6個月的病患後，平均發病至治療間隔為89.19天；結果顯示嗅覺功能有進步病患之發病至治療間隔時間明顯較短（p=0.02）。結論：本研究顯示上呼吸道感染後導致嗅覺喪失的病患仍有不少數尚有嗅覺功能，也有較高機會嗅覺功能會進步。

關鍵字

嗅覺全失 ； 嗅覺部分喪失 ； 嗅覺功能 ； 酚基乙基乙醇氣味查覺閾值試驗 ； 上呼吸道感染

並列摘要

BACKGROUND: Upper respiratory infection (URI) has been reported to be a common cause of olfactory loss, but local reports have not been found. This study tried to investigate our experience about post-URI olfactory dysfunction.METHODS: Patients who complained of loss of smell after an episode of URI were collected between January of 2006 and April of 2012. Their olfactory function was testedby a phenyl ethyl alcohol odor detection threshold test, and the possibility of their olfactory loss caused other causes was excluded by necessary examinations. These patients were treated by low-dose oral steroids (10 mg prednisolone bid) and the phenyl ethyl alcohol threshold test was re-tested to see whether their olfactory function was improved.RESULTS: A total of 100 patients with post-URI olfactory dysfunction were collected in this study. Among them, 74 were treated by at least 2-week oral steroids and re-tested by the phenyl ethyl alcohol threshold test. After taking steroids, the olfactory function was improved in 22 of 47 anosmic patients (threshold = -1) and in 20 of 27 hyposmic ones (threshold ＜ -1). The mean interval between taking steroids and the time of olfactory improvement was 52.4 days in anosmic patients and 26.6 days in hyposmic ones. The olfactory improvement rate was significantly higher in hyposmic patients (p = 0.042) and the interval between taking steroids and the time of olfactory improvement was also significantly shorter in hyposmic ones (p = 0.032). Among 42 whose olfactory function was improved after treatment, the mean interval between the time of loss of olfactory function and taking steroids was 62.3 days after excluding 2 patients whose intervals were more than 6 months. Among 32 whose olfactory function was not improved after treatment, the mean interval between the time of loss of olfactory function and taking steroids was 89.19 days after excluding 5 patients whose intervals were more than 6 months. The interval was significantly shorter in patients whose olfactory function was improved after treatment (p = 0.02).CONCLUSIONS: This study shows that many patients with post-URI olfactory dysfunction did not lose their olfactory function completely, and they had a higher chance to recover their olfactory function.

並列關鍵字

anosmia ； hyposmia ； olfactory function ； phenyl ethyl alcohol odor detection threshold test ； steroid ； upper respiratory infection