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目的研究慢性鼻窦炎伴嗅觉障碍患者行功能性鼻内镜手术前后嗅觉功能的改变,探讨慢性鼻窦炎嗅觉功能与鼻内镜手术的关系,并用透射电镜观察手术对嗅区黏膜超微结构的影响,为临床治疗慢性鼻窦炎患者的嗅觉障碍提供理论依据。方法对慢性鼻窦炎伴嗅觉功能障碍患者行功能性鼻内镜手术,于术前及术后6个月观察嗅觉功能变化并切取嗅区黏膜于透射电镜下观察超微结构。结果术后嗅觉及嗅上皮的超微结构均有不同程度的改善,主观嗅觉改善率为97%;异常超微结构由术前的100%降为20%。结论炎症导致的嗅上皮细胞由表及里各层的超微结构异常与嗅觉功能减退有关。功能性鼻内镜手术改善通气功能后及黏膜炎性反应消除后,随着嗅上皮超微结构的恢复,嗅觉也会有不同程度的改善。
Objective To investigate the changes of olfactory function before and after functional endoscopic sinus surgery in patients with chronic sinusitis and olfactory dysfunction and to explore the relationship between olfactory function and endoscopic sinus surgery. The effects of surgery on the ultrastructure of the mucosa in the olfactory region were observed by transmission electron microscopy , To provide a theoretical basis for the clinical treatment of olfactory disorders in patients with chronic sinusitis. Methods Functional endoscopic sinus surgery was performed in patients with chronic sinusitis and olfactory dysfunction. Olfactory function was observed before and 6 months after operation. The ultrastructure was observed under transmission electron microscopy. Results The ultrastructure of olfactory epithelium and olfactory epithelium were improved to some extent. The improvement rate of subjective olfaction was 97%. The abnormal ultrastructure decreased from 100% to 20%. Conclusion Inflammation of epithelial cells caused by the epithelial and superficial layers of the ultrastructure abnormalities and olfactory dysfunction. Functional endoscopic sinus surgery to improve ventilation and mucosal inflammatory response is eliminated, with the recovery of the ultrastructure of the olfactory epithelium, the sense of smell will have different degrees of improvement.