Morphological Chance Of Olfactory Mucous In Patients With Anosmia After Endoscopic Sinus Surgery

ObjectOlfaction have several functions such as alert, recognition, emotion and physiology mediation, which are closed with people's health and life. Dysosmia affects quantity of life seriously. The physiology and anatomy as well as clinical research of olfaction are intricate relatively, it is less known to us about the olfactory function than auditory, optical and gustatory.Nasal and sinus inflammatory disease is the most common cause of olfactory dysfunction, however, olfactory dysfunction is the main symptom of chronic rhi-nosinusitis and nasal polyps. Some studies have suggested that there are many factors affect olfaction, sentient dysosmia caused by lesions in the olfactory epithelium and olfactory nerve, besides respiratory dysosmia caused by obstruction, in addition, the area and the extent of the lesions in olfactory mucous have the important influence to olfactory recovery.Although it is expected that olfactory dysfunction in chronic rhinosinusitis recovers to a normal level after surgical treatment, the patients have different degree of recovery, despite endoscopic sinus surgery and medical therapy have been used. This type of olfactory disorder has been noted clinically by several authors. However, its pathogenesis is not fully understood to date.The present study is undertaken to examine the histopathologic findings of the olfactory mucosa in patients with anosmia after endoscopic sinus surgery. Understand endoscopic sinus surgery promoting olfactory function and discuss the repair mechanism of olfactory neurons. These will be useful to further ourunderstanding of the pathophysiology of olfactory dysfunction secondary to nasal and sinus disease. We expect that our study would be useful to clinical practice.Materials and MethodsClinical olfactory function in our study was evaluated using the smell identification test of Sun'anna. Patients with chronic rhinosinusitis and nasal polyps were all detected by this test. A total of 33 cases (60 sides) were involved in our study. All the patients underwent functional endoscopic sinus surgery. Olfactory identification and biopsy specimens were obtained from the olfactory region at 4 weeks, 12 weeks and 24 weeks respectively after surgery. Specimens were put in 2. 5% glutaraldehyde conserved at 4℃ refrigeratory. Olfaction completely recovery, partial restoration and no improvement each five groups were stochastic selected at 24 weeks after surgery besides two normal olfactory mucous. All the specimens were observed through transmission electron microsco-py-ResultsThe result of olfactory detection at 24 weeks after surgery is that olfaction completely recovery is 21 sides, partial restoration is 14 sides, no improvement is 12 sides, no cure is 7 sides, no follow - up is 6 sides. The result of morphology observed through transmission electron microscopy is that the group of control shows normal structure, consist of the form and connection. The olfactory mucous show various degree lesions, structures in nucleus and cytoplasm abnormal, connection among cells widen. All kinds of cells in the olfactory mucous display further lesions, the difference in three groups is no significant. At 12 weeks after surgery, Cellular form trend to normal in the group of completely recovery and partial restoration, the difference between two groups is no significant. In the no improvement group, cellular form is better than before, but nucleus bigger and cytoplasm smaller. At 24 weeks after surgery, Cellular form is normal in the group of completely recovery and partial restoration, much better...