创伤性脑损伤中个体气味剂识别成功率的评估：临床随访与嗅觉康复的关键发现
Assessment of individual odorant success rates in traumatic brain injury: key findings for clinical follow-up and olfactory rehabilitation.
文献信息
| PMID | 42958720 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Selçuk Tahsin |
| 作者单位 | Department of Otorhinolaryngology, Alaaddin Keykubat University, Alanya Training and Research Hospital, Alanya, Antalya, Turkey. |
| 期刊 | Brain injury |
| SCI 分区 | Q3 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 创伤性脑损伤（TBI）是感觉功能障碍的主要原因之一，但嗅觉功能障碍常被漏诊。本研究旨在探讨TBI患者嗅觉识别丧失的模式，并评估影像学表现与特定气味剂缺陷之间的关系。
方法： 共纳入106名参与者（53例TBI患者和53名健康对照）。使用Sniffin' Sticks识别测试评估嗅觉功能。TBI患者进一步接受头颅CT和MRI检查，以识别额骨骨折和颅内病变（如皮质挫伤）。进行统计分析，将创伤机制和影像学数据与嗅觉评分相关联。
结果： TBI组的平均嗅觉识别评分显著低于对照组（10.6±3.1 vs. 13.8±1.7，p<0.001）。54.7%的TBI患者存在嗅觉障碍（15.1%为嗅觉丧失，39.6%为嗅觉减退）。皮质挫伤（p<0.001）和额骨骨折（p=0.009）是较低评分的强预测因素。值得注意的是，三叉神经刺激性气味如柠檬（81.1%）和薄荷（79.2%）的保留程度优于纯嗅觉气味如皮革（37.7%）和茴香（41.5%）。颅内病变与识别成功率之间存在强负相关（r=-0.720，p<0.001）。
结论： TBI中的嗅觉识别缺陷遵循特定模式，其中纯嗅觉通路比三叉神经刺激通路更容易受到机械性剪切损伤。嗅觉减退的高患病率提示，应将标准化嗅觉测试纳入创伤后常规神经评估，以促进早期康复并改善生活质量。
英文摘要
OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of sensory morbidity, yet olfactory dysfunction is often underdiagnosed. This study aims to investigate the patterns of olfactory identification loss in TBI patients and evaluate the relationship between radiological findings and specific odorant deficits.
METHODS: A total of 106 participants (53 TBI patients and 53 healthy controls) were included. Olfactory function was assessed using the Sniffin' Sticks identification test. TBI patients were further evaluated with cranial CT and MRI to identify frontal bone fractures and intracranial pathologies (e.g. cortical contusions). Statistical analysis was performed to correlate trauma mechanisms and radiological data with olfactory scores.
RESULTS: The mean olfactory identification score was significantly lower in the TBI group compared to controls (10.6 ± 3.1 vs. 13.8 ± 1.7, p < 0.001). Olfactory impairment was present in 54.7% of TBI patients (15.1% anosmia, 39.6% hyposmia). Cortical contusions (p < 0.001) and frontal fractures (p = 0.009) were strong predictors of lower scores. Notably, trigeminal-stimulating odors such as Lemon (81.1%) and Peppermint (79.2%) were better preserved compared to purely olfactory scents like Leather (37.7%) and Anise (41.5%). A strong negative correlation was found between intracranial pathology and identification success (r = -0.720, p < 0.001).
CONCLUSION: Olfactory identification deficits in TBI follow a specific pattern, where purely olfactory pathways are more susceptible to mechanical shearing injuries than trigeminal-stimulated pathways. The high prevalence of hyposmia suggests that standardized olfactory testing should be integrated into routine post-traumatic neurological assessments to facilitate early rehabilitation and improve quality of life.