Relationships among olfactory epithelium appearance, olfactory test results and prognosis. Analysis of eight patients with olfactory disturbances caused by the common cold.:-Analysis of Eight Patients with Olfactory Disturbances Caused by the Common Cold-
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概要
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Morphological and immunohistochemical examinations were performed on the olfactory mucosa of eight patients with olfactory disturbances caused by the common cold (viral infection). The results of olfactory testing and of follow-up examinations were analyzed.H. E. staining revealed three patterns of degeneration. In Group 1 (3 patients) the olfactory epithelium had adequate thickness and a basic arrangement of supporting cells, olfactory receptor cells, and basal cells, but slightly fewer than normal receptor cells. In Group 2 (3 patients) olfactory receptor cells were greatly decreased. Group 3 (2 patients) had olfactory epithelium which was thin and atrophic with no receptor cells or olfactory vesicles, and only the supporting and basal cells remained. Group 1 patients had Grade 2, Group 2 patients Grade 3, and Group 3 patients Grade 4 damage according to our classification of degeneration proposed in 1988.Immunohistochemically, neuron-specific enolase (NSE) immunoreactivity was found in a number of receptor cells in Group 1 with Grade 2 damage and in some in Group 2 with Grade 3 damage. In Group 3 with Grade 4 damage, there was no NSE-immunoreactivity in the epithelium. Glia-specific S-100 protein immunoreactivity was found in Bowman's glands and olfactory nerve bundles in the lamina propria of Group 1 and 2 patients with Grade 2 and 3 damage. Cytokeratin immunoreactivity was found in the basal cells on the basement membrane in all three groups.Seven patients were found to be anosmic with T & T olfactometry, but the three patients in Group 1 responded well to Alinamin- intravenous injection test, and two of them recovered.These results indicate that there is a strong relationship among the appearance of the olfactory epithelium, results of the Alinamin- test and the outcome of olfactory disturbance caused by the common cold. When an olfactory mucosall biopsy performed at the first visit of the patient shows enough functional receptor cells and the Alinamin- test is positive, it is possible that the olfactory disturbance may improve.
- 耳鼻咽喉科臨床学会の論文
著者
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中野 雄一
新潟大学医学部耳鼻咽喉科学教室
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中村 英生
新潟大学医学部耳鼻咽喉科学教室
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長谷川 聡
新潟大学医学部小児科
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山岸 益夫
新潟大学医学部耳鼻咽喉科学教室
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鈴木 正治
新潟大学医学部耳鼻咽喉科学教室
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