The Effect of Aging on the Nose and Paranasal Sinuses: What We Now Know and a Review of the Literature
Keywords:
Aging, Elderly, Nose, Older, Olfaction, Presbynasalis, Rhinitis, Sinusitis, การสูงวัย, สูงอายุ, จมูก, การดมกลิ่น, จมูกผู้สูงวัย, จมูกอักเสบ, ไซนัสอักเสบAbstract
ผลของการสูงวัยต่อจมูกและโพรงอากาศข้างจมูก: สิ่งที่ทราบในปัจจุบันและการทบทวนวรรณกรรม
เปรมยศ เงาเทพพฤฒาราม และ เจตน์ ลำยองเสถียร
ภาควิชา โสต นาสิก ลาริงซ์วิทยา คณะแพทยศาสตร์ศิริราชพยาบาล มหาวิทยาลัยมหิดล กรุงเทพ
ในช่วงทศวรรษที่ผ่านมา ปรากฏการณ์ของสังคมผู้สูงอายุได้กลายเป็นประเด็นหลักทั่วโลก รวมทั้งในประเทศไทย จุดประสงค์ของการทบทวนวรรณกรรมนี้เพื่อให้แพทย์ได้ทราบถึงความรู้ที่ทันสมัยในปัจจุบันเกี่ยวกับผลของการสูงวัยต่อจมูกและโพรงอากาศข้างจมูกในหลายๆ ด้าน ซึ่งการเปลี่ยนแปลงนี้สามารถพบได้ทั้งในผู้สูงอายุปกติและผู้สูงอายุที่เป็นโรคทางจมูก ความเสื่อมทางสรีรวิทยาของเยื่อบุจมูกในผู้สูงอายุก่อให้เกิดอาการคัดแน่นจมูก จมูกแห้ง มีสะเก็ดในจมูก น้ำมูกไหลลงคอ และกระแอมบ่อยๆ การเสื่อมถอยของระบบภูมิคุ้มกันทำให้ผู้สูงอายุมีแนวโน้มที่จะมีการติดเชื้อในจมูกได้ง่าย ซึ่งจะส่งเสริมทำให้มีการอักเสบในจมูกมากขึ้น นอกจากนี้ แพทย์ควรจะมีความตระหนักและระมัดระวังเกี่ยวกับการใช้ยาร่วมหลายขนาน (polypharmacy) ในผู้สูงอายุ เพื่อที่จะลดความเสี่ยงเกี่ยวกับอันตรกิริยาของยา (drug interaction) และผลข้างเคียง (side effect) ปัญหาการดมกลิ่นสามารถเกิดได้ทั้งในผู้สูงอายุปกติหรืออาจเป็นอาการนำของโรคทางระบบประสาทหลายโรค ความเข้าใจที่มากขึ้นเกี่ยวกับการเปลี่ยนแปลงของโพรงจมูกและไซนัสทั้งหมดนี้ จะนำไปสู่การวินิจฉัยและการดูแลรักษารวมถึงคุณภาพชีวิตของผู้ป่วยที่ดีขึ้น
Over the past decade, the phenomenon of the aging society has become a major topic around the world, and many countries (including Thailand) are now classified as aged societies. Accordingly, the aim of this review was to provide physicians with a multi-perspective update regarding what is now known about the effect of aging on the nose and paranasal sinuses. Multiple changes in the nose and paranasal system can be observed in older aged healthy populations and rhinologic patients. Physiologic deterioration of nasal mucosa that occurs when people get older contributes to nasal obstruction, dryness, crusting, postnasal drip, and frequent throat clearing. Age-related immunosenescence renders people more vulnerable to infection, which may intensify nasal inflammation. Moreover, polypharmacy among older people requires awareness and caution on the part of the physician to decrease the risk of drug interaction and side effect. Olfactory disturbance can occur as a result of physiologic change or premotor manifestation of neurodegenerative diseases. Enhanced understanding of sinonasal change in older adults will improve diagnosis, patient care, and quality of life.
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