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Červený K, Janoušková K, Vaněčková K, Zavázalová Š, Funda D, Astl J, Holy R. Olfactory Evaluation in Clinical Medical Practice. J Clin Med 2022; 11:jcm11226628. [PMID: 36431104 PMCID: PMC9698169 DOI: 10.3390/jcm11226628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 11/10/2022] Open
Abstract
The subjective and demanding nature of olfactory testing means that it is often neglected in clinic despite loss of smell leading to significant limitations in everyday life. The list of diseases associated with loss of olfaction far exceeds the field of otorhinolaryngology and can also be seen in neurodegenerative disorders. Knowledge of possible clinical testing is essential to determine a proper differential diagnosis for the loss of olfactory sense. Causes of olfactory impairment can be divided into either failure in transferring odour to the organ of perception or damage to the olfactory pathway structure itself. Examination should therefore include methods evaluating cross-sectional area and patency of the nasal cavity as well as subjective or objective assessment of olfactory function. In this report we summarize several articles, studies, and our own experiences to provide a comprehensive review of their current clinical usage including their benefits, limitations, and possible outcomes. We also discuss the mechanism of olfaction step by step to provide a full understanding of the possible errors depending on the localization in the pathway and the methods designed for their detection. We discuss the correlation of the microbiome in nasal polyposis and chronic rhinitis with olfactory impairment using objective olfactometry. The topic of objective olfactometry and the examination of olfactory event-related potentials (OERP) is commented upon in detail.
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Affiliation(s)
- Květoslav Červený
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, First Faculty of Medicine, Charles University, 15006 Prague, Czech Republic
- Institute of Anatomy, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Karla Janoušková
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Kristýna Vaněčková
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Šárka Zavázalová
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - David Funda
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the CAS, v. v. i., 14220 Prague, Czech Republic
| | - Jaromír Astl
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Richard Holy
- Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
- Correspondence:
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Masopust V, Holubová J, Skalický P, Rokyta R, Fricová J, Lacman J, Netuka D, Patríková J, Janoušková K. Neuromodulation in the treatment of postoperative epidural fibrosis: comparison of the extent of epidural fibrosis and the effect of stimulation. Physiol Res 2021; 70:461-468. [PMID: 33982586 DOI: 10.33549/physiolres.934617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The goal was to prove that when a cohort of patients is chosen precisely, dorsal column stimulation provides significant improvement to quality of life. We studied a cohort of 50 patients with the history of failed back surgery syndrome coupled with epidural fibrosis (EF). A percutaneous implantation technique was used in each of the 50 patients. The study group was composed of 20 women and 28 men aged 26-67 years (mean age 49). A prospective observational questionnaire-based study was used. According to the methods, Ross's classification was adjusted to four degrees of scar size for our study objective. Despite this adjustment, it was not possible to statistically evaluate our research, due to very similar results in Groups I, III and IV. Patients without epidural fibrosis were assigned to Group 0, and patients with EF of different ranges were assigned to Group 1. The mean change in visual analogue scale DeltaVAS after our division into Group 0 was 4.82; for Group 1 it was 6.13. Evaluation of EF and DeltaVAS correlation by paired t-test shows a statistically higher effect of spinal cord stimulation (SCS) in the epidural fibrosis group, compared to group 0 without postoperative epidural fibrosis (p=0.008). The extent of epidural fibrosis is an important factor for Failed back surgery syndrome (FBSS). FBSS is the basis for the existence of neuropathic pain after lumbar spinal surgery. There is clear evidence of a correlation between patients with epidural scar formation on MR scan and the effect of dorsal column stimulation.
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Affiliation(s)
- V Masopust
- Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University, Prague 6, Czech Republic.
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Abstract
Electrode migration is the most common complication of spinal cord stimulation (SCS). The problem of longitudinal migration has already been solved, but lateral migration remains the most common current complication. The present article describes new electrodes fixation opportunities for the reduction of lateral migration in SCS. The pig was chosen as an animal model to illustrate a new protocol of electrode fixation for the control of lateral and longitudinal migration. The displacement of the electrode was measured using two different optical methods: the digital image stereo-correlation and the digital image processing methods. Fixation with two anchors has always considerably reduced electrode displacement and when fixation is done with two anchors and a loop then lateral migration is reduced by 62.5 % and longitudinal migration is reduced by 94.1 %. It was shown that the results are significantly different at the α=0.001 significance level. Based on a statistical evaluation it is possible to state that the differences between experimental results obtained for three different protocols of lead fixation are statistically significant and we can recommend the new fixation method for common practice.
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Affiliation(s)
- V. Masopust
- Department of neurosurgery and neurooncoogy, First Faculty of Medicine, Charles University, Prague, Czech Republic.
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Procházka M, Velebil P, Binder T, Janoušková K. [Delivery of macrosomic fetus]. Ceska Gynekol 2016; 81:125-128. [PMID: 27457395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Fetal macrosomia is associated with an increased risk of perinatal mortality and morbidity for both, mother and fetus. The frequency of these births is between 1.3 to 1.5%. Macrosomic fetuses are defined with a weight of 4500 g and more. Diagnosis and prediction of macrosomia or fetal birth weight is key to determine the tactics of delivery. It is based on the combination and assessment of medical history, clinical parameters and ultrasound biometry. The limit for elective caesarean section is considered the estimated fetal weight in healthy mothers of more than 5000 g. For mothers with diabetes an indication of the caesarean section should be considered for fetal weight of more than 4000 g. DESIGN A review of the literature.
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