The presence of herpetic infection in the larynx is rare. Herpes zoster is an acute viral disease caused by the varicella zoster virus. The zoster virus is the same as the varicella virus. Varicella is a primary infection of an unimmunized organism and remains in the body for life in the area of the posterior sensitive roots of the spinal ganglia. Reactivation of the virus or reinfection of an already immunized organism causes herpes zoster. Varicella zoster virus is included in the group of alphaviruses, its size is 150–200 nanometers. We present the case of a 67-year-old man with a history of throat pain, hoarseness, difficulty of swallowing, without the presence of skin effusion for several days. On objective examination found the paralysis of the left hemilaryngeus. On the 6th day, there was a generalized sowing of tiny vesicles on the body and a herpetic sowing on the mucosa of the oral cavity, pharynx and larynx. Infection with the varicella zoster virus has been confirmed serologically and by the PCR method from vesicles swabs. Despite complex therapy, the patient still has left hemilaryngeal paralysis after 3 months. Keywords: dysphagia – herpes zoster virus – laryngeal paralysis – aciclovir
{"title":"Laryngeal paralysis due to generalized varicella virus infection – a case report","authors":"Jana Mahútová, J. Večeřa, A. Hajtman","doi":"10.48095/ccorl2022230","DOIUrl":"https://doi.org/10.48095/ccorl2022230","url":null,"abstract":"The presence of herpetic infection in the larynx is rare. Herpes zoster is an acute viral disease caused by the varicella zoster virus. The zoster virus is the same as the varicella virus. Varicella is a primary infection of an unimmunized organism and remains in the body for life in the area of the posterior sensitive roots of the spinal ganglia. Reactivation of the virus or reinfection of an already immunized organism causes herpes zoster. Varicella zoster virus is included in the group of alphaviruses, its size is 150–200 nanometers. We present the case of a 67-year-old man with a history of throat pain, hoarseness, difficulty of swallowing, without the presence of skin effusion for several days. On objective examination found the paralysis of the left hemilaryngeus. On the 6th day, there was a generalized sowing of tiny vesicles on the body and a herpetic sowing on the mucosa of the oral cavity, pharynx and larynx. Infection with the varicella zoster virus has been confirmed serologically and by the PCR method from vesicles swabs. Despite complex therapy, the patient still has left hemilaryngeal paralysis after 3 months. Keywords: dysphagia – herpes zoster virus – laryngeal paralysis – aciclovir","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116558662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The authors describe a very unusual case of double external metachronous fistulation of a second branchial cleft cyst in a 54-year-old man. Signifi cant difficulties in the clinical differential dia gnosis of this developmental anomaly, comprising primarily malignant tumor and tuberculosis, were resolved only with histopathologic examination of the surgical specimen. The mechanism of the formation of both successively manifesting fistulas, developing in the milieu of chronic non-specific inflammation, is not clear. However, the absence of organoid pattern of the fistulas precludes that they were – unlike the cyst – relicts of the branchial apparatus. Key words branchiogenic cyst – fistula – differential diagnosis
{"title":"Unusual case of double fistulation of a brachiogenous cyst","authors":"I. Stárek, Z. Hořáková, R. Salzman, D. Skanderová","doi":"10.48095/ccorl2022234","DOIUrl":"https://doi.org/10.48095/ccorl2022234","url":null,"abstract":"The authors describe a very unusual case of double external metachronous fistulation of a second branchial cleft cyst in a 54-year-old man. Signifi cant difficulties in the clinical differential dia gnosis of this developmental anomaly, comprising primarily malignant tumor and tuberculosis, were resolved only with histopathologic examination of the surgical specimen. The mechanism of the formation of both successively manifesting fistulas, developing in the milieu of chronic non-specific inflammation, is not clear. However, the absence of organoid pattern of the fistulas precludes that they were – unlike the cyst – relicts of the branchial apparatus. Key words branchiogenic cyst – fistula – differential diagnosis","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131223606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The prevalence of dysphagia in the general population is 6–16%. The dysphagia team focuses on diagnosis and treatment of dysphagia. The dysphagia team consists of a clinical speech therapist, an otorhinolaryngologist and nurse (depending on the workplace). Other specialties such as radiologist, nutritionist and physiotherapist can also be a member of the team. FEES (Flexible Endoscopic Evaluation of Swallowing) and VFSS (Videofluoroscopic Swallow Study) are used as the gold standard for objective examination of the dysphagia. Aim of the work: The aim of the work is to evaluate retrospectively the contribution of the dysphagia team working in the department of otorhinolaryngology in Hospital České Budějovice, in the care of patients after stroke disease indicated for examination from the Complex Cerebrovascular Center (CCC) in 2016–2020. Material and methods: The retrospective study included 33 patients after stroke with clinical suspicion of dysphagia, who were referred from the CCC to the Counseling Center for Swallowing Disorders for objective examination of dysphagia. Results: In 9 patients (27.3%), dysphagia was ruled out during FEES, thus enabling oral intake without restrictions. Dysphagia was confirmed in 24 patients (72.7%). Ten patients (30.3%) had a prolonged pharyngeal swallowing phase without food penetration into the airways. Three patients (9.1%) had a bolus penetration into the airways during the examination, but it remained above the vocal cords and it was completely expelled from the airways (PAS 2). In 11 cases (33.3%) aspiration was found, of which nine cases (27.3% of all patients, 81.8% of patients with aspiration) involved silent aspiration without any attempt to expel bolus from the airways (PAS 8). Conclusion: In 31 patients (94.0%) the benefit of examination by the dysphagia team was noted. In the case of 22 patients (66.7%), it was an adjustment of nutrition and swallowing rehabilitation with confirmed dysphagia. Restrictions were lifted in 9 patients (27.3%) with false-positive screening and clinical examination. We observe a positive effect of long-term swallowing rehabilitation in 61.5% of the monitored patients. Keywords: endoscopy – stroke – rehabilitation – deglutition disorder
{"title":"The role of FEES and the dysphagia team in the management of patients after stroke disease in Hospital České Budějovice","authors":"M. Huska, L. Koptíková, P. Lukes, L. Mrzena","doi":"10.48095/ccorl2022196","DOIUrl":"https://doi.org/10.48095/ccorl2022196","url":null,"abstract":"Introduction: The prevalence of dysphagia in the general population is 6–16%. The dysphagia team focuses on diagnosis and treatment of dysphagia. The dysphagia team consists of a clinical speech therapist, an otorhinolaryngologist and nurse (depending on the workplace). Other specialties such as radiologist, nutritionist and physiotherapist can also be a member of the team. FEES (Flexible Endoscopic Evaluation of Swallowing) and VFSS (Videofluoroscopic Swallow Study) are used as the gold standard for objective examination of the dysphagia. Aim of the work: The aim of the work is to evaluate retrospectively the contribution of the dysphagia team working in the department of otorhinolaryngology in Hospital České Budějovice, in the care of patients after stroke disease indicated for examination from the Complex Cerebrovascular Center (CCC) in 2016–2020. Material and methods: The retrospective study included 33 patients after stroke with clinical suspicion of dysphagia, who were referred from the CCC to the Counseling Center for Swallowing Disorders for objective examination of dysphagia. Results: In 9 patients (27.3%), dysphagia was ruled out during FEES, thus enabling oral intake without restrictions. Dysphagia was confirmed in 24 patients (72.7%). Ten patients (30.3%) had a prolonged pharyngeal swallowing phase without food penetration into the airways. Three patients (9.1%) had a bolus penetration into the airways during the examination, but it remained above the vocal cords and it was completely expelled from the airways (PAS 2). In 11 cases (33.3%) aspiration was found, of which nine cases (27.3% of all patients, 81.8% of patients with aspiration) involved silent aspiration without any attempt to expel bolus from the airways (PAS 8). Conclusion: In 31 patients (94.0%) the benefit of examination by the dysphagia team was noted. In the case of 22 patients (66.7%), it was an adjustment of nutrition and swallowing rehabilitation with confirmed dysphagia. Restrictions were lifted in 9 patients (27.3%) with false-positive screening and clinical examination. We observe a positive effect of long-term swallowing rehabilitation in 61.5% of the monitored patients. Keywords: endoscopy – stroke – rehabilitation – deglutition disorder","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129170134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Ugorová, Zuzana Polakovičová, Irena Dobišová, Ľubica Pejhovská, D. Chovancová, M. Profant, L. Varga
Abstract Congenital cytomegalovirus infection (cCMV) is the most common non-genetic cause of congenital sensorineural hearing loss (SNHL) and one of the most prevalent inborn infections. Its symptoms are variable, from thrombocytopenia to neurodevelopmental defects. Long-term consequences, including SNHL, occur in about 15% of newborns. However, they are often born asymptomatic and the SNHL develops later in childhood, leading to a high number of undia gnosed cases. Available dia gnostic methods vary in their reliability and require correct indication and subsequent interpretation of the results. A different approach represents the implementation of full-scale cCMV screening into the current neonatal screening programs. The goal of our review article is to summarize the currently available data about congenital CMV infection associated with hearing loss with particular emphasis on recent diagnostic strategies. Key words cytomegalovirus – newborn – screening – hearing loss
{"title":"Congenital cytomegalovirus infection from the viewpoint of otorhinolaryngologist","authors":"Diana Ugorová, Zuzana Polakovičová, Irena Dobišová, Ľubica Pejhovská, D. Chovancová, M. Profant, L. Varga","doi":"10.48095/ccorl2022210","DOIUrl":"https://doi.org/10.48095/ccorl2022210","url":null,"abstract":"Abstract Congenital cytomegalovirus infection (cCMV) is the most common non-genetic cause of congenital sensorineural hearing loss (SNHL) and one of the most prevalent inborn infections. Its symptoms are variable, from thrombocytopenia to neurodevelopmental defects. Long-term consequences, including SNHL, occur in about 15% of newborns. However, they are often born asymptomatic and the SNHL develops later in childhood, leading to a high number of undia gnosed cases. Available dia gnostic methods vary in their reliability and require correct indication and subsequent interpretation of the results. A different approach represents the implementation of full-scale cCMV screening into the current neonatal screening programs. The goal of our review article is to summarize the currently available data about congenital CMV infection associated with hearing loss with particular emphasis on recent diagnostic strategies. Key words cytomegalovirus – newborn – screening – hearing loss","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129816147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The authors present a case report of a patient with unilateral tonsillitis and severe non-specific inflammatory response not responding to anti- biotic therapy. Along with persistent local and systemic symptoms, the patient also developed skin exanthema and cervical lymphadenopathy. The definitive dia gnosis of oropharyngeal tularemia was confirmed after several weeks, based on serological and histological findings. Finally, the targeted antibiotic therapy led to rapid symptom resolution. The authors describe an unusual combination of the diagnoses, which resulted in a prolonged and initially unsuccessful therapy. Symptoms resembling to tonsillitis, which persist despite the use of antibiotics, should lead to reconsideration of suspected diagnosis. Key words tularemia – Sweet’s syndrome – lymphadenopathy – tonsillitis
{"title":"Oropharyngeal tularemia with skin manifestation: Sweet’s syndrome","authors":"Berenika Stárková, R. Salzman","doi":"10.48095/ccorl2022225","DOIUrl":"https://doi.org/10.48095/ccorl2022225","url":null,"abstract":"The authors present a case report of a patient with unilateral tonsillitis and severe non-specific inflammatory response not responding to anti- biotic therapy. Along with persistent local and systemic symptoms, the patient also developed skin exanthema and cervical lymphadenopathy. The definitive dia gnosis of oropharyngeal tularemia was confirmed after several weeks, based on serological and histological findings. Finally, the targeted antibiotic therapy led to rapid symptom resolution. The authors describe an unusual combination of the diagnoses, which resulted in a prolonged and initially unsuccessful therapy. Symptoms resembling to tonsillitis, which persist despite the use of antibiotics, should lead to reconsideration of suspected diagnosis. Key words tularemia – Sweet’s syndrome – lymphadenopathy – tonsillitis","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131221057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiří Blecha, T. Filipovský, J. Betka, T. Králová, L. Dostálová, Šárka Zavázalová, J. Astl
Chronic rhinosinusitis is a common disease of the nose and paranasal sinuses. We note diseases of dental origin occurring with an increasing regularity. This cause tends to be overlooked. Treatment is longer and more complicated compared to rhinogenic sinusitis due to the higher prevalence of anaerobic bacteria. The treatment can be divided into two main steps. The first is to remove the cause of the odontogenic infection itself, followed by the remediation of secondary nasal cavities using functional endoscopic surgery (FESS). In order to treat this disease properly, inter-disciplinary cooperation between an otorhinolaryngologist and a dentist or oral surgeon is necessary. Conclusions of this paper is to highlight the idea of treating these two seemingly separate issues and procedures into one functional unit that will be most effective and least burdensome for the patient. From my point of view, it seems ideal to address this issue comprehensively. This shortens the treatment time and eliminates the need for the patient to move between different departments. Keywords: apical periodontitis – odontogenic sinusitis – oroantral fi stula – maxillary sinusitis of dental origin – endoscopic sinus surgery – root canal infection
{"title":"Chronic rhinosinusitis of dental origin","authors":"Jiří Blecha, T. Filipovský, J. Betka, T. Králová, L. Dostálová, Šárka Zavázalová, J. Astl","doi":"10.48095/ccorl2022218","DOIUrl":"https://doi.org/10.48095/ccorl2022218","url":null,"abstract":"Chronic rhinosinusitis is a common disease of the nose and paranasal sinuses. We note diseases of dental origin occurring with an increasing regularity. This cause tends to be overlooked. Treatment is longer and more complicated compared to rhinogenic sinusitis due to the higher prevalence of anaerobic bacteria. The treatment can be divided into two main steps. The first is to remove the cause of the odontogenic infection itself, followed by the remediation of secondary nasal cavities using functional endoscopic surgery (FESS). In order to treat this disease properly, inter-disciplinary cooperation between an otorhinolaryngologist and a dentist or oral surgeon is necessary. Conclusions of this paper is to highlight the idea of treating these two seemingly separate issues and procedures into one functional unit that will be most effective and least burdensome for the patient. From my point of view, it seems ideal to address this issue comprehensively. This shortens the treatment time and eliminates the need for the patient to move between different departments. Keywords: apical periodontitis – odontogenic sinusitis – oroantral fi stula – maxillary sinusitis of dental origin – endoscopic sinus surgery – root canal infection","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125299089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hana Faitlová, Michaela Bukvová, J. Mejzlík, T. Valenta, Václav Kortán, V. Chrobok, J. Vodička
Introduction: Emphysema of the neck represents a crucial symptom of swallowing/respiratory pathways injuries or rarely passes to the neck area from diff erent locations. The clinical image can develop dramatically in the fi rst hours after onset and frequently the etiology remains unclear. Dyspnoea, dysphagia, retrosternal or interscapular pain usually follows. In the diff erential dia gnosis, not only traumatic etiology but also other acute conditions must be considered – e. g. acute coronary syndrome etc. The size of emphysema varies, also head and chest area can also be aff ected. Pneumomediastinum or partial pneumothorax are also often presented. The primarily aim of this paper is to discuss a dia gnostic and therapeutic possibilities, not to determine the incidence of emphysema. Methodology: This is a retrospective multicenter study involving patients from three regional ENT departments – Pardubice Hospital, Hradec Králové University Hospital and Liberec Hospital over a period of 15 years (2005–2020). Only clinically signifi cant emphysema, emphysema of unclear origin and emphysema requiring intensive care were in-rolled. Results: In a group of 15 patients, there are the following causes of cervical emphysema – 3 laryngeal injuries, 3 Hamman’s syndromes, 2 tracheal intubations, 2 traumas of swallowing pathways, 2 in COVID-19 disease, 1 tonsillectomy, 1 urgent tracheostomy and 1 sneezing. Etiologically, the Valsalva maneuver is an important (co)factor, dominating especially in adolescents and young adults (53%, 8 patients). Traumatic etiology occurred at the age of 17–53 years (33%, 5 patients). Iatrogenic involvement is more common over the age of 55 years. Pneumomediastinum occurred in 47% and partial pneumothorax in 40% of patients. Four of those initially unclear cases are discussed in detail. Conclusion: Imaging methods and endoscopic examination are indicated in a patient with cervical emphysema of unclear origin. Prophylactic use of broad-spectrum antibio tics, observation and interdisciplinary cooperation are always necessary. Key words emphysema – Hamman’s syndrome – pneumothorax – pneumomediastinum – covid lung injury
{"title":"Diagnostic and therapy of a cervical emphysema","authors":"Hana Faitlová, Michaela Bukvová, J. Mejzlík, T. Valenta, Václav Kortán, V. Chrobok, J. Vodička","doi":"10.48095/ccorl2022131","DOIUrl":"https://doi.org/10.48095/ccorl2022131","url":null,"abstract":"Introduction: Emphysema of the neck represents a crucial symptom of swallowing/respiratory pathways injuries or rarely passes to the neck area from diff erent locations. The clinical image can develop dramatically in the fi rst hours after onset and frequently the etiology remains unclear. Dyspnoea, dysphagia, retrosternal or interscapular pain usually follows. In the diff erential dia gnosis, not only traumatic etiology but also other acute conditions must be considered – e. g. acute coronary syndrome etc. The size of emphysema varies, also head and chest area can also be aff ected. Pneumomediastinum or partial pneumothorax are also often presented. The primarily aim of this paper is to discuss a dia gnostic and therapeutic possibilities, not to determine the incidence of emphysema. Methodology: This is a retrospective multicenter study involving patients from three regional ENT departments – Pardubice Hospital, Hradec Králové University Hospital and Liberec Hospital over a period of 15 years (2005–2020). Only clinically signifi cant emphysema, emphysema of unclear origin and emphysema requiring intensive care were in-rolled. Results: In a group of 15 patients, there are the following causes of cervical emphysema – 3 laryngeal injuries, 3 Hamman’s syndromes, 2 tracheal intubations, 2 traumas of swallowing pathways, 2 in COVID-19 disease, 1 tonsillectomy, 1 urgent tracheostomy and 1 sneezing. Etiologically, the Valsalva maneuver is an important (co)factor, dominating especially in adolescents and young adults (53%, 8 patients). Traumatic etiology occurred at the age of 17–53 years (33%, 5 patients). Iatrogenic involvement is more common over the age of 55 years. Pneumomediastinum occurred in 47% and partial pneumothorax in 40% of patients. Four of those initially unclear cases are discussed in detail. Conclusion: Imaging methods and endoscopic examination are indicated in a patient with cervical emphysema of unclear origin. Prophylactic use of broad-spectrum antibio tics, observation and interdisciplinary cooperation are always necessary. Key words emphysema – Hamman’s syndrome – pneumothorax – pneumomediastinum – covid lung injury","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130505326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary Only a few cases of a round windows atresia have been reported in the literature so far. The dia gnosis is based on the preoperative CT scan and local fi ndings during a middle ear exploration. The complete round window closure leads to a signifi cant conductive hearing loss. The hearing test result might be similar to the one found in otosclerosis. We report a case of 30-year-old woman, who previously underwent three surgeries for suspected otosclerosis without any hearing improvement. A round window atresia was only identified during following revision surgery, as well as a missing stapedial muscle, an abnormal shape and movement of the stapes footplate. In order to achieve a functional inner ear hydrodynamics, a cochlear fenestration was performed. Although there was a signifi cant improvement in the cochlear reserve at speech frequencies after the operation, the patient didn’t report any hearing improvement. Although otosclerosis may be considered as a cause of the conductive hearing loss preoperatively, rare dia gnoses should not be neglected. The aim of this case report is to share the experience and highlight mistakes made. After each unsuccessful stapedoplasty with unsatisfying hearing gain, a high resolution CT should be performed to exclude third window syndrome or another rare abnormality. Key words atresia – cochlear fenestration – round window – stapes surgery
{"title":"Round window atresia – a case report","authors":"Kryštof Vitoul, R. Salzman","doi":"10.48095/ccorl2022162","DOIUrl":"https://doi.org/10.48095/ccorl2022162","url":null,"abstract":"Summary Only a few cases of a round windows atresia have been reported in the literature so far. The dia gnosis is based on the preoperative CT scan and local fi ndings during a middle ear exploration. The complete round window closure leads to a signifi cant conductive hearing loss. The hearing test result might be similar to the one found in otosclerosis. We report a case of 30-year-old woman, who previously underwent three surgeries for suspected otosclerosis without any hearing improvement. A round window atresia was only identified during following revision surgery, as well as a missing stapedial muscle, an abnormal shape and movement of the stapes footplate. In order to achieve a functional inner ear hydrodynamics, a cochlear fenestration was performed. Although there was a signifi cant improvement in the cochlear reserve at speech frequencies after the operation, the patient didn’t report any hearing improvement. Although otosclerosis may be considered as a cause of the conductive hearing loss preoperatively, rare dia gnoses should not be neglected. The aim of this case report is to share the experience and highlight mistakes made. After each unsuccessful stapedoplasty with unsatisfying hearing gain, a high resolution CT should be performed to exclude third window syndrome or another rare abnormality. Key words atresia – cochlear fenestration – round window – stapes surgery","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"237 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132858487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monika Debnárová, Jakub Mičaník, M. Masárová, M. Plášek, P. Matoušek, P. Komínek
Isolated sphenoid fungal sinusitis is a relatively rare disease with non-specifi c symptoms. The most common symptom is headache and the typical symptoms of sinusitis may be completely absent. A CT examination with specifi c radiological signs plays an important role in the diagnostic process but the defi nitive dia gnosis is determined by a histological examination. Due to the location of the sphenoid sinus, in some cases, the delayed dia gnosis may cause serious consequences. The article presents a case report of a patient with isolated mycotic infl ammation of the sphenoid sinus. The aim of the article is to point out the non-specifi c symptoms of the disease and the typical radiological signs that can help us in the dia gnostics. Key words mycotic infl ammation – sphenoid sinus – headache
{"title":"Isolated sphenoid fungal sinusitis – a case report","authors":"Monika Debnárová, Jakub Mičaník, M. Masárová, M. Plášek, P. Matoušek, P. Komínek","doi":"10.48095/ccorl2022169","DOIUrl":"https://doi.org/10.48095/ccorl2022169","url":null,"abstract":"Isolated sphenoid fungal sinusitis is a relatively rare disease with non-specifi c symptoms. The most common symptom is headache and the typical symptoms of sinusitis may be completely absent. A CT examination with specifi c radiological signs plays an important role in the diagnostic process but the defi nitive dia gnosis is determined by a histological examination. Due to the location of the sphenoid sinus, in some cases, the delayed dia gnosis may cause serious consequences. The article presents a case report of a patient with isolated mycotic infl ammation of the sphenoid sinus. The aim of the article is to point out the non-specifi c symptoms of the disease and the typical radiological signs that can help us in the dia gnostics. Key words mycotic infl ammation – sphenoid sinus – headache","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133209679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Doležal, E. Račeková, M. Martončíková, M. Skálová, L. Varga, M. Tedla, P. Lukášek, V. Calkovsky, R. Zigo, J. Večeřa, S. Dobrović, T. Pniak, M. Sabo, M. Almasi, J. Korch, I. Hriseňko, S. Straka
Objective: The aim of this study is to fi nd out how many patients with an ongoing smell and taste disorder after COVID-19 infection, can improve the subjective perception of smell by olfactory training method. Methods: Patients after COVID-19 (fi rst and second wave of the pandemic in 2020 and 2021) with persisting smell disorder (hyposmia, anosmia, parosmia, fantosmia) with or without taste disorder and while the olfactory disorder did not improve within one month afterrecovery, signed up on the website www.cuch.sk and asked for a testing set (perfumed felt-tip pens) to be sent. After a self-examination at home, each respondent fi lled out an on-line questionnaire and sent it to the Neurobio logical Institute of the BMC SAV. Patient with confi rmed hypo and anosmia underwent an ENT examination at contracted ENT workplaces in Slovakia. All the 117 patients included got through the olfactory training, twice a day, following the instructions. The control examination was performed after three and six months of smell training. Smell and taste status was evaluated by visual analogue scale (VAS) from 1 to 10 in admission and discharge of the study. According to VAS, the average entering olfactory status was 4 and the average taste status reached an average of 2. At admission, 28 patients entering the study suff ered from parosmia, 18 from phantosmia, and 20 from dysgeusia. Results: After the olfactory training, improvement of smell capability was observed in 96 patients, which is 73% from the whole group of patiets (117) with hyposmia and anosmia. The discharge olfactory score after 6 months of olfactory training reached grade 8 according to VAS. Improvement of taste capability was observed in 47 patients, which is 65% from the whole group of patients (72) with hypogeusia and dysgeusia. The discharge taste score after six months of olfacory training reached grade 4 according to VAS. However, various forms of dysgeusia, parosmia, or phantosmia persisted after the olfactory training in 18 patients. Conclusion: Smell (olfactory) training is currently considered the most eff ective rehabilitation method for improving impaired olfactory function after COVID-19 infection. Better subjective results were observed in the restitution of quantitative smell disorder than in quantitative taste disorder. Key words anosmia – hyposmia – COVID-19 – parosmia – phantosmia – hypogeusia – dysgeusia – olfactory training
{"title":"Results of treatment of olfactory disorders after COVID-19 disease using olfactory training","authors":"P. Doležal, E. Račeková, M. Martončíková, M. Skálová, L. Varga, M. Tedla, P. Lukášek, V. Calkovsky, R. Zigo, J. Večeřa, S. Dobrović, T. Pniak, M. Sabo, M. Almasi, J. Korch, I. Hriseňko, S. Straka","doi":"10.48095/ccorl2022147","DOIUrl":"https://doi.org/10.48095/ccorl2022147","url":null,"abstract":"Objective: The aim of this study is to fi nd out how many patients with an ongoing smell and taste disorder after COVID-19 infection, can improve the subjective perception of smell by olfactory training method. Methods: Patients after COVID-19 (fi rst and second wave of the pandemic in 2020 and 2021) with persisting smell disorder (hyposmia, anosmia, parosmia, fantosmia) with or without taste disorder and while the olfactory disorder did not improve within one month afterrecovery, signed up on the website www.cuch.sk and asked for a testing set (perfumed felt-tip pens) to be sent. After a self-examination at home, each respondent fi lled out an on-line questionnaire and sent it to the Neurobio logical Institute of the BMC SAV. Patient with confi rmed hypo and anosmia underwent an ENT examination at contracted ENT workplaces in Slovakia. All the 117 patients included got through the olfactory training, twice a day, following the instructions. The control examination was performed after three and six months of smell training. Smell and taste status was evaluated by visual analogue scale (VAS) from 1 to 10 in admission and discharge of the study. According to VAS, the average entering olfactory status was 4 and the average taste status reached an average of 2. At admission, 28 patients entering the study suff ered from parosmia, 18 from phantosmia, and 20 from dysgeusia. Results: After the olfactory training, improvement of smell capability was observed in 96 patients, which is 73% from the whole group of patiets (117) with hyposmia and anosmia. The discharge olfactory score after 6 months of olfactory training reached grade 8 according to VAS. Improvement of taste capability was observed in 47 patients, which is 65% from the whole group of patients (72) with hypogeusia and dysgeusia. The discharge taste score after six months of olfacory training reached grade 4 according to VAS. However, various forms of dysgeusia, parosmia, or phantosmia persisted after the olfactory training in 18 patients. Conclusion: Smell (olfactory) training is currently considered the most eff ective rehabilitation method for improving impaired olfactory function after COVID-19 infection. Better subjective results were observed in the restitution of quantitative smell disorder than in quantitative taste disorder. Key words anosmia – hyposmia – COVID-19 – parosmia – phantosmia – hypogeusia – dysgeusia – olfactory training","PeriodicalId":423943,"journal":{"name":"Otorinolaryngologie a foniatrie","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116724824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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