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Shahan Momjian, Rémi Tyrand, Basile N. Landis and Colette Boëx

. 30 Besides these routinely performed modalities, neuromonitoring of visual pathways has been shown to be feasible. 6 , 15 , 25 In contrast, neither of the chemical senses (i.e., smell and taste) has yet been considered in intraoperative neuromonitoring. 35 Olfaction allows sensing of millions of odors through chemical receptors of the olfactory epithelium. The peripheral olfactory system consists of many different chemical receptor cells in the olfactory epithelium located in the nasal cavity. 29 The axons of these olfactory receptor cells pass the cribriform

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Eduardo Santamaria Carvalhal Ribas and Hugues Duffau

taste qualities affect only 0.85% patients presenting to a specialized medical center. 62 Indeed, most patients erroneously report both smell and taste disorders given the fact that these two senses are functionally associated, but upon testing, severe generalized taste loss as a clinical entity is very rare. 41 Although these symptoms are usually seen as minor deficits, their implications can be important. Olfactory loss has been associated with a greater incidence of depression 20 and decreased quality of life, 35 since more than 70% of patients with

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Joost de Vries, Tomas Menovsky and Koen Ingels

C linical studies on ONF in patients with an aneurysmal SAH are limited. The neurosurgical literature focuses mainly on olfactory preservation during surgery. 3 , 5 , 6 , 8 , 9 , 18 , 21–23 , 25 In our experience over the last years, however, some patients did report a loss of smell and/or taste after SAH and before surgery. In general, patients with loss of smell and/or taste believe that this affects their quality of life very negatively. The negative impact of olfactory dysfunction on quality of life was recently confirmed. 12 , 17 , 24 The aim of

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Gemma Escartin Martin, Carme Junqué, Montserrat Juncadella, Andreu Gabarrós, Maria Angels de Miquel and Francisco Rubio

O lfactory dysfunction can arise from a variety of causes and may greatly influence the patient's quality of life. 14 , 17 In patients suffering from SAH caused by a ruptured ACoA, anosmia (the inability to smell) has been reported in surgically treated patients, with the prevalence of this dysfunction depending on the type of treatment approach for the aneurysm. 1 , 9 , 11 , 22 A recent study has also reported anosmia in patients with SAH who were treated using endovascular coil embolization. 25 These studies usually assess odor detection with either a

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Maaike R. Moman, Bon H. Verweij, Joeri Buwalda and Gabriël J. E. Rinkel

O lfactory disturbances have considerable effect on the quality of life and on nutritional intake. 6 In a previous study we found that patients who have survived an episode of aneurysmal SAH and in whom the aneurysm has been treated often experience a loss of smell. 9 Damage to the olfactory nerve during surgical treatment of the aneurysm is frequently implicated as a cause for this loss of smell after SAH, although the degree of olfactory nerve damage is not always related to the occurrence of postoperative anosmia. 8 However, surgical damage cannot be

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Yi Yuen Wang, Vinothan Srirathan, Erica Tirr, Tara Kearney and Kanna K. Gnanalingham

for symptoms at 3 time points * Symptom Percentage of Patients Selecting Grade p Value † Preop 3–6 Mos Postop 6–24 Mos Postop 0 1 2 3 0 1 2 3 0 1 2 3 1 I have sores inside my nose 99 1 0 0 84 9 7 0 90 10 0 0 0.001 2 I get headaches 53 7 15 25 69 11 13 7 75 5 14 6 0.002 3 I take too many painkillers 86 2 4 8 92 7 1 0 94 5 1 0 0.01 4 There is an unpleasant smell in my nose 96 3 1 0 78 6 11 5 90 5

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Akira Nakamizo, Koji Yoshimoto, Toshiyuki Amano, Masahiro Mizoguchi and Tomio Sasaki

T he term “crocodile tears” arises out of an ancient Greek myth that crocodiles use tears to lure their prey and then continue to shed tears as they devour them. 6 Crocodile tears syndrome is a lacrimal hypersecretion disorder characterized by excessive tearing with gustatory stimulation while eating, drinking, or smelling food. 3 , 11 , 13 It is a relatively rare syndrome that has mainly been observed after incomplete recovery from peripheral facial nerve palsy. This condition most commonly occurs after a Bell palsy, but can also be seen after other

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Bertrand Actor, Johannes Sarnthein, Peter Prömmel, David Holzmann and René L. Bernays

1987, has been applied for TSS at our department. Nasal complications caused by this approach have previously been described, but olfactory disturbance has never been investigated in a systematic fashion. The consideration that the sense of smell is deeply anchored and interwoven within the CNS, and that the coding of its function requires 1% of our genome, 2 yields ample incentive for its preservation. These circumstances have motivated us to explore olfactory complications in this widely established surgical approach systematically, to allow more precise

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Gabriel Zada, Daniel F. Kelly, Pejman Cohan, Christina Wang and Ronald Swerdloff

expressed complaints about the procedure. The frequency of sinonasal complaints declined from two weeks after surgery to 3 months or more after surgery ( Fig. 1 ). At the later time point, patients quantified these problems as follows: regarding facial pain, none 83%, mild 8%, moderate 5%, and severe 4%; regarding nasal congestion, none 74%, mild 13%, moderate 10%, and severe 3%; regarding decreased nasal airflow, none 77%, mild 12%, moderate 7%, and severe 4%; regarding a decreased sense of smell, none 73%, mild 18%, moderate 5%, and severe 4%; and regarding upper lip

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Geoffrey Siegel, Nilesh Patel and Rakesh Ramakrishnan

The authors report a case of rectal injury, rectocutaneous fistula, and pseudarthrosis after a TranS1 axial lumbar interbody fusion (AxiaLIF) L5–S1 fixation. The TranS1 AxiaLIF procedure is a percutaneous minimally invasive approach to transsacral fusion of the L4–S1 vertebral levels. It is gaining popularity due to the ease of access to the sacrum through the presacral space, which is relatively free from intraabdominal and neurovascular structures.

This 35-year-old man had undergone the procedure for the treatment of degenerative disc disease. The patient subsequently presented with fever, syncope, and foul-smelling gas and bloody drainage from the surgical site. A CT fistulagram and flexible sigmoidoscopy showed evidence of rectocutaneous fistula, which was managed with intravenous antibiotic therapy and bowel rest with total parenteral nutrition. Subsequent studies performed 6 months postoperatively revealed evidence of pseudarthrosis. The patient's rectocutaneous fistula symptoms gradually subsided, but his preoperative back pain recurred prompting a revision of his L5–S1 spinal fusion.