Michael Philip, Raut Vivek
New Cross Hospital, Wolverhampton, West Midlands, United Kingdom.
Otolaryngol Head Neck Surg. 2007 Jun;136(6):978-81. doi: 10.1016/j.otohns.2006.12.022.
This study aims to assess whether operative findings of chorda tympani nerve (CTN) trauma correlate with postoperative symptoms.
A prospective study was conducted over 2 years on 140 middle ear operations analyzing taste disturbances. The operations were subdivided into myringoplasty/tympanoplasty (56 cases), mastoidectomy (64 cases), and tympanotomy (20 cases).
Twenty-one (15%) patients reported taste disturbance. Altered taste was most reported (n=15, 71%) with loss of taste reported by 29% (n=6). Symptoms were most observed in the tympanotomy group (45%). Stretching of the CTN was associated with more symptoms than nerve transection. Recovery was complete in 76% (n=16) of the symptomatic cases by 12 months.
Patients who undergo middle ear surgery should be thoroughly counseled with respect to CTN injury and symptoms regardless of the type of damage to the nerve.
This study highlights the high incidence of postoperative alterations in taste after middle ear surgery, especially in non-diseased ears, and that CTN transection results in fewer symptoms than CTN stretching.
本研究旨在评估鼓索神经（CTN）损伤的手术所见是否与术后症状相关。
一项前瞻性研究历时2年，对140例中耳手术患者的味觉障碍进行分析。手术分为鼓膜成形术/鼓室成形术（56例）、乳突根治术（64例）和鼓室切开术（20例）。
21例（15%）患者报告有味觉障碍。味觉改变最为常见（n = 15，71%），味觉丧失占29%（n = 6）。症状在鼓室切开术组最为常见（45%）。CTN拉伸比神经横断导致更多症状。12个月时，76%（n = 16）的有症状病例完全恢复。
无论神经损伤类型如何，对于接受中耳手术的患者，均应就CTN损伤及症状进行充分的咨询。
本研究强调了中耳手术后味觉改变的高发生率，尤其是在无病变耳中，且CTN横断比CTN拉伸导致的症状更少。
