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中耳手术后患者口腔三叉神经敏感性的变化。

Changes of oral trigeminal sensitivity in patients after middle ear surgery.

作者信息

Just Tino, Steiner Susanne, Strenger Tobias, Pau Hans W

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Rostock, Germany.

出版信息

Laryngoscope. 2007 Sep;117(9):1636-40. doi: 10.1097/MLG.0b013e31806dd060.

Abstract

OBJECTIVES

The specific aim of this study was to re-investigate the effect of chorda tympani damage on both trigeminal sensitivity and taste ability.

STUDY DESIGN

Prospective study.

METHODS

Capsaicin-impregnated filter paper strips (5 concentrations, 0.0001-1%) were used to measure trigeminal thresholds. The strips were placed on the anterior tongue for 10 seconds. Thresholds were estimated in two ways: 1) thresholds related to sensory perception and 2) intensity-related thresholds. The test was applied to 29 patients who underwent middle ear surgery (mean age, 49 yr; 16 females, 13 males). Results were compared with those of 63 healthy subjects (mean age, 40 yr; 36 females, 29 males). In addition to trigeminal thresholds, measures of gustatory function were also obtained using both the validated "taste strips" test kit and electrogustometry.

RESULTS

For lateralized testing with capsaicin, significant differences were found between preoperative and postoperative thresholds and between the operated and nonoperated side, with thresholds being higher postoperatively on the operated side. The sensation-related thresholds from the operated tongue side exhibited a correlation with the corresponding postoperative electrogustometric thresholds. A higher degree of chorda manipulation was associated with higher postoperative capsaicin thresholds at the operated tongue side.

CONCLUSION

Pain-related sensitivity of the tongue decreases after middle ear surgery, indicating that chorda tympani function also influences intraoral trigeminal sensitivity.

摘要

目的

本研究的具体目的是重新调查鼓索损伤对三叉神经敏感性和味觉能力的影响。

研究设计

前瞻性研究。

方法

使用含辣椒素的滤纸条(5种浓度,0.0001 - 1%)测量三叉神经阈值。将纸条置于舌前部10秒。阈值通过两种方式估算:1)与感觉知觉相关的阈值和2)与强度相关的阈值。该测试应用于29例接受中耳手术的患者(平均年龄49岁;女性16例,男性13例)。结果与63名健康受试者(平均年龄40岁;女性36例,男性29例)的结果进行比较。除了三叉神经阈值外,还使用经过验证的“味觉试纸”测试试剂盒和电味觉测量法获得味觉功能测量结果。

结果

对于用辣椒素进行的单侧测试,术前和术后阈值之间以及手术侧和非手术侧之间存在显著差异,手术侧术后阈值更高。手术侧舌侧与感觉相关的阈值与相应的术后电味觉测量阈值存在相关性。更高程度的鼓索操作与手术侧舌侧术后更高的辣椒素阈值相关。

结论

中耳手术后舌部与疼痛相关的敏感性降低,表明鼓索功能也会影响口腔内的三叉神经敏感性。

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