Guinand N, Just T, Stow N W, Van H Cao, Landis B N
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland.
J Laryngol Otol. 2010 Sep;124(9):999-1002. doi: 10.1017/S0022215110000733. Epub 2010 Apr 7.
Chorda tympani injury as a complication of middle-ear surgery has been extensively studied with regard to its effects upon taste. However, the chorda tympani also carries parasympathetic fibres to the salivary glands of the oral cavity. To date, little has been reported about the effect of chorda tympani section upon salivary function.
Tertiary care centre.
We report a case series of three patients with bilateral chorda tympani lesions. Chorda tympani function was assessed using 'taste strips' and unstimulated sialometry. A careful history of oral symptoms was taken.
All patients showed transient or permanent bilateral ageusia of the anterior two-thirds of the tongue, and a decreased resting salivary flow rate. In addition, all patients suffered from transient or persistent, distressing xerostomia.
Taste disorders may occur after middle-ear surgery but they are mostly transient, even when the chorda tympani nerves are sectioned bilaterally. In contrast, bilateral chorda tympani lesions may lead to severe, persistent and distressing xerostomia. Based on this neglected aspect of chorda tympani function, we emphasise the importance of preserving the chorda tympani whenever possible.
鼓索神经损伤作为中耳手术的一种并发症，其对味觉的影响已得到广泛研究。然而，鼓索神经还携带副交感神经纤维至口腔的唾液腺。迄今为止，关于鼓索神经切断对唾液功能的影响鲜有报道。
三级医疗中心。
我们报告了一组3例双侧鼓索神经病变患者的病例系列。使用“味觉试纸”和非刺激性唾液流量测定法评估鼓索神经功能。详细询问了口腔症状病史。
所有患者均出现双侧舌前三分之二短暂或永久性味觉丧失，以及静息唾液流速降低。此外，所有患者均患有短暂或持续性的、令人痛苦的口干症。
中耳手术后可能会出现味觉障碍，但即使双侧切断鼓索神经，味觉障碍大多也是短暂的。相比之下，双侧鼓索神经病变可能导致严重、持续且令人痛苦的口干症。基于鼓索神经功能这一被忽视的方面，我们强调尽可能保留鼓索神经的重要性。
