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镫骨手术后的味觉功能。

Taste function after stapes surgery.

作者信息

Guder Ellen, Böttcher Arne, Pau Hans Wilhelm, Just Tino

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Doberaner Strasse 137-139, Rostock, Germany.

出版信息

Auris Nasus Larynx. 2012 Dec;39(6):562-6. doi: 10.1016/j.anl.2011.10.020. Epub 2012 Feb 10.

Abstract

OBJECTIVE

A manipulation of chorda tympani nerve (CTN) is frequently necessary during the surgical therapy of stapedial ankylosis. The aim of this study was to re-assess the taste function before and after stapes surgery in patients with unilateral stapes ankylosis.

METHODS

Eighteen patients (14 female and 4 male) with unilateral stapedial ankylosis were included. Taste and olfactory function were measured preoperatively, 3 days and 3 months after surgery by questionnaire, chemical taste test, electrogustometry, and Sniffin'Sticks. The patients who reported deterioration in taste and revealed pathological taste test results were re-investigated 8-12 months after surgery. Postoperatively 11 patients were treated intravenously for 3 days for inner ear protection with 1g of cortisone. The gustatory and olfactory results were compared with age and sex specific normative data.

RESULTS

A significant transient decrease of gustatory measurement values was found on the ipsilateral two thirds of the anterior tongue. 12 out of 17 patients whose CTN was slightly manipulated during stapes surgery reported tongue sensations, such as numbness or gustatory blindness of the ipsilateral tongue side. The measures of chemical taste test significantly decrease in lateralized taste test on the ipsilateral side and in whole mouth testing. There was no significant increase of the EGM measures at the ipslateral tongue. In 11 of 12 patients with symptoms, complaints recovered within one year after surgery completely. The factor "cortisone" did not have a significant effect on the taste test results after surgery.

CONCLUSION

In conclusion, even after minor CTN manipulation the rate of postoperative taste disorders or tongue symptoms after stapes surgery is high. The symptoms appear to be transient. Therefore CTN should be preserved in stapes surgery after mild trauma of the CTN. Transient taste alteration should be mentioned prior to stapes surgery.

摘要

目的

在镫骨固定症的手术治疗过程中,经常需要对鼓索神经(CTN)进行操作。本研究的目的是重新评估单侧镫骨固定症患者在镫骨手术前后的味觉功能。

方法

纳入18例单侧镫骨固定症患者(14例女性,4例男性)。术前、术后3天和3个月通过问卷调查、化学味觉测试、电味觉测试和嗅觉棒测试来测量味觉和嗅觉功能。对报告味觉减退且味觉测试结果异常的患者在术后8 - 12个月进行再次调查。术后11例患者静脉注射1g皮质类固醇进行为期3天的内耳保护治疗。将味觉和嗅觉结果与年龄和性别特异性的标准数据进行比较。

结果

在前舌同侧三分之二区域发现味觉测量值有显著的短暂下降。17例在镫骨手术中对CTN进行轻微操作的患者中有12例报告有舌部感觉,如同侧舌侧麻木或味觉丧失。化学味觉测试的测量值在同侧侧化味觉测试和全口测试中显著降低。同侧舌部的电味觉测试测量值没有显著增加。12例有症状的患者中有11例术后一年内症状完全恢复。“皮质类固醇”因素对术后味觉测试结果没有显著影响。

结论

总之,即使对CTN进行轻微操作,镫骨手术后味觉障碍或舌部症状的发生率仍很高。这些症状似乎是短暂的。因此,在CTN轻度损伤后的镫骨手术中应保留CTN。在镫骨手术前应告知患者有短暂味觉改变的情况。

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