Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Fukui, Fukui, Japan.
Otol Neurotol. 2012 Dec;33(9):1567-72. doi: 10.1097/MAO.0b013e3182713997.
To compare the incidence of regeneration of the chorda tympani nerve (CTN) and taste function recovery between pediatric and adult patients after severing the CTN.
Retrospective study.
University hospital.
Consecutive 31 pediatric patients and 61 adult patients who underwent staged tympanoplasty (86 patients) or reoperation (6 patients) because of chronic otitis media with (89 patients) or without cholesteatoma (3 patients) and whose CTN was severed during primary surgery were included.
Therapeutic.
The severed nerves were readapted or approximated on the temporalis muscle fascia used to reconstruct the eardrum. During secondary surgery, we tried to detect regenerated CTN. Preoperative and postoperative gustatory function was assessed using electrogustometry.
Regenerated CTN was detected during secondary surgery in 58.1% (18/31) of pediatric patients and 31.1% (19/61) of adults (p < 0.05). However, the number of patients with preoperatively elevated electrogustometry threshold was greater in adult patients. When the subjects were limited to those with preoperatively normal taste function, there was no significant difference between the 2 groups. Among patients with CTN regeneration, the incidence of taste function recovery was higher (12/18; 66.7%) in children than that (6/19; 31.6%) in adults (p < 0.05). However, there was no significant difference when the subjects were limited to those with preoperatively normal taste function.
Chronic inflammation may not severely affect the CTN in pediatric patients, resulting in higher incidences of CTN regeneration and gustatory function recovery after severing the nerve, compared with those in adult patients.
比较儿童和成人患者切断鼓索神经（CTN）后 CTN 再生和味觉功能恢复的发生率。
回顾性研究。
大学医院。
连续纳入 31 例儿童患者和 61 例因慢性中耳炎伴（89 例）或不伴胆脂瘤（3 例）而行分期鼓室成形术（86 例）或再次手术（6 例）且初次手术中切断 CTN 的成年患者。
治疗。
将切断的神经重新连接或接近用于重建鼓膜的颞肌筋膜。在二次手术中，我们试图检测再生的 CTN。使用味觉电刺激计评估术前和术后的味觉功能。
在 31 例儿童患者中有 58.1%（18/31），在 61 例成年患者中有 31.1%（19/61）在二次手术中检测到再生 CTN（p < 0.05）。然而，成年患者中术前味觉电刺激计阈值升高的患者更多。当将研究对象限于术前味觉功能正常的患者时，两组之间无显著差异。在 CTN 再生的患者中，味觉功能恢复的发生率在儿童（12/18；66.7%）中高于成人（6/19；31.6%）（p < 0.05）。然而，当将研究对象限于术前味觉功能正常的患者时，两组之间无显著差异。
慢性炎症可能不会严重影响儿童患者的 CTN，导致与成年患者相比，切断神经后 CTN 再生和味觉功能恢复的发生率更高。
