Alzhrani F, Lenarz T, Teschner M
Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
Cochlear Implants Int. 2013 Sep;14(4):200-6. doi: 10.1179/1754762812Y.0000000018. Epub 2012 Nov 27.
The chorda tympani nerve (CTN) is at risk of damage during cochlear implantation, especially during posterior tympanotomy. The aim of this study was, therefore, to elicit the risk of taste disorders following cochlear implantation surgery involving a mastoidectomy and a posterior tympanotomy approach.
Twenty-six patients underwent a taste test before, 3 days after, and 6 weeks after cochlear implantation surgery. The taste sensations - sweet, sour, salt and bitter - were determined. Patients' self-ratings of taste function were also obtained. In addition, the surgeons provided information concerning the intraoperative status of the CTN.
In total, 19.2% (5 of 26) of the patients had postoperative taste dysfunction, as measured either subjectively or objectively or both. One of these five individuals had taste disturbance as assessed by both subjective and objective measures; in another, it was merely reported subjectively. Three patients were subjectively asymptomatic but the postoperative taste test revealed a dysfunction. Sixteen percent of the patients in whom the CTN was reported to be preserved intraoperatively had a postoperative taste dysfunction. Although the CTN was rerouted in five patients, only two of them (40%) had transient gustatory dysfunction. In two of those patients with postoperative taste dysfunction, the CTN was not intraoperatively exposed (being protected by bone) despite these individuals' experiencing postoperative taste problems. The recovery rate was 100% at 6 weeks after surgery.
Our study indicates that cochlear implantation entails only a minimal risk of taste dysfunction and that this is chiefly a transient problem.
鼓索神经(CTN)在人工耳蜗植入过程中,尤其是后鼓室切开术期间,有受损风险。因此,本研究的目的是探究采用乳突切除术和后鼓室切开术入路的人工耳蜗植入手术后味觉障碍的风险。
26例患者在人工耳蜗植入手术前、术后3天和术后6周接受味觉测试。测定甜、酸、咸和苦四种味觉。还获取了患者对味觉功能的自我评分。此外,外科医生提供了有关鼓索神经术中状况的信息。
总共19.2%(26例中的5例)的患者术后存在味觉功能障碍,通过主观或客观测量或两者兼用进行评估。这5例患者中有1例经主观和客观测量均显示味觉障碍;另一例仅为患者主观报告。3例患者主观上无症状,但术后味觉测试显示存在功能障碍。术中报告鼓索神经得以保留的患者中有16%术后存在味觉功能障碍。尽管有5例患者的鼓索神经进行了改道,但其中只有2例(40%)出现短暂性味觉功能障碍。在2例术后味觉功能障碍的患者中,尽管他们术后出现味觉问题,但术中鼓索神经未暴露(被骨质保护)。术后6周恢复率为100%。
我们的研究表明,人工耳蜗植入导致味觉功能障碍的风险极小,且这主要是一个短暂性问题。