Saito Takehisa, Ito Tetsufumi, Kato Yuji, Yamada Takechiyo, Manabe Yasuhiro, Narita Norihiko
*Department of Otolaryngology, Head and Neck Surgery; †Department of Anatomy, Faculty of Medicine; and ‡Research and Education Program for Life Science, University of Fukui, Fukui, Japan.
Otol Neurotol. 2014 Mar;35(3):e110-6. doi: 10.1097/MAO.0000000000000223.
To evaluate whether regenerated fungiform taste buds after severing the chorda tympani nerve can be detected by confocal laser scanning microscopy in vivo.
Retrospective study.
University hospital.
Six patients with a normal gustatory function (Group 1), 9 patients with taste function recovery after severing the CTN (Group 2), and 5 patients without taste function recovery (Group 3) were included. In Groups 2 and 3, canal wall up (closed) tympanoplasty or canal wall down with canal reconstruction tympanoplasty was performed in all patients.
Diagnostic.
The severed nerves were readapted or approximated on the temporalis muscle fascia used to reconstruct the eardrum during surgery. Preoperative and postoperative gustatory functions were assessed using electrogustometry. Twelve to 260 months after severing the CTN, the surface of the midlateral region of the tongue was observed with a confocal laser microscope.
EGM thresholds showed no response 1 month after surgery in all patients of Groups 2 and 3. In Group 2, EGM thresholds showed recovery 1 to 2 years after surgery and before confocal microscopy (-1.3 ± 6.5 dB). There was a significant difference between Group 1 (-5.7 ± 2.0 dB; p < 0.01) and Group 2. In Group 3, EGM thresholds showed no response for more than 2 years. In the control group (Group 1), 0 to 16 taste buds were observed in each FP, and 55 (79.7%) of 69 FP contained at least 1 taste bud. The mean number of taste bud per papilla was 3.7 ± 3.6. In patients with a recovered taste function (Group 2), 0 to 8 taste buds were observed in each FP. In this group, 54 (56.2%) of 94 FP contained at least 1 taste bud. The mean number of taste bud per papilla was 2.0 ± 2.2 (p < 0.01). In Group 3, without recovery, the FP was atrophied, and no taste bud was observed.
Regenerated fungiform taste bud could be observed in vivo using confocal laser scanning microscopy, indicating that regenerated taste bud can be detected without biopsy.
评估在鼓索神经切断后，再生的菌状味蕾能否通过共聚焦激光扫描显微镜在体内检测到。
回顾性研究。
大学医院。
纳入6名味觉功能正常的患者（第1组）、9名鼓索神经切断后味觉功能恢复的患者（第2组）和5名味觉功能未恢复的患者（第3组）。在第2组和第3组中，所有患者均接受了上鼓室（封闭）鼓室成形术或下鼓室伴外耳道重建鼓室成形术。
诊断性。
在手术过程中，将切断的神经重新适应或靠近用于重建鼓膜的颞肌筋膜。术前和术后使用电味觉测试评估味觉功能。在切断鼓索神经12至260个月后，用共聚焦激光显微镜观察舌中外侧区域的表面。
第2组和第3组所有患者术后1个月电味觉测试阈值均无反应。在第2组中，术后1至2年且在共聚焦显微镜检查前电味觉测试阈值显示恢复（-1.3±6.5dB）。第1组（-5.7±2.0dB；p<0.01）和第2组之间存在显著差异。在第3组中，电味觉测试阈值超过2年无反应。在对照组（第1组）中，每个味蕾乳头中观察到0至16个味蕾，69个味蕾乳头中有55个（79.7%）至少含有1个味蕾。每个乳头的味蕾平均数量为3.7±3.6。在味觉功能恢复的患者（第2组）中，每个味蕾乳头中观察到0至8个味蕾。在该组中，94个味蕾乳头中有54个（56.2%）至少含有1个味蕾。每个乳头的味蕾平均数量为2.0±2.2（p<0.01）。在第3组中，未恢复，味蕾乳头萎缩，未观察到味蕾。
使用共聚焦激光扫描显微镜可在体内观察到再生的菌状味蕾，这表明无需活检即可检测到再生的味蕾。
