Saito Takehisa, Ito Tetsufumi, Ito Yumi, Kato Yuji, Manabe Yasuhiro, Narita Norihiko
*Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, †Research and Education Program for Life Science, and ‡Department of Anatomy, Faculty of Medicine, University of Fukui, Japan.
Otol Neurotol. 2015 Mar;36(3):539-44. doi: 10.1097/MAO.0000000000000444.
To elucidate the degeneration process of fungiform taste buds after severing the chorda tympani nerve (CTN) by confocal laser scanning microscopy in vivo.
Prospective study.
University hospital.
Seven consecutive patients whose CTN was severed during tympanoplasty for middle ear cholesteatoma.
Diagnostic.
Preoperative and postoperative gustatory functions were assessed by electrogustometry (EGM). An average of 10 fungiform papillae (FP) in the midlateral region of the tongue were periodically observed, and the number of taste buds was counted using a confocal laser microscope. Among them, 2 to 3 reference FPs were selected based on the typical form of the FP or characteristic arrangements of taste pores. Observation was performed before surgery, 1 or 2 days after surgery, 2 or 3 times a week until 2 weeks after surgery, once a week between 2 and 4 weeks, and every 2 to 4 weeks thereafter until all taste buds had disappeared.
EGM thresholds showed no response within 1 month after surgery in all patients. The initial change in the degeneration process was the disappearance of taste pores. The surface of taste buds became covered with epithelium. Finally, taste buds themselves atrofied and disappeared. The time course of degeneration differed depending upon individuals, each FP, and each taste bud. By employing the generalized linear mixed model under the Poisson distribution, it was calculated that all taste buds would disappear at around 50 days after surgery.
Confocal laser scanning microscopy was useful for clarifying the degeneration process of fungiform taste buds.
通过共聚焦激光扫描显微镜在体内观察切断鼓索神经（CTN）后菌状味蕾的退变过程。
前瞻性研究。
大学医院。
7例在中耳胆脂瘤鼓室成形术中切断CTN的连续患者。
诊断性研究。
术前和术后通过电味觉测试（EGM）评估味觉功能。定期观察舌中外侧区域平均10个菌状乳头（FP），并使用共聚焦激光显微镜计数味蕾数量。其中，根据FP的典型形态或味孔的特征排列选择2至3个参考FP。在手术前、手术后1或2天、术后2周内每周观察2或3次、术后2至4周每周观察1次、此后每2至4周观察1次，直至所有味蕾消失。
所有患者术后1个月内EGM阈值均无反应。退变过程的初始变化是味孔消失。味蕾表面被上皮覆盖。最后，味蕾自身萎缩并消失。退变的时间进程因个体、每个FP和每个味蕾而异。通过采用泊松分布下的广义线性混合模型计算得出，所有味蕾将在术后约50天消失。
共聚焦激光扫描显微镜有助于阐明菌状味蕾的退变过程。
Zotero 插件