Maeda Emi, Katsura Hirokazu, Nin Tomomi, Sakaguchi-Fukunaga Akiko, Mishiro Yasuo, Sakagami Masafumi
Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan.
Department of Otolaryngology, Osaka Minato Central Hospital, Osaka, Japan.
Laryngoscope. 2018 Mar;128(3):701-706. doi: 10.1002/lary.26598. Epub 2017 Apr 11.
Patients after middle ear surgery often complain of taste disturbance and a lingual numbness. The purpose of this study was to objectively assess changes in the somatosensation of the tongue and taste function in patients undergoing stapes surgery.
Prospective study.
Symptoms of taste disturbance and tongue numbness after surgery were investigated before and after surgery in 41 patients (13 males, 28 females; mean age 41.8 years) who underwent stapes surgery. Twenty-eight patients (9 males, 19 females; mean age 43.1 years) underwent sensory and taste function tests before and after surgery. Sensory function of the tongue was measured at the operated side and the nonoperated side using the 2-point discrimination test and an electrostimulator test. Taste function was assessed with electrogustometry (EGM).
The chorda tympani nerve (CTN) was gently touched or stretched in all patients. Postoperative thresholds on the operated side were significantly higher than preoperative thresholds in all tests in the patients who underwent all three kinds of tests. Tongue somatosensory symptoms improved significantly earlier than the taste disturbance postoperatively, and the sensory thresholds returned to the baseline along with recovery of symptoms.
These findings suggest that dysfunction of the CTN occurred following surgery even when the CTN was preserved, and that the sensory nerve threshold of the tongue correlated with the symptom of lingual numbness. The CTN may play a role not only in taste function but also in the somatosensory function of the tongue.
中耳手术后的患者常主诉味觉障碍和舌部麻木。本研究的目的是客观评估接受镫骨手术患者的舌部躯体感觉和味觉功能变化。
前瞻性研究。
对41例接受镫骨手术的患者（13例男性，28例女性；平均年龄41.8岁）在手术前后调查味觉障碍和舌部麻木症状。28例患者（9例男性，19例女性；平均年龄43.1岁）在手术前后接受感觉和味觉功能测试。使用两点辨别试验和电刺激器测试在手术侧和非手术侧测量舌部的感觉功能。用电味觉测量法（EGM）评估味觉功能。
所有患者的鼓索神经（CTN）均受到轻触或牵拉。在接受所有三种测试的患者中，手术侧的术后阈值在所有测试中均显著高于术前阈值。术后舌部躯体感觉症状比味觉障碍显著更早改善，并且感觉阈值随着症状的恢复而恢复到基线水平。
这些发现表明，即使保留了CTN，手术后CTN仍会发生功能障碍，并且舌部的感觉神经阈值与舌部麻木症状相关。CTN可能不仅在味觉功能中起作用，还在舌部的躯体感觉功能中起作用。
4。《喉镜》，128:701 - 706，2018年。
