鼓索神经损伤在耳内镜与显微镜镫骨手术中的比较：一项随机对照临床试验。
Chorda tympani injury during endoscopic versus microscopic stapes surgery: a randomized controlled clinical trial.
机构信息
Department of Otorhinolaryngology, Mansoura University, Mansoura, 35511, Egypt.
出版信息
Eur Arch Otorhinolaryngol. 2023 Feb;280(2):689-693. doi: 10.1007/s00405-022-07550-0. Epub 2022 Jul 24.
OBJECTIVES
The aim of this study was to compare the incidence of chorda tympani nerve (CTN) injury between endoscopic and microscopic stapes surgery.
METHODS
This randomized controlled clinical trial included 88 patients who were randomly divided into two groups: endoscopic stapedotomy group (n = 44) and microscopic stapedotomy group (n = 44). The incidence of chorda tympani nerve (CTN) injury after surgery was determined by both subjective taste testing and chemical taste tests, before and after surgery. The results were compared between the two groups.
RESULTS
The total number of patients who were identified as having CTN affection (based on the chemical testing) was 16 out of 88 (18.2%). The incidence was significantly lower in the endoscopic group (n = 2) than the microscopic group (n = 14) (p = 0.019).
CONCLUSION
Altered taste as a result of iatrogenic CTN injury can affect the patients' quality of life. Endoscopic ear surgery offers better visualization, less need for extensive manipulation of the chorda tympani, and consequently decreased incidence of CTN injury.
目的
本研究旨在比较内镜和显微镜镫骨手术中鼓索神经（CTN）损伤的发生率。
方法
这是一项随机对照临床试验，纳入了 88 名患者，他们被随机分为两组：内镜镫骨切开术组（n=44）和显微镜镫骨切开术组（n=44）。通过术前和术后的主观味觉测试和化学味觉测试来确定手术后鼓索神经（CTN）损伤的发生率，并对两组结果进行比较。
结果
88 例患者中，有 16 例（18.2%）被确定为 CTN 受累。内镜组（n=2）的发生率明显低于显微镜组（n=14）（p=0.019）。
结论
医源性 CTN 损伤引起的味觉改变会影响患者的生活质量。内镜耳科手术提供了更好的可视化效果，对鼓索神经的广泛操作需求较少，因此 CTN 损伤的发生率降低。
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