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[中耳手术后早期味觉功能障碍]

[Early postoperative gustatory dysfunction after middle ear surgery].

作者信息

Székely László, Gáborján Anita, Tamás László, Polony Gábor

机构信息

1 Semmelweis Egyetem, Általános Orvostudományi Kar, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika Budapest, Szigony u. 36., 1083 Magyarország.

出版信息

Orv Hetil. 2022 Jun 5;163(23):920-925. doi: 10.1556/650.2022.32465.

Abstract

Introduction: Preserving maximal quality of life is an important factor in middle ear surgery according to current standards. Taste disturbance is a common postoperative complication, which can be explained with the risk of injury due to the localisation of chorda tympani. The knowledge about this complication is mandatory for optimal surgical decision-making and for patient education as well. Objective: Investigation of early postoperative taste disturbances, to clarify the differences between the impact of different surgical interventions, and the impact of nerve manipulation. Methods: 15 stapes surgeries and 28 tympanoplasties were investigated. Patients answered subjective questionnaires before surgery and on the first postoperative day. Visual analogue scale (VAS) was used to measure the degree of disturbances (0-10). Degree of nerve manipulation was classified into 5 groups. Results: No significant differences between the impact of stapes surgeries and tympanoplasties could be found (9, 9.1; p = 0.861). In groups '0', '1' and '2', the VAS scores were 10, 9.26, and 8.5. Between the groups no manipulation (0) and significant manipulation without macroscopic injury (2), the difference was significant (10, 8.5; p = 0.039). In the stapes surgery group, no severe taste disturbance (VAS<5) was found. Discussion: In the case of adequate microscopic surgical technique, the rate of postoperative taste disturbances is relatively low. Conclusions: The rate of postoperative taste disturbance could be kept at a low level while the continuity of the chorda tympani could be preserved in the majority of cases. The postoperative morbidity rate is primarily influenced by the degree of nerve manipulation and not by the type of surgery.

摘要

引言

根据当前标准,在中耳手术中保持最大生活质量是一个重要因素。味觉障碍是一种常见的术后并发症,这可以通过鼓索神经的位置所导致的损伤风险来解释。了解这种并发症对于优化手术决策以及患者教育来说都是必不可少的。目的:调查术后早期味觉障碍,以阐明不同手术干预的影响以及神经操作的影响之间的差异。方法:对15例镫骨手术和28例鼓室成形术进行了调查。患者在手术前和术后第一天回答主观问卷。使用视觉模拟量表(VAS)来测量障碍程度(0 - 10)。神经操作程度分为5组。结果:未发现镫骨手术和鼓室成形术的影响之间存在显著差异(9,9.1;p = 0.861)。在“0”组、“1”组和“2”组中,VAS评分分别为10、9.26和8.5。在无操作组(0)和无肉眼可见损伤的显著操作组(2)之间,差异显著(10,8.5;p = 0.039)。在镫骨手术组中,未发现严重味觉障碍(VAS < 5)。讨论:在具备足够的显微手术技术的情况下,术后味觉障碍的发生率相对较低。结论:在大多数情况下,可以将术后味觉障碍的发生率保持在较低水平,同时保留鼓索神经的连续性。术后发病率主要受神经操作程度的影响,而非手术类型的影响。

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