Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands.
Brain Center, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands.
PLoS One. 2023 May 18;18(5):e0284571. doi: 10.1371/journal.pone.0284571. eCollection 2023.
The chorda tympani nerve (CTN) is a mixed nerve, which carries sensory and parasympathetic fibres. The sensory component supplies the taste sensation of the anterior two-thirds of the ipsilateral side of the tongue. During middle ear surgery the CTN is exposed and frequently stretched or sacrificed, because it lacks a bony covering as it passes through the middle ear. Injury may cause hypogeusia, ageusia or altered taste sensation of the ipsilateral side of the tongue. To date, there is no consensus regarding which type of CTN injury (sacrificing or stretching), during middle ear surgery, leads to the least burden for the patient.
A double-blind prospective prognostic association study was designed in a single medical centre in the Netherlands to determine the effect of CTN injury on postoperative taste disturbance and quality of life. 154 patients, who will undergo primary stapes surgery or cochlear implantation will be included. The taste sensation, food preferences and quality of life of these patients will be evaluated preoperatively and at one week, six weeks and six months postoperatively using the Taste Strip Test, Electrogustometry, supplementary questionnaire on taste disturbance, Macronutrient and Taste Preference Ranking Task, Appetite, Hunger and Sensory Perception questionnaire and Questionnaire of Olfactory Disorders to assess the association of these outcomes with CTN injury. Evaluation of olfactory function will only take place preoperatively and at one week postoperatively using the Sniffin' Sticks. The patient and outcome assessor are blinded to the presence or absence of CTN injury.
This study is the first to validate and quantify the effect of chorda tympani nerve injury on taste function. The findings of this study may lead to evidence-based proof of the effect of chorda tympani injury on taste function with consequences for surgical strategies.
Netherlands Trial Register NL9791. Registered on 10 October 2021.
鼓索神经（CTN）是一种混合神经，它携带感觉和副交感纤维。感觉成分提供同侧舌前 2/3 的味觉感觉。在中耳手术中，CTN 暴露并经常被拉伸或牺牲，因为它在穿过中耳时缺乏骨覆盖。损伤可能导致同侧舌味觉减退、味觉丧失或味觉改变。迄今为止，对于哪种类型的 CTN 损伤（牺牲或拉伸）在中耳手术中对患者的负担最小，尚无共识。
在荷兰的一家单一医疗中心设计了一项双盲前瞻性预后关联研究，以确定 CTN 损伤对术后味觉障碍和生活质量的影响。将纳入 154 名接受初次镫骨手术或耳蜗植入术的患者。使用 Taste Strip Test、Electrogustometry、味觉障碍补充问卷、Macronutrient 和 Taste Preference Ranking Task、食欲、饥饿和感官知觉问卷以及嗅觉障碍问卷，在术前和术后 1 周、6 周和 6 个月评估这些患者的味觉感知、食物偏好和生活质量，以评估这些结果与 CTN 损伤的相关性。嗅觉功能的评估仅在术前和术后 1 周使用 Sniffin' Sticks 进行。患者和结果评估者对 CTN 损伤的存在或不存在均不知情。
这项研究首次验证和量化了鼓索神经损伤对味觉功能的影响。这项研究的结果可能会为鼓索神经损伤对味觉功能的影响提供循证证据，并对手术策略产生影响。
荷兰试验注册 NL9791。于 2021 年 10 月 10 日注册。
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