Department of Otolaryngology-Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Otol Neurotol. 2023 Sep 1;44(8):749-757. doi: 10.1097/MAO.0000000000003949. Epub 2023 Jul 18.
There is a paucity of data reporting the rate of chorda tympani nerve injury during cochlear implantation (CI) surgery. To better provide clarity to patients and surgeons regarding the risk of taste change, we performed a systematic review and meta-analysis of prospective studies examining taste change after CI.
PubMed, Embase, and Cochrane Library databases were queried.
Databases were queried according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included "(chorda tympani OR gustatory OR taste OR chemosensory OR dysgeusia OR nervus intermedius) AND (cochlea OR cochlear implant OR cochlear implantation)." Prospective studies were included and further divided into "objective" and "subjective" assessments of taste dysfunction. A systematic review was performed for all studies. A random-effects model was used to compare studies with similar methods and patient demographics.
The initial database query yielded 2,437 articles, which were screened according to inclusion and exclusion criteria. Nine appropriate studies were identified, including 442 total patients-254 with subjective assessment and 271 with objective assessment of gustation. Seventeen of 144 patients (11.8%) reported short-term taste change (incidence = 0.09 [0.02-0.16], 95% confidence interval with pooled data). Twenty-six of 265 patients (9.8%) reported long-term taste change (incidence = 0.07 [0.01-0.13]). Objective results were heterogenous and therefore not amenable to pooled meta-analysis.
Taste change from chorda tympani nerve injury is a likely underrecognized complication of CI and may be the most common adverse consequence of CI surgery. Surgeons should counsel prospective patients on this potential complication and that the risk of taste change may persist longer than the immediate postoperative period.
有关耳蜗植入（CI）手术中鼓索神经损伤发生率的数据很少。为了更好地向患者和外科医生阐明味觉改变的风险，我们对检查 CI 后味觉改变的前瞻性研究进行了系统回顾和荟萃分析。
检索了 PubMed、Embase 和 Cochrane Library 数据库。
根据系统评价和荟萃分析的首选报告项目指南对数据库进行了查询。搜索词包括“（鼓索神经或味觉或味觉或化学感觉或味觉障碍或中间神经）和（耳蜗或耳蜗植入或耳蜗植入）”。纳入前瞻性研究，并进一步分为味觉功能障碍的“客观”和“主观”评估。对所有研究进行系统评价。使用随机效应模型比较具有相似方法和患者人口统计学特征的研究。
最初的数据库查询产生了 2437 篇文章，根据纳入和排除标准对其进行了筛选。确定了 9 项合适的研究，包括 442 名总患者-254 名接受主观评估，271 名接受味觉的客观评估。144 名患者中有 17 名（11.8%）报告了短期味觉改变（发生率=0.09 [0.02-0.16]，合并数据的 95%置信区间）。265 名患者中有 26 名（9.8%）报告了长期味觉改变（发生率=0.07 [0.01-0.13]）。客观结果存在异质性，因此不适合合并荟萃分析。
鼓索神经损伤引起的味觉改变是 CI 的一种可能被低估的并发症，可能是 CI 手术最常见的不良后果。外科医生应向预期患者告知这种潜在并发症的风险，并且味觉改变的风险可能会持续超过术后即刻期。
