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中耳手术后味觉障碍:鼓索神经损伤与生活质量。

Taste Disorders After Middle Ear Surgery: Chorda Tympani Nerve Injury and Quality of Life.

机构信息

ENT Department, University Hospital Center of Nice, Nice, France.

UR2CA-Unité de Recherche Clinique Côte d'Azur, University Côte d'Azur, Nice, France.

出版信息

Otolaryngol Head Neck Surg. 2024 Dec;171(6):1834-1841. doi: 10.1002/ohn.920. Epub 2024 Aug 1.

Abstract

OBJECTIVE

To evaluate taste disorders after middle ear surgery, their modifying factors especially chorda tympani nerve injury or underlying otologic disease. We investigated consequences of taste disorders on quality of life.

STUDY DESIGN

Prospective cohort study.

SETTING

Monocentric study in tertiary care center.

METHODS

A total of 214 patients who underwent middle ear surgery were included. Data regarding taste disorders were collected by questionnaires over a 1-year follow-up period.

RESULTS

Taste disorders were reported in 42.7% at 10 days, in 23.3% at 4 months, and in 9.2% 1 year postoperatively. When the chorda tympani nerve was initially healthy, taste disorders were more frequent after its transection throughout the follow-up period. When it was involved in a cholesteatoma or inflammatory process, postoperative taste disorders were more frequent after nerve stretching. Postoperative discomfort in daily life was rated on the Likert scale at 3.5 out of 10. Dietary modifications were reported by 25.8% of patients, and mood alterations by 15% of patients.

CONCLUSION

Taste disorders are frequent after middle ear surgery although they mostly improve in the first months. When the CTN is healthy, cutting it leads to more taste disorders than stretching it, thus advocating its preservation to prevent these symptoms. However, in cases of pathological CTN, cutting this nerve, which is sometimes necessary to control the disease, is less likely to cause taste disorders than stretching it. These taste disorders are a source of discomfort and may present risks of dietary modifications and emotional impact.

摘要

目的

评估中耳手术后味觉障碍及其影响因素,尤其是鼓索神经损伤或潜在耳科疾病。我们研究了味觉障碍对生活质量的影响。

研究设计

前瞻性队列研究。

地点

单中心三级护理中心。

方法

共纳入 214 例行中耳手术的患者。通过问卷调查收集术后 1 年味觉障碍的数据。

结果

术后 10 天味觉障碍发生率为 42.7%,术后 4 个月为 23.3%,1 年时为 9.2%。当鼓索神经最初正常时,在整个随访期间,切断神经后味觉障碍更常见。当它参与胆脂瘤或炎症过程时,神经拉伸后术后味觉障碍更常见。术后日常生活不适程度在 10 分制中评分为 3.5 分。25.8%的患者报告了饮食改变,15%的患者报告了情绪改变。

结论

中耳手术后味觉障碍很常见,但大多在最初几个月内改善。当 CTN 正常时,切断它比拉伸它更容易引起味觉障碍,因此提倡保护它以预防这些症状。然而,在 CTN 病变的情况下,为了控制疾病而有时需要切断神经,与拉伸它相比,引起味觉障碍的可能性较小。这些味觉障碍会引起不适,并可能导致饮食改变和情绪影响的风险。

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