Clinical Assessment of Gustatory Function before and after Middle Ear Surgery: A Prospective Study with a Two-Year Follow-up Period

Mueller, Christian A.; Khatib, Saher; Naka, Asami; Temmel, Andreas F P; Hummel, Thomas

doi:10.1177/000348940811701012

Cited by 32 publications

(40 citation statements)

References 14 publications

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“…In cases in which the chorda tympani is manipulated but preserved, taste function decreases initially but recovers within a few months, 3,5 as seen in our third patient. In contrast, a sectioned chorda tympani will not recover to the level of normal function, even if the patient's symptoms resolve.…”

Section: Discussionsupporting

confidence: 55%

“…5,6 There are many reports suggesting that section of the chorda tympani leads to more severe and persistent taste symptoms. 1,3,5,6,20,21 The dilemma for otological surgeons is not whether to cut or preserve the chorda tympani but, rather, whether to cut or retain severely traumatised chorda tympani nerves. Based on the reported three cases, it is impossible to answer this question.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 The occurrence of taste disorders following middle-ear surgery have been reported for over a century, 4 and continue to be problematic. 5 There are still diverse opinions among otologists about what constitutes acceptable manipulation of the chorda tympani during surgery. [6][7][8] Based upon their clinical observations, House and Rice both claimed that cutting the chorda tympani, rather than leaving it severely traumatised, resulted in a lower incidence of taste disturbance.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] Based upon their clinical observations, House and Rice both claimed that cutting the chorda tympani, rather than leaving it severely traumatised, resulted in a lower incidence of taste disturbance. 9,10 While certain authors still defend this point of view, 8 recent studies have suggested that preserving the chorda tympani is preferable, 5,6 because long-term recovery of taste function is far better if the chorda tympani remains intact. 3 Section of the chorda tympani not only affects taste, but also leads to parasympathetic denervation of the ipsilateral submandibular, sublingual and accessory oral salivary glands.…”

Section: Introductionmentioning

confidence: 99%

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Cutting the chorda tympani: not just a matter of taste

et al. 2010

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Introduction: Chorda tympani injury as a complication of middle-ear surgery has been extensively studied with regard to its effects upon taste. However, the chorda tympani also carries parasympathetic fibres to the salivary glands of the oral cavity. To date, little has been reported about the effect of chorda tympani section upon salivary function.Setting: Tertiary care centre. Material and methods: We report a case series of three patients with bilateral chorda tympani lesions. Chorda tympani function was assessed using 'taste strips' and unstimulated sialometry. A careful history of oral symptoms was taken.Results: All patients showed transient or permanent bilateral ageusia of the anterior two-thirds of the tongue, and a decreased resting salivary flow rate. In addition, all patients suffered from transient or persistent, distressing xerostomia.Conclusion: Taste disorders may occur after middle-ear surgery but they are mostly transient, even when the chorda tympani nerves are sectioned bilaterally. In contrast, bilateral chorda tympani lesions may lead to severe, persistent and distressing xerostomia. Based on this neglected aspect of chorda tympani function, we emphasise the importance of preserving the chorda tympani whenever possible.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cutting the chorda tympani: not just a matter of taste

et al. 2010

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“…Causes for dysgeusia are variable and include primary medical 1 and psychological disorders 2 , medication side effects 3 , chemicals and toxins 4 , local disorders of the mouth 5 , insufficient production of saliva 6 , surgery 7, 8 , and gastroesophageal reflux disease. Here we describe a case of hypogeusia following oral contact with a commercial cleaning agent, and discuss diagnostic considerations in determining the nature and extent of taste dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Diagnosis of hypogeusia after oral exposure to commercial cleaning agent and considerations for clinical taste testing

2017

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Few reports in the literature document acute taste disturbance following exposure to toxic chemicals. We describe the case of a 54-year-old man who presented with primary complaint of tongue numbness and persistent problems with taste 1.5 years following oral exposure to a commercial cleaning agent. A test of olfaction revealed normosmia for age and gender. Lingual tactile two-point discrimination testing showed reduced somatosensation. Taste threshold testing using a 3-drop method demonstrated severe hypogeusia, though the patient was able to discriminate tastants at lower concentrations with a whole mouth swish and spit test. We conclude that clinical evaluation of dysgeusia can be performed using a number of previously published testing methods, however, determining causative factors may be confounded by duration since exposure, lack of knowledge of baseline taste function, and medications. Although many testing options exist, basic taste testing can be performed with minimal expertise or specialized equipment, depending on the patient history and goals of evaluation.

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