Short term and long term subjective taste disorder after middle ear cleft surgery

Abstract

Aim:The present study is a prospective study that looks into the prevalence of chorda tympani nerve injury and related symptoms following varying degrees of trauma to the nerve during four common types of middle-ear operations; namely, Tympanomastoid operations, myringoplasty, Tympanoplasty and Exploratory tympanotomy. Materials and Methods: 178 patients who underwent middle ear cleft surgery were included in this prospective study. Childrens below 20 years and patients with other potential cause of taste disturbance were excluded. Patients were given a single questionnaire, so as to assess their post-operative taste disturbance. Patient name, Age, Sex, Type of middle ear surgery, side of surgery were recorded. Any change in sense of taste immediately (after 2-4 weeks) or delayed (2-3 years)were recorded. Results: The number of patients with Chorda tympani nerve-related symptoms varied widely between these four groups. Increased occurrence of the nerve related symptoms were observed in Tympanomastoid and Myringoplasty, and a prolonged recovery time were observed in the tympanomastoid group. Stretching of the nerve produced more symptomatic cases than thermal injury or drying. Conclusion: It is important to inform patients about the possibility of Chorda Tympani Nerve injury during middle-ear operations, and it should also be emphasized that symptoms related to Chorda Tympani Nerve injury can occur irrespective of the type of damage to the nerve.

Feasibility of preservation of chorda tympani nerve during noninflammatory ear surgery: A systematic review

“…In 10 studies, no clear report was available regarding CTN preservation or iatrogenic lesion. Outcome of these studies did not evaluate CTN status . Seven studies were excluded due to a lack of preoperative diagnosis for ear surgery because it was unclear if patients with inflammatory disease were included.…”

“…After title and abstract screening, 58 articles were assessed for eligibility in full text. In total, 30 studies reported on the gustatory function after ear surgery . In 10 studies, no clear report was available regarding CTN preservation or iatrogenic lesion.…”

“…Outcome of these studies did not evaluate CTN status. 20,21,23,[28][29][30]32,33,36,37 Seven studies were excluded due to a lack of preoperative diagnosis for ear surgery because it was unclear if patients with inflammatory disease were included. In addition, studies with a low number (< 5) of reported patients were excluded.…”

Chorda tympani injury during endoscopic versus microscopic stapes surgery: a randomized controlled clinical trial

“…Stretching occurs frequently during tympano-meatal flap elevation during tympanoplasty, or during exposure of the ossicular chain during stapedectomy or ossiculoplasty [ 12 ]. In the current study, the CTN was grossly damaged in six cases (stretched in five and cut in one).…”