Surgery for Chronic Otitis Media Causes Greater Taste Disturbance Than Surgery for Otosclerosis

Holm, Katarina Berling; Bornefalk-Hermansson, Anna; Knutsson, Johan; Unge, Magnus von

doi:10.1097/mao.0000000000002048

Cited by 8 publications

(6 citation statements)

References 27 publications

(24 reference statements)

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“…Nine studies combined patients who underwent stapedectomy along with patients who underwent other otologic surgeries, but the results were combined and stapedectomy-specific data could not be extracted. This left eight studies with clear methodology and reported results which met inclusion criteria and were eligible for analysis (3)(4)(5)(6)(7)(8)(9). Seven studies included subjective assessment of taste (Table 2), of which only five studies included objective assessment of taste (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Subjective and Objective Taste Change After Stapes Surgery Systematic Review and Meta-Analysis

Coelho¹,

Lee²,

Yang³

et al. 2022

Otol Neurotol

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Iatrogenic injury to the chorda tympani (CT) is a well recognized, although potentially underestimated, consequence of stapes surgery. This study aims to review the currently available literature to determine the incidence and prognosis of taste disturbances in these patients. Data Sources: PubMed, Embase, and Cochrane Library databases Methods: Databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Search terms included (chorda tympani OR gustatory OR taste OR chemosensory OR dysgeusia OR nervus intermedius) AND (ear surgery OR middle ear OR stapes OR stapedectomy OR stapedotomy). Patients with prospective data collection including preoperative data were further divided by methodology into "objective" and "subjective" assessments of taste dysfunction. A systematic review was performed for all included studies, with meta-analysis using a random-effects model was used for those with comparable methodology and patient populations.Results: Initial search yielded 2,959 articles that were screened according to inclusion and exclusion criteria. Once duplicates were removed, seven studies were identified, representing 173 patients with subjective testing (all seven studies) and 146 with objective testing (five studies). Eighty of 173 patients (46.2%) noted a disturbance in taste at early follow-up, whereas as 26 of 173 (15.0%) noted long-term problems. Objective methodology and result reporting were heterogenous and not amenable to pooled meta-analysis for all studies included. Conclusion: Changes in taste occur relatively frequently after stapedectomy. Surgeons should continue to counsel prospective patients as to the risks of both short-and long-term taste disturbances.

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Section: Resultsmentioning

confidence: 99%

Subjective and Objective Taste Change After Stapes Surgery Systematic Review and Meta-Analysis

Coelho¹,

Lee²,

Yang³

et al. 2022

Otol Neurotol

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“…Previous studies have shown the effect of chronic ear infection and otologic surgery on CTN function. 12 , 13 , 14 , 15 , 16 , 17 Seaberg et al 18 performed EGM studies in 142 obese children and stratified the study groups based on a history of Otitis Media (OM). Those authors did not find any correlation between a history of OM and gustatory dysfunction, but they did not look at an ongoing middle ear infection in the acute phase.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Increase of Gustatory Thresholds in Acute Otitis Media: A Pilot Study

Klein¹,

Barkai²,

Neiderman³

et al. 2023

Int Adv Otol

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BACKGROUND: To evaluate chorda tympani nerve function as measured by unilateral increases of gustatory thresholds in the presence of ipsilateral acute otitis media. Methods: Prospective clinical study comparing electrogustometric measurements was conducted to evaluate the taste thresholds of each side of the tongue in a patient during an acute episode of unilateral acute otitis media. Included were patients aged 12-40 who presented to the emergency department and outpatient ear, nose, and throat clinic of a university-affiliate tertiary medical center with unilateral acute otitis media between January 2019 and January 2020 and consented to the study. Results: Eleven patients were initially recruited into the study, and 10 patients aged (mean ± standard deviation) 26.1 ± 11.2 years comprised the final study group. Taste thresholds were significantly elevated on the side ipsilateral to the ear affected by acute otitis media ( P < .05). Conclusion: Chorda tympani nerve conductance is impaired during the acute stage of acute otitis media. This may have implications in the understanding of peripheral neural properties during acute middle ear inflammatory conditions and on the diagnosis of acute otitis media.

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“…However, the incidence of these complications is low, approximately 1%, if a trained surgeon performs the surgery 4,5 . On the other hand, trauma to the chorda tympani nerve (CTN) is reported as the most frequent complication, occurring in 15%–55% of patients who undergo middle ear surgery 6–8 …”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 On the other hand, trauma to the chorda tympani nerve (CTN) is reported as the most frequent complication, occurring in 15%–55% of patients who undergo middle ear surgery. 6 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Factors affecting the incidence of chorda tympani nerve transection in middle ear surgery

Takihata

Kurioka

Mizutari

et al. 2022

Laryngoscope Investig Oto

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Objective: To reveal the factors affecting the incidence of chorda tympani nerve (CTN) transection during middle ear surgery. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: We analyzed 232 ears (117 ears with cholesteatoma, 101 ears with chronic otitis media, and 14 ears with otosclerosis) that underwent tympanoplasty or stapes surgery during 2017-2020. Intervention: Eighty-four ears underwent transcanal endoscopic ear surgery (TEES), 103 ears underwent microscopic ear surgery (MES), and 45 ears underwent surgery using both endoscopy and microscopy (Dual). Main Outcome Measure: To confirm CTN transection, intraoperative endoscopic/ microscopic video images were evaluated. We used the same video images to determine the anatomical variation of the CTN course in the middle ear. Results: In 18 ears (7.8%: 6/84 TEES ears [7.1%], 6/103 MES ears [5.8%], and 6/45Dual ears [13.3%]), the CTN was cut during middle ear surgery. There was no significant difference in CTN transection among groups. In cholesteatoma patients, stapes involvement resulted in a significantly higher CTN transection incidence. CTN anatomical variants such as the "Attached Short type" and "Ultrashort type" showed a significantly higher CTN transection incidence. Conclusion:Although endoscopic surgery did not reduce the incidence of CTN transection during middle ear surgery, pathological involvement of the stapes and CTN anatomical variants, such as the "Attached Short type" and "Ultrashort type," may increase this incidence. Preoperative evaluation of stapes involvement and anatomical location of the CTN course could help identify patients at greater risk for iatrogenic CTN transection.Level of Evidence: 4. Saki Takihata and Takaomi Kurioka have contributed equally to this work.

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Surgery for Chronic Otitis Media Causes Greater Taste Disturbance Than Surgery for Otosclerosis

Cited by 8 publications

References 27 publications

Subjective and Objective Taste Change After Stapes Surgery Systematic Review and Meta-Analysis

Subjective and Objective Taste Change After Stapes Surgery Systematic Review and Meta-Analysis

Unilateral Increase of Gustatory Thresholds in Acute Otitis Media: A Pilot Study

Factors affecting the incidence of chorda tympani nerve transection in middle ear surgery

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