The Chorda Tympani in Stapedectomy

Rice, John C

doi:10.1017/s0022215100061545

Cited by 30 publications

(23 citation statements)

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“…The rate of symptoms in this study was higher than in studies by Moon and Pullen (18.3%), Rice (49%), and Harbert et al (62.9%) [1,2,5]. The reason behind this may be that our study was a prospective study, and patients were questioned about their postoperative symptoms in detail during the 2 weeks of hospitalization.…”

Section: Discussioncontrasting

confidence: 71%

“…Further, otosclerosis is a common ear disease among the caucasian population [13,14]. Therefore, since the 1960s, several reports have focused on taste disturbance after stapes surgery [1,2,5].…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of a patient questionnaire, Moon and Pullen reported that the symptom initially occurred in 28/ 153 patients (18.3%) and persisted for 6 months in 19/153 patients (12.4%) if the chorda tympani nerve (CTN) was preserved [1]. In addition, Rice reported that when the CTN was preserved, the symptoms appeared initially in 31/64 patients (48.4%) and in 10/64 patients (15.6%) at 3 months after surgery [2]. These studies suggested that postoperative symptoms did not occur frequently, and they ceased in most of the patients within 6 months.…”

Section: Introductionmentioning

confidence: 99%

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Taste disturbance after stapes surgery – clinical and experimental study

Miuchi¹,

Sakagami²,

Tsuzuki³

et al. 2009

Acta Oto-Laryngologica

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Conclusion: Most of the clinical cases experienced taste disturbance after stapes surgery, and in a few cases this disturbance persisted for a long time. The animal experiment suggested the role of geniculate ganglion (GG) cells in nerve generation. Objectives: To clinically examine taste disorder and its recovery after stapes surgery and experimentally demonstrate a role of GG. Patients and methods: Taste function after preservation of chorda tympani nerve (CTN) in stapes surgery was prospectively investigated with a questionnaire and electrogustometry (EGM). Further, expression of neurotrophic factors in GG after injury of CTN was examined by in situ hybridization histochemistry (ISSH) and RT-PCR. Results: Among the cases, 15/18 (83.3%) were associated with taste disturbance and 6/18 (33.3%) were associated with tongue numbness 2 weeks after surgery; however, the symptoms ceased in 14/18 cases (77.8%). Two weeks after surgery, the EGM threshold was found to be elevated in 15/18 cases (83.3%), while in 10/18 cases (55.6%), it did not decrease until 1 year after surgery. Expression of ISSH and amplified bands of BDNF and GFR increased at 7 and 14 days after nerve injury in ipsilateral GGs and also increased at 7 days on the contralateral side.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Taste disturbance after stapes surgery – clinical and experimental study

Miuchi¹,

Sakagami²,

Tsuzuki³

et al. 2009

Acta Oto-Laryngologica

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“…In cases involving CT trauma sustained during otologic surgery, advances in technique have eased the recovery process: Oral sequelae are less frequent when the CT is stretched rather than cut [31-37] and recovery rates following transection are highest when the cut ends are reattached [38, 39]. Still, in these and other cases of CT damage, follow-up taste testing often reveals persistent change and incomplete recovery of function [e.g., 36, 40, 41]. These results coincide with structural data from patients with sectioned CT nerves: Regeneration occurs in many cases, but microscopy shows significant fibrosis and fewer intact nerve cells [42].…”

Section: Consequences Of Oral Sensory Nerve Damagementioning

confidence: 99%

Oral sensory nerve damage: Causes and consequences

Snyder

Bartoshuk

2016

Rev Endocr Metab Disord

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Oral sensations (i.e., taste, oral somatosensation, retronasal olfaction) are integrated into a composite sense of flavor, which guides dietary choices with long-term health impact. The nerves carrying this input are vulnerable to peripheral damage from multiple sources (e.g., otitis media, tonsillectomy, head injury), and this regional damage can boost sensations elsewhere in the mouth because of central interactions among nerve targets. Mutual inhibition governs this compensatory process, but individual differences lead to variation in whole-mouth outcomes: some individuals are unaffected, others experience severe loss, and some encounter sensory increases that may (if experienced early in life) elevate sweet-fat palatability and body mass. Phantom taste, touch, or pain sensations (e.g., burning mouth syndrome) may also occur, particularly in those expressing the most taste buds. To identify and treat these conditions effectively, emerging clinical tests measure regional vs. whole-mouth sensation, stimulated vs. phantom cues, and oral anatomy. Scaling methods allowing valid group comparisons have strongly aided these efforts. Overall, advances in measuring oral sensory function in health and disease show promise for understanding the varied clinical consequences of nerve damage.

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“…[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%

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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The Chorda Tympani in Stapedectomy

Cited by 30 publications

References 1 publication

Taste disturbance after stapes surgery – clinical and experimental study

Taste disturbance after stapes surgery – clinical and experimental study

Oral sensory nerve damage: Causes and consequences

Cutting the chorda tympani: not just a matter of taste

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