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Taste disturbance after stapes surgery: an evaluation of frequency, severity, duration, and quality-of-life
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
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2017 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 37, no 1, p. 39-43Article in journal (Refereed) Published
Abstract [en]

 Conclusion: The incidence of taste disturbance after stapes surgery is high (61.9 %), whereas the majority (94.8 %) recovers within 1 year. More severe surgical nerve trauma caused more disturbance, implying that the nerve should be handled carefully during surgery.

 

Objectives: Patients operated on for otosclerosis seem more often to complain about post-operative taste disturbance than those operated on for chronic otitis media, although the chorda tympani nerve more seldom becomes maltreated in stapedotomy. These observations seem paradoxical. It is unclear to what extent a post-operative taste disturbance affects the quality-of-life. This study aims to shed light on the occurrence of post-operative taste disturbances, on possible prognostic factors, and to what extent post-operative taste disturbance impairs the quality-of-life.

 

Methods: One hundred and thirty-four adults undergoing primary stapedotomy were included. Questionnaires on taste disturbance and quality-of-life (SF-36) were answered before and after surgery, until 1 year post-operatively.

 

Results: Eighty-three (61.9%) study persons reported post-operative taste disturbance. Seven (5.2%) reported persisting disturbance at 1 year. Surgically more traumatized chorda tympani nerves correlated with more severe taste disturbance post-operatively than less traumatized.  Taste disturbance at 1 year post-operatively correlate with a decrease of the physical function domain in the SF-36.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2017. Vol. 37, no 1, p. 39-43
Keywords [en]
Chorda tympani nerve, otosclerosis, stapedotomy, taste, questionnaire, QoL, SF-36
National Category
Otorhinolaryngology
Research subject
Oto-Rhino-Laryngology
Identifiers
URN: urn:nbn:se:uu:diva-315775DOI: 10.1080/00016489.2016.1217562ISI: 000390666600007OAI: oai:DiVA.org:uu-315775DiVA, id: diva2:1075785
Available from: 2017-02-21 Created: 2017-02-21 Last updated: 2018-09-13Bibliographically approved
In thesis
1. The Chorda Tympani Nerve: Role in Taste Impairment in Middle Ear Disease and after Ear Surgery
Open this publication in new window or tab >>The Chorda Tympani Nerve: Role in Taste Impairment in Middle Ear Disease and after Ear Surgery
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The chorda tympani nerve, also known as the taste nerve, runs uncovered through the middle ear cavity, a localization that exposes the nerve to pathological processes and surgical trauma in the middle ear. People operated on for otosclerosis tend to complain more about postoperative taste disturbances than those operated on for chronic otitis media. It has been suggested that this difference may be explained by gradual deterioration of chorda tympani nerve function caused by chronic otitis media infection and that further impairment caused by surgery is less noticeable in these patients.

This thesis aimed to evaluate the function of the chorda tympani nerve, the effects of middle ear disease on taste and complications resulting from ear surgery for chronic otitis media or otosclerosis. This information will help to improve the ear surgeon’s ability to predict the prognosis of iatrogenic taste disturbances in patients with middle ear disease and after ear surgery.

Taste was assessed using electrogustometry and the filter paper disc method before and after surgery for chronic otitis media or otosclerosis. Patients also completed questionnaires about symptoms and quality of life. The status of the chorda tympani nerve upon surgical opening of the ear and grading of the trauma to the nerve during the surgery were recorded. The ultrastructure of the chorda tympani nerve from healthy ears and from ears with chronic otitis media was examined. Electrogustometry and the filter paper disc method were evaluated.

The results of electrogustometry and the filter paper disc method were highly reproducible, although their correlation was moderate. Patients with chronic otitis media, patients with a more traumatized nerve, female patients and younger patients were more likely to report postoperative taste disturbances. Most of the patients recovered their taste after 1 year. The quality of life study showed only minor changes after surgery. Electron microscopic observations of nerves from ears with chronic otitis media showed signs of structural degeneration, although signs of regeneration, such as sprouting were also observed. This results may explain the recovery of taste postoperatively and indicate that the nerve should be carefully handled during surgery.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. p. 54
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1306
Keywords
Chorda tympani nerve, ear surgery, taste, chronic suppurative otitis media, otosclerosis, electrogustometry, filter paper disc method, quality of life, transmission electron microscopy, degeneration, sprouting
National Category
Medical and Health Sciences
Research subject
Surgery
Identifiers
urn:nbn:se:uu:diva-316591 (URN)978-91-554-9837-5 (ISBN)
Public defence
2017-04-27, Vårdskolans Aula, Ing 21, Västmanlands sjukhus Västerås, Västerås, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-04-05 Created: 2017-03-07 Last updated: 2018-05-24

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Knutsson, JohanStrömbäck, KarinDanckwardt-Lillieström, NiklasRosenblad, Andreasvon Unge, Magnus

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Berling Holm, KatarinaKnutsson, JohanStrömbäck, KarinDanckwardt-Lillieström, NiklasRosenblad, Andreasvon Unge, Magnus
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Centre for Clinical Research, County of VästmanlandOtolaryngology and Head and Neck Surgery
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