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The chorda tympani degenerates during chronic otitis media: an electron microscopy study
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.
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2015 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 6, 542-548 p.Article in journal (Refereed) Published
Description
Abstract [en]

Conclusion: Chorda tympani nerve specimens from ears with chronic inflammatory middle ear disease exhibit structural signs of degeneration. These correlate well with taste disturbance. Simultaneously, they exhibit signs of regeneration, which may explain the ability for taste recovery. Objectives: The chorda tympani, the major taste nerve, runs uncovered through the middle ear cavity. This situation exposes it to various forms of middle ear pathology. A difference has been noticed regarding taste symptoms pre- and postoperatively between inflammatory and non-inflammatory diseases. The present study aimed to investigate ultrastructural changes of chorda tympani in different forms of inflammatory middle ear disease, such as chronic suppurative otitis media and cholesteatoma, as compared with normal. Methods: Five chorda tympani specimens were collected from healthy middle ears of patients subjected to surgery for acoustic neuroma, to be used as normal controls, and five from middle ears with chronic otitis media or cholesteatoma, where the nerve could not be saved during the operation. Light and electron microscopy were performed. Results: For all five nerves from diseased ears, microscopy showed a higher percentage of axon and myelin sheath degeneration than in the normal controls. Furthermore, three of the five also exhibited sprouting.

Place, publisher, year, edition, pages
2015. Vol. 135, no 6, 542-548 p.
Keyword [en]
Taste, otosurgery, degeneration, sprouting
National Category
Otorhinolaryngology
Identifiers
URN: urn:nbn:se:uu:diva-255041DOI: 10.3109/00016489.2014.999875ISI: 000354215700004PubMedID: 25719908OAI: oai:DiVA.org:uu-255041DiVA: diva2:825353
Funder
Swedish Research Council, 2010-7209
Available from: 2015-06-23 Created: 2015-06-12 Last updated: 2017-12-04Bibliographically 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. 54 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1306
Keyword
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: 2017-04-18

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