中耳手术中鼓索神经损伤后对味觉的影响  

Change of taste function after chorda tympani nerve injury in patients undergoing surgical treat-ments for otitis media

作　　者：郭小艳[1] 耿曼英[1] GUO Xiaoyan;GENG Manying(Department of Otolaryngology Head and Neck Surgery,Second Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州大学第二附属医院耳鼻咽喉头颈外科,河南郑州450000

出　　处：《中国耳鼻咽喉头颈外科》2020年第4期219-221,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：河南省科技计划资助项目(172102310838)。

摘　　要：目的观察中耳手术中鼓索神经损伤对味觉的影响,探讨鼓索神经保护的必要性.方法以2014年3月~2018年12月行中耳手术的168例(168耳)患者为研究对象,其中男82例,女86例,年龄18~71岁,平均(42.15±3.6)岁.观察术中鼓索神经损伤患者术后3天的味觉情况.结果术中共71例鼓索神经损伤,其中8例慢性化脓性中耳炎静止期术中鼓索神经损伤患者术后3天有7例出现味觉减退;17例慢性化脓性中耳炎活动期患者术后3天有6例味觉减退;44例中耳胆脂瘤患者术后3天有2例味觉减退;2例鼓室硬化症患者术后未见味觉减退.慢性化脓性中耳炎静止期术中鼓索神经损伤味觉减退发生率87.50%与慢性化脓性中耳炎活动期发生率(35.29%)相比,差异有统计学意义(P=0.03);慢性化脓性中耳炎活动期鼓索神经损伤发生率35.29%与中耳胆脂瘤发生率(4.55%)相比,差异有统计学意义(P=0.004).结论慢性化脓性中耳炎病理状态与味觉减退不呈正比,病变较重者术中鼓索神经损伤对味觉影响较小,可能原因为长期炎症刺激使鼓索神经功能代偿.OBJECTIVE To observe the effect of chorda tympani nerve injury after middle ear surgery for taste changes,and to discuss the necessity of chorda tympanic nerve protection.METHODS From March 2014 to December 2018,168 cases of middle ear surgeries at the second affiliated hospital of Zhengzhou university were included in this study,including 82 males and 86 females.And to observe the taste of patients with tympanic nerve injury at the third days after operation.RESULTS There were 71 cases of tympanic nerveinjury during surgeries,of which 7 out of 8 cases of chronic suppurative otitis media had the taste disorder with the rate being 87.50%(7/8),6 out of 17 cases of chronic suppurative otitis media active period had the taste disorder with the rate being 35.29%(6/17),2 out of 44 cases of cholesteatoma had taste disorder with the rate being 4.55%(2/44),2 cases of tympanosclerosis had no significant taste disorder.There was a significant difference in the incidence of postoperative abnormal taste between chronic suppurative otitis media and cholesteatoma(P=0.004,P=0.000).CONCLUSION Chronic suppurative otitis media and cholesteatoma can cause abnormal taste,but its pathological state and taste disorder was not proportional,the heavier the pathology,the less the effect on taste due to chorda tympanic nerve injury.The possible reason may be thefunction compensationas a result of long-term inflammation stimulation from otitis media.

关 键 词：耳外科手术 鼓索神经 味觉异常 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]