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Cutting the chorda tympani: not just a matter of taste

Published online by Cambridge University Press:  07 April 2010

N Guinand ,
T Just ,
N W Stow ,
H Cao Van  and
B N Landis
N Guinand
Affiliation:
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland
T Just
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Rostock, Germany
N W Stow
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Mona Vale Hospital, Sydney, New South Wales, Australia
H Cao Van
Affiliation:
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland
B N Landis*
Affiliation:
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland Smell and Taste Clinic, Department of Otorhinolaryngology, Medical School, Technische Universität Dresden, Germany
*
Address for correspondence: Dr Basile N Landis, Department of Otorhinolaryngology, Geneva Neuroscience Center, University of Geneva Medical School, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva, Switzerland. Fax: +41 22 372 82 40 E-mail: [email protected]
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Abstract

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.

Keywords

Chorda TympaniTasteFacial Nerve InjuriesOtologic Surgical Procedures
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 999 - 1002
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Bull, TR. Taste and the chorda tympani. J Laryngol Otol 1965;79:479–93CrossRefGoogle Scholar
2Landis, BN, Beutner, D, Frasnelli, J, Huttenbrink, KB, Hummel, T. Gustatory function in chronic inflammatory middle ear diseases. Laryngoscope 2005;115:1124–7CrossRefGoogle ScholarPubMed
3Saito, T, Manabe, Y, Shibamori, Y, Yamagishi, T, Igawa, H, Tokuriki, M et al. Long-term follow-up results of electrogustometry and subjective taste disorder after middle ear surgery. Laryngoscope 2001;111:2064–70CrossRefGoogle ScholarPubMed
4Wolf, O. Concerning the function of the chorda tympani [in German]. Zeitschrift für Ohrenheilkunde 1880;9:152–8Google Scholar
5Mueller, CA, Khatib, S, Naka, A, Temmel, AF, Hummel, T. Clinical assessment of gustatory function before and after middle ear surgery: a prospective study with a two-year follow-up period. Ann Otol Rhinol Laryngol 2008;117:769–73CrossRefGoogle ScholarPubMed
6Mahendran, S, Hogg, R, Robinson, JM. To divide or manipulate the chorda tympani in stapedotomy. Eur Arch Otorhinolaryngol 2005;262:482–7CrossRefGoogle ScholarPubMed
7Gopalan, P, Kumar, M, Gupta, D, Phillipps, JJ. A study of chorda tympani nerve injury and related symptoms following middle-ear surgery. J Laryngol Otol 2005;119:189–92CrossRefGoogle ScholarPubMed
8Michael, P, Raut, V. Chorda tympani injury: operative findings and postoperative symptoms. Otolaryngol Head Neck Surg 2007;136:978–81CrossRefGoogle ScholarPubMed
9Rice, JC. The chorda tympani in stapedectomy. J Laryngol Otol 1963;77:943–4CrossRefGoogle ScholarPubMed
10House, HP. Early and late complications of stapes surgery. Arch Otolaryngol 1963;78:606–13Google Scholar
11Landis, BN, Welge-Luessen, A, Bramerson, A, Bende, M, Mueller, CA, Nordin, S et al. “Taste Strips” – a rapid, lateralized, gustatory bedside identification test based on impregnated filter papers. J Neurol 2009;256:242–8CrossRefGoogle ScholarPubMed
12Osterberg, T, Landahl, S, Hedegard, B. Salivary flow, saliva, pH and buffering capacity in 70-year-old men and women. Correlation to dental health, dryness in the mouth, disease and drug treatment. J Oral Rehabil 1984;11:157–70Google Scholar
13Becks, H, Wainwright, WW. Human saliva: XIII. Rate of flow of resting saliva of healthy individuals. J Dent Res 1943;22:391–6CrossRefGoogle Scholar
14Chen, JM, Bodmer, D, Khetani, JD, Lin, VV. Tactile dysgeusia: a new clinical observation of middle ear and skull base surgery. Laryngoscope 2008;118:99–103CrossRefGoogle ScholarPubMed
15Toremalm, NG, Bjerre, I. Surgical elimination of drooling. Laryngoscope 1976;86:104–12CrossRefGoogle ScholarPubMed
16Grant, R, Miller, S, Simpson, D, Lamey, PJ, Bone, I. The effect of chorda tympani section on ipsilateral and contralateral salivary secretion and taste in man. J Neurol Neurosurg Psychiatry 1989;52:1058–62CrossRefGoogle ScholarPubMed
17Saito, T, Shibamori, Y, Manabe, Y, Yamagishi, T, Igawa, H, Yamamoto, T et al. Intraoperative identification of regenerated chorda tympani nerve and its relationship to recovered taste function. ORL J Otorhinolaryngol Relat Spec 2001;63:359–65CrossRefGoogle ScholarPubMed
18Saito, T, Shibamori, Y, Manabe, Y, Yamagishi, T, Yamamoto, T, Ohtsubo, T et al. Morphological and functional study of regenerated chorda tympani nerves in humans. Ann Otol Rhinol Laryngol 2000;109:703–9Google Scholar
19Saito, T, Shibamori, Y, Manabe, Y, Yamagishi, T, Igawa, H, Ohtsubo, T et al. Incidence of regeneration of the chorda tympani nerve after middle ear surgery. Ann Otol Rhinol Laryngol 2002;111:357–63Google ScholarPubMed
20Just, T, Homoth, J, Graumuller, S, Pau, HW. Disorders and recovery of taste function after middle ear surgery [in German]. Laryngorhinootologie 2003;82:494–500Google ScholarPubMed
21Berteretche, MV, Eloit, C, Dumas, H, Talmain, G, Herman, P, Tran Ba Huy, P et al. Taste deficits after middle ear surgery for otosclerosis: taste somatosensory interactions. Eur J Oral Sci 2008;116:394–404CrossRefGoogle ScholarPubMed
22Sakagami, M, Sone, M, Tsuji, K, Fukazawa, K, Mishiro, Y. Rate of recovery of taste function after preservation of chorda tympani nerve in middle ear surgery with special reference to type of disease. Ann Otol Rhinol Laryngol 2003;112:52–6CrossRefGoogle ScholarPubMed