中耳炎手术损伤鼓索神经后味觉的变化与恢复性观察研究

Change and recovery of taste function after chorda tympani nerve injury in patients undergoing surgical treatments for otitis media

目的分析中耳炎手术损伤患者鼓索神经后其味觉的变化以及恢复性观察研究,为临床诊断治疗提供依据。方法本组研究正常人24例与慢性中耳炎患者60例;依据患者病变的不同采取不同类型的乳突手术和鼓室成形术;观察比较切断鼓索神经手术前后慢性中耳炎患者外观正常、水肿的味阈变化及切断鼓索神经手术前后慢性中耳炎患者鼓索神经断裂的味阈变化,采用SPSS 19.0软件进行统计分析处理。结果鼓索神经断裂组味觉与鼓索神经正常组、鼓索神经外观正常组、鼓索神经水肿之间对比显著减退,差异有统计学意义(P<0.05);切断鼓索神经手术前后慢性中耳炎患者外观正常的味阈结果表明,术后15 d、术后3个月及术后6个月的味阈与术前对比差异有统计学意义(P<0.05);切断鼓索神经手术前后慢性中耳炎患者水肿的味阈结果表明,术后15 d、术后3个月及术后6个月的味阈与术前对比差异有统计学意义(P<0.05);术后的1年进行随访,结果表明,除4例患者味觉有持续的感觉不舒适外,其余患者无明显的味觉异常。结论中耳炎可致使味觉异常,但其病理状态与味觉丧失不呈正比。鼓索神经切除可致使该侧舌味觉丧失,但因多种作用后,味觉会有不同程度地恢复,同时中耳炎手术时应可能确保鼓索神经的完整性,具有重要临床研究价值,值得推广。

Objective To explore the changes in their sense of taste after otitis chorda tympani nerve recovery observa- tional study of patients and surgical injury, and to provide the basis for clinical diagnosis and treatment. Methods The study group of 60 cases of patients with chronic otitis media and 24 cases of normal were enrolled ; take different types of mastoid surgery and tympanoplasty depending on the patient lesions ; observed in patients with relatively normal appear- ance off chronic otitis media , taste edema after chorda tympani nerve surgery before and after the change in the threshold and cut chorda tympani nerve surgery in patients with chronic otitis media chorda tympani nerve transection taste threshold changes ,using SPSS 19.0 software for statistical analysis. Results Chorda tympani nerve transection group taste and chorda tympani nerve normal group , chorda tympani nerve appearance of the normal group , between the chorda tympani nerve edema contrast significantly diminished, and there was a significant difference （ P 〈 0.05 ） ; after chorda tympani nerve surgery and chronic appearance of otitis media in patients with normal taste threshold results showed that there was a significant difference in comparison（P 〈 0.05 ） afterthe first taste threshold 15 d, after three months and six months af- ter the surgery ;around the cut chorda tympani nerve surgery in chronic otitis media taste threshold in patients with edema results showed that there was a significant difference（P 〈 0.05 ） after the first taste threshold 15 d, after three months and six months after the surgery contrast. 1 year postoperative follow-up, results showed that, in addition to taste 4 patients had persistent feeling uncomfortable, the remaining patients had no obvious abnormal taste. Conclusion Otitis media can cause abnormal taste, but its pathological state and loss of taste was not proportional. Chorda tympani nerve resection can cause the side of the tongue,loss of taste,but a variety of roles, the taste will be different degrees of recovery,while otitis media surgery should be possible to ensure the integrity of the chorda tympani nerve, which had important clinical research value, should be widely applied.