鼓索神经损伤引起味觉障碍的临床研究

Drug intervention in taste disorders induced by chorda tympai nerve injury

目的本研究旨在探讨临床药物干预对不同因素引起鼓索神经损伤的味觉改善是否存在可行性和必要性和评价常规中耳炎手术中是否保留鼓素神经的必要性。方法按照House Brikman(HB)评级入组病人120例分为两组,实验组和对照组各60例。各组再分为二亚组:一亚组贝尔氏面瘫30例,另一亚组鼓室成形术30例。实验组采用神经营养药(甲钴胺)及改善微循环药(复方丹参)治疗,对照组不做治疗。结果实验组味觉恢复病例多于对照组(6月,P=0.02;12月P<0.01),实验组有效率高于对照组(P<0.01),实验组面瘫味觉恢复病例高于对照组(P<0.01),实验组鼓室成形术病例有效率高于对照组(P<0.01)。结论提示药物治疗周围性面瘫和鼓室成形术中切断鼓索神经皆有效,中耳手术时勿损伤鼓索神经,尤其是双侧中耳炎患者。

Objective To investigate the feasibility and necessity of clinical drug intervention in improving taste function in patients with chorda tympai nerve injury caused by different factors and evaluate the necessity of preserving chorda tympani nerve in otologic surgery. Methods One hundred and twenty patients were enrolled in this study according to House-Birkman rating levels. These patients were divided into experimental and control group, with 60 cases in each group. Furthermore, each group was divided into two subgroups equally. One subgroup with Bell’s palsy and another undergone tympanoplasty. Improving microcirculation medicine was administered in the experimental group while no intervention was used in the control group. Results Experimental group had more patients recovering from taste dysfunction compared with control group （6 months, P=0.02; 12 months P〈0.01）. Effective rate in experimental group was higher than that in control group （P〈0.01）, There were more patients with Bell’s palsy recovering from taste dysfunction in experimental group than those in control group （P〈0.01）,Effective rate of patients undergone tympanoplasty in experimental group was higher than that in control group （P〈0.01）. Conclusion These results indicate that medicinal intervention is effective in treating both facial paralysis and transected chorda tympain nerve in tympanoplasty, Chorda tympani nerve injury should be avoided during middle ear operation, especially for patients with bilateral otitis media.