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Iatrogenic injury of the chorda tympani: a systematic review

Published online by Cambridge University Press:  26 August 2011

L J McManus ,
M D Stringer  and
P J D Dawes
L J McManus
Affiliation:
Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand
M D Stringer
Affiliation:
Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand
P J D Dawes*
Affiliation:
Otorhinolaryngology and Head and Neck Surgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
*
Address for correspondence: Associate Professor PJD Dawes, Department of Otorhinolaryngology and Head and Neck Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand Fax: +64 3 474 5496 E-mail: [email protected]
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Abstract

Objective:

To review the currently available literature on iatrogenic injury of the adult chorda tympani.

Design:

Systematic literature review.

Method

Five electronic databases and one search engine were used to access available English language literature on the chorda tympani, focusing on iatrogenic injury.

Results:

The chorda tympani is most often injured during middle-ear surgery, after which at least 15–22 per cent of patients experience symptoms, mostly changes in taste and dryness of the mouth. Numerous factors influence whether injury to the chorda tympani causes symptoms, including the extent of injury, type of surgery, age of the patient, anatomical variables and subjective adaptation. Although most patients experience gradual symptomatic recovery, complaints can be persistent and troublesome.

Conclusion:

Care should be taken to preserve the chorda tympani during middle-ear surgery, and to warn patients pre-operatively about this potential complication. This is particularly important if surgery is bilateral.

Keywords

Ear, MiddleChorda Tympani NerveOtologic Surgical ProceduresComplicationsGustation
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 1 , January 2012 , pp. 8 - 14
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Clark, MPA, O'Malley, S. Chorda tympani nerve function after middle ear surgery. Otol Neurotol 2007;28:335–40CrossRefGoogle ScholarPubMed
2Michael, P, Raut, V. Chorda tympani injury: operative findings and postoperative symptoms. Otolaryngol Head Neck Surg 2007;136:978–81CrossRefGoogle 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
4Lloyd, S, Meerton, L, Di Cuffa, R, Lavy, J, Graham, J. Taste change following cochlear implantation. Cochlear Implants Int 2007;8:203–10CrossRefGoogle ScholarPubMed
5Hansen, S, Anthonsen, K, Strangerup, S-E, Jensen, JH, Thomsen, J, Caye-Thomasen, P. Unexpected findings and surgical complications in 505 consecutive cochlear implantations: a proposal for reporting consensus. Acta Otolaryngol 2010;130:540–9CrossRefGoogle ScholarPubMed
6Mueller, CA, Khatib, S, Temmel, AF, Baumgartner, W-D, Hummel, T. Effects of cochlear implantation on gustatory function. Ann Otol Rhinol Laryngol 2007;116:498–501Google Scholar
7Bull, TR. Taste and the chorda tympani. J Laryngol Otol 1965;79:479–93CrossRefGoogle Scholar
8Dawes, PJ. Early complications of surgery for chronic otitis media. J Laryngol Otol 1999;113:803–10CrossRefGoogle ScholarPubMed
9Griffith, IP. Observations on the pathology of chorda tympani nerve in temporal bone sections. J Laryngol Otol 1977;91:151–7CrossRefGoogle ScholarPubMed
10Yeo, SB, Loy, AH. Chorda tympani trauma – how much does it affect taste? Singapore Med J 1997;38:329–31Google Scholar
11Mahendran, S, Hogg, R, Robinson, JM. To divide or manipulate the chorda tympani in stapedotomy. Eur Arch Otorhinolaryngol 2005;262:482–7Google Scholar
12Harkness, P, Brown, P, Fowler, S, Grant, H, Ryan, R, Topham, J. Mastoidectomy audit: results of the Royal College of Surgeons of England comparative audit of ENT surgery. Clin Otolaryngol Allied Sci 1995;20:89–94CrossRefGoogle ScholarPubMed
13Gent, JF, Shafer, DM, Frank, ME. The effect of orthognathic surgery on taste function on the palate and tongue. J Oral Maxillofac Surg 2003;61:766–73CrossRefGoogle ScholarPubMed
14Hotta, M, Endo, S, Tomita, H. Taste disturbance in two patients after dental anesthesia by inferior alveolar nerve block. Acta Otolaryngol Suppl 2002;546:94–8CrossRefGoogle Scholar
15Paxton, MC, Hadley, JN, Hadley, MN, Edwards, RC, Harrison, SJ. Chorda tympani nerve injury following inferior alveolar injection: a review of two cases. J Am Dent Assoc 1994;125:1003–6CrossRefGoogle ScholarPubMed
16Pogrel, MA, Bryan, J, Regezi, J. Nerve damage associated with inferior alveolar nerve blocks. J Am Dent Assoc 1995;126:1150–5CrossRefGoogle ScholarPubMed
17Akal, UK, Küçükyavuz, Z, Nalçaci, R, Yilmaz, T. Evaluation of gustatory function after third molar removal. Int J Oral Maxillofac Surg 2004;33:564–8Google Scholar
18Gedikli, O, Dogru, H, Aydin, G, Tuz, M, Uygur, K, Sari, A. Histopathological changes of chorda tympani in chronic otitis media. Laryngoscope 2001;111:724–7Google Scholar
19Nin, T, Sakagami, M, Sone-Okunaka, M, Muto, T, Mishiro, Y, Fukazawa, K. Taste function after section of chorda tympani nerve in middle ear surgery. Auris Nasus Larynx 2006;33:13–17CrossRefGoogle ScholarPubMed
20Lundborg, G, Rydevik, B. Effects of stretching the tibial nerve of the rabbit. J Bone Joint Surg Br 1973;55:390–401CrossRefGoogle ScholarPubMed
21Rice, JC. The chorda tympani in stapedectomy. J Laryngol Otol 1963;77:943–4CrossRefGoogle ScholarPubMed
22Berteretche, M-V, 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
23Miuchi, S, Sakagami, M, Tsuzuki, K, Noguchi, K, Mishiro, Y, Katsura, H. Taste disturbance after stapes surgery – clinical and experimental study. Acta Otolaryngol Suppl 2009;562:71–8CrossRefGoogle Scholar
24Moon, CN, Pullen, EW. Effects of chorda tympani section during middle ear surgery. Laryngoscope 1963;73:392–405CrossRefGoogle Scholar
25Mueller, 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
26Perez, R, Fuoco, G, Dorion, JM, Ho, PH, Chen, JM. Does the chorda tympani nerve confer general sensation from the tongue? Otolaryngol Head Neck Surg 2006;135:368–73CrossRefGoogle ScholarPubMed
27Chen, JM, Bodmer, D, Khetani, JD, Lin, VVY. Tactile dysgeusia: a new clinical observation of middle ear and skull base surgery. Laryngoscope 2008;118:99–103CrossRefGoogle ScholarPubMed
28Chilla, R, Bruner, M, Arglebe, C. Function of submaxillary gland following iatrogenic damage to chorda tympani nerve. Acta Otolaryngol (Stockh) 1979;87:152–5CrossRefGoogle ScholarPubMed
29Chilla, R, Nicklatsch, J, Arglebe, C. Late sequelae of iatrogenic damage to chorda tympani nerve. Acta Otolaryngol (Stockh) 1982;94:461–5Google Scholar
30Sone, M, Sakagami, M, Tsuji, K, Mishiro, Y. Younger patients have a higher rate of recovery of taste function after middle ear surgery. Arch Otolaryngol Head Neck Surg 2001;127:967–9CrossRefGoogle ScholarPubMed
31Gopalan, 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;119:189–92Google Scholar
32Terada, T, Sone, M, Tsuji, K, Mishiro, Y, Sakagami, M. Taste function in elderly patients with unilateral middle ear disease. Acta Otolaryngol Suppl 2004;553:113–16CrossRefGoogle Scholar
33Catalanotto, FA, Bartoshuk, LM, Ostrom, KM, Gent, JF, Fast, K. Effects of anesthesia of the facial nerve on taste. Chem Senses 1993;18:461–70CrossRefGoogle Scholar
34Sakagami, 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
35Kveton, JF, Bartoshuk, LM. The effect of unilateral chorda tympani damage on taste. Laryngoscope 1994;104:25–9CrossRefGoogle ScholarPubMed
36Lehman, CD, Bartoshuk, LM, Catalanotto, FC, Kveton, JF, Lowlicht, RA. Effect of anesthesia of the chorda tympani nerve on taste perception in humans. Physiol Behav 1995;57:943–51CrossRefGoogle ScholarPubMed
37Saito, 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
38Tomita, H, Ikeda, M, Okuda, Y. Basis and practice of clinical taste examinations. Auris Nasus Larynx 1986;13(suppl 1):S1–15CrossRefGoogle ScholarPubMed
39Just, T, Gafumbegete, E, Kleinschmidt, EG, Pau, HW. Contact endoscopic quantification of fungiform papillae – correlation to taste ability. [in German] Laryngorhinootologie 2003;82:501–7Google ScholarPubMed
40Negoro, A, Umetmoto, M, Fukazawa, K, Sakagami, M. Observation of tongue papillae by video microscopy and contact endoscopy to investigate their correlation with taste function. Auris Nasus Larynx 2004;31:255–60CrossRefGoogle ScholarPubMed
41Wiet, RJ, Harvey, SA, Bauer, GP. Complications in stapes surgery: options for prevention and management. Otolaryngol Clin North Am 1993;26:471–90Google Scholar
42Yaginuma, Y, Kobayashi, T, Sai, Y, Takasaka, T. Predictive value of electrogustometry in the preoperative diagnosis of severity of middle ear pathology [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho 1996;99:1635–40CrossRefGoogle ScholarPubMed
43Guagliardo, NA, Hill, DL. Fungiform taste bud degeneration in C57BL/6J mice following chorda-lingual nerve transection. J Comp Neurol 2007;504:206–16CrossRefGoogle ScholarPubMed
44Miman, MC, Sigirci, A, Ozturan, O, Karatas, E, Erdem, T. The effects of the chorda tympani damage on submandibular glands: biometric changes. Auris Nasus Larynx 2003;30:21–4Google Scholar
45Yagmur, C, Miman, MC, Karatas, E, Akarcay, M, Erdem, T, Ozturan O. Effects of the chorda tympani damage on submandibular glands: scintigraphic changes. J Laryngol Otol 2004;118:102–5CrossRefGoogle ScholarPubMed
46Meningaud, J-P, Pitak-Arnnop, P, Chikhani, L, Bertrand, J-C. Drooling of saliva: a review of the etiology and management options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:48–57Google Scholar
47Benson, J, Daugherty, KK. Botulinum toxin A in the treatment of sialorrhea. Ann Pharmacother 2007;41:79–85CrossRefGoogle ScholarPubMed
48McManus, LJ, Dawes, PJD, Stringer, MD. Clinical anatomy of the chorda tympani: a systematic review. J Laryngol Otol 2011;125, in pressCrossRefGoogle ScholarPubMed
49Kronenberg, J, Migirov, L. The suprameatal approach: an alternative surgical technique for cochlear implantation. Cochlear Implants Int 2006;7:142–7CrossRefGoogle ScholarPubMed
50Taibah, K. The transmeatal approach: a new technique in cochlear and middle ear implants. Cochlear Implants Int 2009;10:218–28CrossRefGoogle ScholarPubMed
51Landis, BN, Hummel, T. Chorda tympani injury: operative findings and postoperative symptoms. Otolaryngol Head Neck Surg 2008;138:694–5CrossRefGoogle ScholarPubMed
52Saravanappa, N, Balfour, A, Bowdler, D. Informed consent for middle ear operations: a United Kingdom survey. Clin Otolaryngol Allied Sci 2003;28:91–9CrossRefGoogle ScholarPubMed
53Dawes, PJD, Kitcher, E. Informed consent: British otolaryngologists surveyed. Clin Otolaryngol Allied Sci 1999;24:198–207CrossRefGoogle ScholarPubMed