Cutting the chorda tympani: not just a matter of taste

AbstractIntroduction: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.

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Parotid salivary flow after middle ear surgery.

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.82.827 ◽

1989 ◽

Vol 82 (6) ◽

pp. 827-834

Author(s):

Hiroyuki Oiki ◽

Kiyotaka Murata ◽

Fumihiko Ohta

Keyword(s):

Middle Ear ◽

Salivary Flow ◽

Middle Ear Surgery ◽

Ear Surgery

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Accidental tramadol ingestion in children admitted in tertiary care centre

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20195200 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2661

Author(s):

Vadlakonda Sruthi ◽

Annaladasu Narendra

Keyword(s):

Pediatric Population ◽

Care Center ◽

Tertiary Care ◽

Ventilatory Support ◽

Case Series ◽

Pediatric Intensive Care ◽

Hemodynamic Instability ◽

Tertiary Care Centre ◽

Medical College ◽

History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

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Low-Entry-Point Method for Chorda Tympani Nerve Preservation during Middle Ear Surgery

Otolaryngology ◽

10.1177/0194599812453554 ◽

2012 ◽

Vol 147 (5) ◽

pp. 972-974

Author(s):

Chien-Hao Chen ◽

Peir-Rong Chen ◽

Chia-Fone Lee ◽

Lee-Ping Hsu ◽

Yu-Fu Chou

Keyword(s):

Middle Ear ◽

Point Method ◽

Entry Point ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Ear Surgery ◽

Nerve Preservation

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Dysfunction of chorda tympani after middle ear surgery.

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.81.193 ◽

1988 ◽

Vol 81 (2) ◽

pp. 193-200

Author(s):

Zenya Ito ◽

Ryo Yuasa ◽

Shigeru Saijo ◽

Sachiko Tomioka ◽

Masaru Toshima ◽

...

Keyword(s):

Middle Ear ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Ear Surgery

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Taste Function after Section of Chorda Tympani Nerve in Middle Ear Surgery

Otolaryngology ◽

10.1016/j.otohns.2004.06.478 ◽

2004 ◽

Vol 131 (2) ◽

pp. P241-P241

Author(s):

Masafumi Sakagami ◽

Toshihiko Muto ◽

Yasuo Mishiro ◽

Keijiro Fukazawa ◽

Makito Okamoto

Keyword(s):

Middle Ear ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Ear Surgery

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A study of chorda tympani nerve injury and related symptoms following middle-ear surgery

The Journal of Laryngology & Otology ◽

10.1258/0022215053561657 ◽

2005 ◽

Vol 119 (3) ◽

pp. 189-192 ◽

Cited By ~ 34

Author(s):

P Gopalan ◽

M Kumar ◽

D Gupta ◽

J J Phillipps

Keyword(s):

Prospective Study ◽

Middle Ear ◽

Recovery Time ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Ear Surgery ◽

Number Of Patients ◽

Prolonged Recovery ◽

A Prospective Study

This is a prospective study that looks into the prevalence of chorda tympani nerve (CTN) injury and related symptoms following varying degrees of trauma to the nerve during three common types of middle-ear operation: myringoplasty, tympanotomy and mastoidectomy. The number of patients with CTN-related symptoms varied widely between the three groups. Increased occurrence of the nerve related symptoms and a prolonged recovery time were observed in the tympanotomy group. Stretching of the nerve produced more symptomatic cases than cutting it in the myringoplasty and mastoidectomy groups. Recovery was complete in 92 per cent of the symptomatic patients by 12 months. It is important to inform patients about the possibility of CTN injury during middle-ear operations, and it should also be emphasized that symptoms related to CTN injury can occur irrespective of the type of damage to the nerve.

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Iatrogenic injury of the chorda tympani: a systematic review

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002039 ◽

2011 ◽

Vol 126 (1) ◽

pp. 8-14 ◽

Cited By ~ 22

Author(s):

L J McManus ◽

M D Stringer ◽

P J D Dawes

Keyword(s):

Middle Ear ◽

English Language ◽

Iatrogenic Injury ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Ear Surgery ◽

Injury Type ◽

Patients Experience ◽

Type Of Surgery ◽

Language Literature

AbstractObjective:To review the currently available literature on iatrogenic injury of the adult chorda tympani.Design:Systematic literature review.MethodFive 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.

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Regeneration of the Chorda Tympani Nerve and Fungiform Papillae after Middle Ear Surgery

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.100.867 ◽

2007 ◽

Vol 100 (11) ◽

pp. 867-876

Author(s):

Takehisa Saito

Keyword(s):

Middle Ear ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Fungiform Papillae ◽

Ear Surgery

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Are head bandages really required after middle-ear surgery? A systematic review

The Journal of Laryngology & Otology ◽

10.1017/s0022215115001565 ◽

2015 ◽

Vol 129 (8) ◽

pp. 740-743 ◽

Cited By ~ 4

Author(s):

I Khan ◽

S Mohamad ◽

S Ansari ◽

A Iyer

Keyword(s):

Systematic Review ◽

Middle Ear ◽

Cochlear Implantation ◽

Randomised Controlled Trials ◽

Case Series ◽

Middle Ear Surgery ◽

Controlled Trials ◽

Retrospective Case ◽

Ear Surgery ◽

Randomised Controlled

AbstractObjective:A systematic review was performed to evaluate the role and effectiveness of head bandages after routine elective middle-ear surgery.Methods:Studies that compared the effectiveness of head bandage use after elective middle-ear surgery (e.g. myringoplasty, mastoidectomy and cochlear implantation) were identified using the following databases: Ovid Medline and Embase, the Ebsco collections, the Cochrane Library, PubMed, and Google Scholar. An initial search identified 71 articles. All titles and abstracts were reviewed. Thirteen relevant articles were inspected in more detail; of these, only five met the inclusion criteria. These included three randomised, controlled trials, one retrospective case series and one literature review.Results:The three randomised, controlled trials (level of evidence 1b) showed no statistically significant differences in post-operative outcomes (in terms of complications) associated with head bandage use in middle-ear surgery. This finding was supported by the retrospective case series involving patients undergoing cochlear implantation.Conclusion:Current available evidence shows no advantage of head bandage use after middle-ear surgery. Head bandages may not be required after routine, uncomplicated middle-ear surgery.

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