Chorda tympani injury: Operative findings and postoperative symptoms

Objectives: This study aims to assess whether operative findings of chorda tympani nerve (CTN) trauma correlate with postoperative symptoms. Study Design and Setting: A prospective study was conducted over 2 years on 140 middle ear operations analyzing taste disturbances. The operations were subdivided into myringo-plasty/tympanoplasty (56 cases), mastoidectomy (64 cases), and tympanotomy (20 cases). Results: Twenty-one (15%) patients reported taste disturbance. Altered taste was most reported (n = 15, 71%) with loss of taste reported by 29% (n = 6). Symptoms were most observed in the tympanotomy group (45%). Stretching of the CTN was associated with more symptoms than nerve transection. Recovery was complete in 76% (n = 16) of the symptomatic cases by 12 months. Conclusion: Patients who undergo middle ear surgery should be thoroughly counseled with respect to CTN injury and symptoms regardless of the type of damage to the nerve. Significance: This study highlights the high incidence of postoperative alterations in taste after middle ear surgery, especially in non-diseased ears, and that CTN transection results in fewer symptoms than CTN stretching. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.