Chorda Tympani Nerve Injury during Tympanoplasty: Comparison of Endoscopic and Microscopic Methods

Abstract

Article information Background: The chorda tympani is frequently harmed during middle ear surgery. Surgery-related chorda tympani injury is rarely associated with impaired taste perception in patients. The use of microscopes marked the beginning of modern tympanoplasty techniques, and the endoscopic tympanoplasty approach is now described in terms of minimally invasive surgery. Aim of the Study: The aim of the current study is to compare chorda tympani nerve [CTN] injuries occurring because of tympanoplasty performed using microscopic and endoscopic methods. Patients and Methods: This prospective study was carried out on 50 patients from Al-Azhar University hospitals who suffered from chronic suppurative otitis media [safe type]. Patients were randomized equally using opaque sealed envelopes into two groups. Group A: 25 patients underwent transcanal endoscopic tympanoplasty with elevation of the tympamomeatal flap. Group B: 25 patients underwent microscopic tympanoplasty by postauricular incision. Results: Chorda tympani nerve was with no injury in 24 [96%] cases in group A and 14 [56%] cases in group B, while 1 [4%] case in group A and 8 [32%] cases in group B had stretched chorda tympani nerve and 3 [12%] cases in group B had transected chorda tympani nerve. The Chorda tympani nerve was significantly less injury, less stretched in group A than group B, and more transected in group B than group A [P value=0.012]. Conclusion: In patients undergoing tympanoplasty, Endoscopic ear surgery provides superior visualization, reduces the necessity for extensive manipulation of the chorda tympani, and subsequently lowers the occurrence of CTN injury compared to microscopic ear surgery.