Taste Disturbance After Endoscopic Tympanoplasty with Tragal Cartilage Graft and Improvement Strategies.

Yi-Bo Huang, Xin-Da Xu, Jihan Lyu, Yan-Mei Wang, Xiao Fu, Meng-Ye Ma, Binjun Chen, Min-Fang Sun, Dong-Dong Ren
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Abstract

Objectives: To explore the risk factors of early postoperative taste disturbance (EPTD) after type I endoscopic tympanoplasty and operative modification strategies to improve taste disturbance. Methods: This was a controlled study. One hundred and twenty-four patients who underwent type I endoscopic tympanoplasty with tragal cartilage graft were separated evenly into control and modified groups. The full-thickness tragus cartilage graft was placed close to the bony annulus to ensure drum integrity in the control group, and in the modified group, the cartilage graft was not in contact with the posterior-superior bony annulus, and the inferior-posterior of the scutum. Univariate and multivariate models were used to analyze the possible factors affecting EPTD and the prognosis of taste recovery. Results: The incidence of EPTD was significantly lower in the modification group (24.19%) than in the control group (56.45%) (OR: 4.24, 95% CI: 1.93-9.33, P < .001). Surgical manipulation of the chorda tympani nerve resulted in a higher incidence of EPTD (OR: 2.43; 95% CI: 1.06-5.57, P = .035). The size of the graft did not affect taste disturbance. No difference in the taste recovery rate was observed between the control and test groups (Z = -1.57, P = .116) after 3 months. The recovery rate of patients with manipulated chorda tympani nerves was still lower than that of patients without at 3 months (Z = -2.74, P = .006). Conclusion: Modified surgery and reduced manipulation of the chorda tympani nerve effectively reduce EPTD. Manipulated chorda tympani nerves may have a persistent effect on taste recovery.

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内窥镜鼓室成形术与耳廓软骨移植术后的味觉障碍及改善策略
目的探讨 I 型内窥镜鼓室成形术后早期术后味觉障碍(EPTD)的风险因素以及改善味觉障碍的手术调整策略。方法:这是一项对照研究:这是一项对照研究。将 124 名接受 I 型内窥镜鼓室成形术并进行耳廓软骨移植的患者平均分为对照组和改良组。对照组的全厚耳廓软骨移植靠近骨性环,以确保鼓膜的完整性,而改良组的软骨移植则不接触骨性环的后上方和颅骨的后下方。采用单变量和多变量模型分析影响 EPTD 和味觉恢复预后的可能因素。结果改良组 EPTD 的发生率(24.19%)明显低于对照组(56.45%)(OR:4.24,95% CI:1.93-9.33,P < .001)。手术操作鼓室神经导致 EPTD 的发生率更高(OR:2.43;95% CI:1.06-5.57,P = .035)。移植物的大小对味觉障碍没有影响。3 个月后,对照组和测试组的味觉恢复率无差异(Z = -1.57, P = .116)。操作过鼓室神经的患者在 3 个月后的恢复率仍低于未操作过鼓室神经的患者(Z = -2.74,P = .006)。结论改良手术和减少对鼓室神经的操作可有效减少 EPTD。操作鼓室神经可能会对味觉恢复产生持续影响。
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