ANALYSIS OF TASTE DISTURBANCES IN PATIENTS BEFORE AND AFTER MASTOID SURGERY

Abstract

Objectives:

To observe the frequency of taste disturbance in all patients undergoing mastoid surgery and to correlate between peroperative status of chorda tympani nerve (CTN) and type of peroperative CTN injury with postoperative taste disturbance.

Materials and methods:

A prospective analysis of patients who underwent mastoid surgery over 18 months period in Ganesh Man Singh Memorial Academy of ENT and Head & Neck Studies, TU Teaching Hospital, Kathmandu, Nepal. The peroperative status of CTN and different types of peroperative CTN injuries were also noted and categorized. Subjective assessment of taste disturbance was categorized as altered taste sensation/metallic taste, tongue numbness, absence of taste sensation and dry mouth.

Results:

All patients did not have any preoperative taste disturbance. On the 2nd postoperative day (POD), taste disturbances were found in 13 patients (11.5%), out of which 10 patients (76.96%) had numbness and 3 patients (23.07%) had absence of taste sensation. On the 10th POD the finding was similar as previous. However, two months after surgery, only one patient (7.69%) remained symptomatic. This symptomatic patient also recovered his taste sensation after 4th months of surgery. Out of these 13 patients who developed postoperative taste disturbances, in 5 patients (38.46%) CTN was not found/not identified. Remaining 8 patients, in whom the CTN was found/identified, in 5 patients (38.46%) it was clean cut with micro-scissors, in whom 4 patients had numbness of tongue and 1 patient had absence of taste sensation. Remaining 2 patients in whom the CTN was cut while using burr, both patients developed numbness of tongue  and the single remaining  patient in whom the CTN was stretched but preserved, the patient also developed numbness of tongue (p>0.05).

Conclusion:

No patients in this study suffered from taste disturbance before mastoid surgery despite of the fact that, in 44 patients (39%) the CTN was not identified at the time of surgery. Postoperatively taste disturbance was found in 13 patients (11.50%) , among them in 10 patients (76.92%) the disturbance was in the form of numbness.

Keywords: chorda tympani nerve (CTN), mastoid surgery, taste disturbance