ANALYSIS OF POST OPERATIVE TASTE DISTURBANCE FOLLOWING MASTOID SURGERY

Abstract

Objectives:

To observe the  type of peroperative pathology (cholesteatoma, granulation tissues or both) in patients with COM squamous type , to observe the frequency of damage to chorda tympani nerve (CTN) by cholesteatoma, granulation tissues or both and to observe the taste disturbance  postoperatively in relation to peroperative status of the chorda tympani nerve.

Materials and methods:

A prospective, analytical of 113 patients who underwent mastoid surgery from 1st October  2007 to 30th March 2009 in Tribhuvan University Teaching Hospital was carried out. The peroperative pathology and peroperative status of CTN were noted. All patients were asked about the taste disturbance on 2nd and 10th day postoperative day (POD).

Results:

One hundred and thirteen (113) patients who underwent mastoidectomy were enrolled for this study and the mean age of patients was 23.76 years. The peroperative pathology identified was cholesteatoma in 9 (8%) patients (CTN was found in 6 and not found in 3), granulation tissue in 9 (8%) patients (CTN was found in 3 and not found in 6) and mixed pathologies (both cholesteatoma and granulation tissue) in 95 (84%) patients (CTN was found in 60 and not found in 35). One patient with peroperative pathology of cholesteatoma in whom chorda was identified but injured during surgery and 12 patients with mixed (both cholesteatoma and granulation) pathology (p=0.320) developed taste disturbance. Out of the 13 patients  who developed postoperative taste disturbance, in 5 patients CTN was not found/not identified and in 8 patients CTN was identified but injured.

Conclusion:

Mixed type of pathology (both cholesteatoma and granulation) was the commonest pathology in 95(84%) patients . The chorda tympani nerve was not identified in 44 (39%) patients and this was most commonly seen in mixed type of pathology (cholesteatoma and granulation) as compared to other pathologies like cholesteatoma alone or granulation alone. However, this was not statistically significant (p=0.320). Functional recovery was early in all patients.

Keywords: chorda tympani nerve, mastoid surgery, taste disturbance