Factors affecting the incidence of chorda tympani nerve transection in middle ear surgery

Takihata, Saki; Kurioka, Takaomi; Mizutari, Kunio; Shiotani, Akiko

doi:10.1002/lio2.976

Cited by 7 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During myringoplasty, it is challenging to repair large marginal perforations, which typically require raising a mucosal-tympanomeatal flap by making an incision in the EAC to reinforce the graft [ 1 , 2 , 8 ]. However, raising the mucosal-tympanomeatal flap via an EAC incision is time-consuming and can lead to chorda tympani damage, EAC stenosis, iatrogenic cholesteatoma, and delayed healing [ 3 , 4 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, raising the mucosal-tympanomeatal flap and creating a tunnel via an incision in the external auditory canal (EAC) remains technically challenging for novice surgeons. In addition, the process of raising the mucosal-tympanomeatal flap can lead to complications, such as damage to the chorda tympani, EAC stenosis, iatrogenic cholesteatoma, delayed healing, and prolonged operation times [ 3 , 4 ]. Few studies have been conducted on raising a mucosal-tympanomeatal flap for repairing anterior marginal perforations [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Inside-out raising mucosal-tympanomeatal flap approach for the repair of large marginal perforations

Zhang,

Lou

2023

BMC Surg

View full text Add to dashboard Cite

Objective This study evaluated the graft success rate and hearing outcomes of the inside-out raising mucosal-tympanomeatal flap technique for the repair of large marginal perforations. Study design Prospective case series. Materials and methods The study enrolled patients with large marginal perforations who underwent endoscopic cartilage myringoplasty with the inside-out raising mucosal-tympanomeatal flap technique. The graft success rate, hearing outcomes, and complications were evaluated at 12 months postoperatively. Results In total, 48 patients with large marginal perforations were included. 81% of the population had large perforation, 14.6 had subtotal and total perforation was seen in 4.2%. The mean operation time was 38.6 ± 7.1 min. At 12 months postoperatively, the graft success rate was 89.6% (43/48). The mean air-bone gap was 25.6 ± 5.2 dB preoperatively and 16.5 ± 4.1 dB at 12 months postoperatively, with significant differences between these values (p = 0.001). The functional success rate was 85.4% (41/48). None of the patients experienced worsened sensorineural hearing loss or graft-related complications, such as graft lateralization, significant blunting, and graft medialization, during follow-up. Conclusions Endoscopic cartilage-perichondrium myringoplasty for the repair of large marginal perforations using the inside-out raising mucosal-tympanomeatal flap technique was associated with satisfactory graft outcomes and minimal complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inside-out raising mucosal-tympanomeatal flap approach for the repair of large marginal perforations

Zhang,

Lou

2023

BMC Surg

View full text Add to dashboard Cite

show abstract

The Impact of Different Manipulations of the Chorda Tympani Nerve on Taste in Endoscopic Ear Surgery

Li,

Chen,

et al. 2024

Flavour & Fragrance J

View full text Add to dashboard Cite

The chorda tympani nerve (CTN) plays a significant role in taste transmission and salivary secretion. Due to its course in the tympanic cavity and its relation to the ossicular chain, there is a high risk of iatrogenic damage to the CTN during otologic surgeries. This study aimed to assess the impact of different handling methods of the CTN during endoscopic ear surgery on patients' taste perception. A cohort study conducted from 2022 to 2023 in a tertiary hospital involved participants undergoing various types of endoscopic ear surgeries. Based on intraoperative handling of the CTN, participants were divided into three groups: intact, traction (subdivided into mild, moderate and severe traction subgroups) and transection (subdivided into transection without tension, with tension and tearing subgroups). Taste tests were administered from 1 day before surgery to 6 months postoperatively. Endoscopic ear surgery for treating ear pathologies. Taste test scores, other relevant symptoms. Significant differences were observed in the incidence and recovery time of taste dysfunction across groups. The rate of taste abnormalities and recovery time increased with the degree of traction; the severe traction and transection subgroups showed the highest rates of abnormalities and cases of incomplete recovery. In terms of disease type, patients with chronic suppurative otitis media and cholesteatoma showed significant differences in preoperative taste status, abnormality rates and recovery times compared to patients with non‐inflammatory ear diseases. General sensory abnormalities of the tongue were mainly found in moderate‐to‐severe traction subgroups and all transection groups, often accompanying taste reduction or loss. Some patients in the transection group experienced only numbness or both increased taste sensation and numbness. The study underscores the importance of delicate handling of the CTN in endoscopic ear surgery, especially in patients with inflammatory middle ear diseases. It suggests minimising severe traction injuries and considering early and accurate transection to reduce traction injuries when preservation is challenging; any manipulation of the CTN should be avoided in patients with non‐inflammatory conditions. This research provides valuable theoretical support for clinical practice.

show abstract

Split‐Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations

Abdelghany,

Gadulhaq

2024

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

ObjectiveThis study aims to describe our new modification to cartilage tympanoplasty for endoscopic repair of total and subtotal tympanic membrane perforations and evaluate its outcomes.Study DesignRetrospective case series.SettingMultiple institutions.MethodsThe study was conducted using records of patients who underwent tympanoplasty for subtotal and total perforations from January 2018 to June 2022. Utilizing an endoscopic transcanal approach, we employed a double graft consisting of outer tragal perichondrium supported by inner split‐thickness tragal cartilage as separate layers, both placed in an underlay fashion lateral to the malleus, without the need to elevate a tympanomeatal flap. Anatomical success was defined as complete primary closure of the perforation, while functional success was defined as achieving an air‐bone gap of ≤20 dB at 12 months postoperative.ResultsThe series involved 64 patients, predominantly males (53%). The mean age was 30.8 years. 56.3% of patients had subtotal perforations. The anatomical success rate was 90.6% while the functional success rate was 87.5%. Postoperative speech discrimination scores significantly increased in all patients.ConclusionOur modification provides effective anatomical and audiological outcomes. This technique reliably resists graft displacement and shrinkage before adequate healing. It avoids problems of elevating tympanomeatal flaps with comparable results to traditional approaches.

show abstract

Factors affecting the incidence of chorda tympani nerve transection in middle ear surgery

Cited by 7 publications

References 24 publications

Inside-out raising mucosal-tympanomeatal flap approach for the repair of large marginal perforations

Inside-out raising mucosal-tympanomeatal flap approach for the repair of large marginal perforations

The Impact of Different Manipulations of the Chorda Tympani Nerve on Taste in Endoscopic Ear Surgery

Split‐Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations

Contact Info

Product

Resources

About