Subjective and Objective Taste Change After Stapes Surgery Systematic Review and Meta-Analysis

Abstract

Iatrogenic injury to the chorda tympani (CT) is a well recognized, although potentially underestimated, consequence of stapes surgery. This study aims to review the currently available literature to determine the incidence and prognosis of taste disturbances in these patients. Data Sources: PubMed, Embase, and Cochrane Library databases Methods: Databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Search terms included (chorda tympani OR gustatory OR taste OR chemosensory OR dysgeusia OR nervus intermedius) AND (ear surgery OR middle ear OR stapes OR stapedectomy OR stapedotomy). Patients with prospective data collection including preoperative data were further divided by methodology into "objective" and "subjective" assessments of taste dysfunction. A systematic review was performed for all included studies, with meta-analysis using a random-effects model was used for those with comparable methodology and patient populations.Results: Initial search yielded 2,959 articles that were screened according to inclusion and exclusion criteria. Once duplicates were removed, seven studies were identified, representing 173 patients with subjective testing (all seven studies) and 146 with objective testing (five studies). Eighty of 173 patients (46.2%) noted a disturbance in taste at early follow-up, whereas as 26 of 173 (15.0%) noted long-term problems. Objective methodology and result reporting were heterogenous and not amenable to pooled meta-analysis for all studies included. Conclusion: Changes in taste occur relatively frequently after stapedectomy. Surgeons should continue to counsel prospective patients as to the risks of both short-and long-term taste disturbances.

Subjective and Objective Taste Change After Cochlear Implantation Systematic Review and Meta-Analysis

“…The sensitivity and specificity of taste solution testing for gustatory function vary with the concentration of each solution but reportedly have a higher test-retest correlation than taste strips ( r = 0.80 for sweet stimuli, r = 0.73 for salty, r = 0.76 for sour, r = 0.74 for bitter; all p < 0.0001) (34). Despite this, it seems that the incidence of postoperative taste change is lower for CI than for some other otologic procedures, such as stapedectomy and stapedotomy, which have an incidence of short-term taste change of about 50% and long-term taste change of about 15% (9).…”

“…An often-overlooked complication of CI, however, is the potential for damage to or disruption of the chorda tympani nerve (CTN), which provides taste to the anterior tongue and parasympathetic innervation to the submandibular and sublingual glands. More commonly associated with middle ear surgery, including stapedectomy (9), the nerve may be damaged during the creation of a facial recess/posterior tympanotomy to access the basal turn of the cochlea and round window in any transmastoid surgery, including CI (10).…”