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Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?

Post-operative dysgeusia after EStS

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS.

Methods

Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale.

Results

The most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%).

Conclusion

Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS.

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Availability of data and material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy

    Giulia Molinari, Marella Reale, Marco Bonali, Daniela Lucidi, Livio Presutti & Matteo Alicandri-Ciufelli

  2. Department of Otolaryngology-Head and Neck Surgery, IRCCS Policlinico S.Orsola-Malpighi, Bologna, Italy

    Giulia Molinari & Livio Presutti

  3. Department of Otolaryngology-Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland

    Lukas Anschuetz

Authors
  1. Giulia Molinari
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Contributions

GM: conceived the presented idea, wrote the manuscript, patients’ enrollement, verified the analytical methods, supervised the work, final approval of the submitted version. MR: conceived the presented idea, wrote the manuscript, patients’ enrollement, verified the analytical methods, supervised the work, final approval of the submitted version. MB: conceived the presented idea, verified the analytical methods, final approval of the submitted version. LA: conceived the presented idea, wrote the manuscript, supervised the work, final approval of the submitted version. DL: conceived the presented idea, statistical analysis, verified the analytical methods, supervised the work, final approval of the submitted version. LP: conceived the presented idea, verified the analytical methods, critical revision of the manuscript, final approval of the submitted version. MA-C: conceived the presented idea, wrote the manuscript, verified the analytical methods, critical revision of the manuscript, final approval of the submitted version.

Corresponding author

Correspondence to Marella Reale.

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All the authors declare no conflicts of interest.

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For this kind of retrospective investigation, our Institutional Review Board does not perform a formal ethical assessment.

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All patients received appropriate and comprehensible information about the surgical procedures and tests and gave their written consent.

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Molinari, G., Reale, M., Bonali, M. et al. Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?. Eur Arch Otorhinolaryngol 279, 2269–2277 (2022). https://doi.org/10.1007/s00405-021-06908-0

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