Chorda tympani injury: operative findings and postoperative symptoms

This study aims to assess whether operative findings of chorda tympani nerve (CTN) trauma correlate with postoperative symptoms.

A prospective study was conducted over 2 years on 140 middle ear operations analyzing taste disturbances. The operations were subdivided into myringoplasty/tympanoplasty (56 cases), mastoidectomy (64 cases), and tympanotomy (20 cases).

Twenty-one (15%) patients reported taste disturbance. Altered taste was most reported (n=15, 71%) with loss of taste reported by 29% (n=6). Symptoms were most observed in the tympanotomy group (45%). Stretching of the CTN was associated with more symptoms than nerve transection. Recovery was complete in 76% (n=16) of the symptomatic cases by 12 months.

Patients who undergo middle ear surgery should be thoroughly counseled with respect to CTN injury and symptoms regardless of the type of damage to the nerve.

This study highlights the high incidence of postoperative alterations in taste after middle ear surgery, especially in non-diseased ears, and that CTN transection results in fewer symptoms than CTN stretching.