Use of the chorda tympani nerve in reconstruction of the ossicular chain.
We conducted a study to assess the use of the chorda tympani nerve in reconstruction of the ossicular chain. We retrospectively examined the medical records of 141 patients (154 ears) who had undergone middle ear surgery with 12 months of follow-up. The study population was made up of 58 males and 83 females, aged 9 to 83 years (mean: 45). These patients were divided into three groups based on the specific type of surgery they had undergone: in 35 patients, the chorda tympani nerve was used to spring and press the auricular bone prosthesis (CTN group); in 67 patients, the tympanic membrane was used to spring and press the auricular bone prosthesis (TM group); and in 39 patients, a gelatin sponge was used to support the auricular bone prosthesis (GS group). We compared pre- and postoperative air-bone gaps (ABGs) in each group, as well as the differences between these gaps among the three groups. We found significant differences between the pre- and postoperative ABGs in all three groups (all p < 0.01). These differences were also compared between the CTN and TM groups (t = 0.41; p > 0.05), between the CTN and GS groups (t = 2.07; p < 0.05), and between the TM and GS groups (t = 2.51; p < 0.05). In the CTN group, 1 patient experienced temporary postoperative hypogeusia, and another developed a mild case of delayed facial paralysis; both patients recovered within 2 weeks. We conclude that the chorda tympani nerve can be used to repair the ossicular chain to improve hearing without causing taste and facial nerve dysfunction and without the need for a second operation.
Department of Otolaryngology-Head and Neck Surgery, the Branch of Shanghai 1st People's Hospital, No. 1878, Sichuan North Rd., Shanghai 200081, PRC.
Yi
Y
Qiao
Wen-Wen
WW
Chen
Ya-Xin
YX
Deng
Jun
J
Tong
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002814:Chorda Tympani Nerve / Q000601:surgery*; D004427:Ear Diseases / Q000601:surgery; D004429:Ear Ossicles / Q000601:surgery*; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019933:Ossicular Replacement / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult