Taste function after section of chorda tympani nerve in middle ear surgery.

OBJECTIVE: To investigate prospectively the clinical manifestations and the functional recovery of taste after section of chorda tympani nerve (CTN) during middle ear surgery, the subjective and objective study on the patients was performed. METHODS: Thirty-five patients underwent surgery with unilateral (n=32) or bilateral (n=3) section of CTN between January 2000 and April 2002. The patients were asked about taste symptoms before surgery and 2 weeks and 2 years after surgery. The CTN function was also measured with electrogustometry (EGM) at the same time points. RESULTS: In unilateral section of CTN, 19/32 (59.4%) complained of taste disorder and 11/32 (34.4%) tongue numbness. Most of these taste symptoms disappeared within 2 years although the EGM threshold did not recover. 16/17 patients (94.1%) who used to cook everyday had little difficulty in flavoring dishes. In bilateral section of CTN, the patients had no problem of taste at 2 years after surgery, either. CONCLUSION: These findings help explain the potential complications to the patients before surgery, although the number of cases was small in this series.

Reevaluation of bilateral same-day surgery for bilateral perforated chronic otitis media.

OBJECTIVE: To evaluate the results of bilateral same-day surgery for bilateral perforated chronic otitis media in comparison with our previous report. STUDY DESIGN: Prospective study. PATIENTS: Seventeen patients ranging in age from 5 to 70 years (mean, 52.5 yr), with bilateral perforated chronic otitis media. METHODS: Two hundred cases of chronic otitis media were operated on at the Department of Otolaryngology, Hyogo College of Medicine from December 1998 to November 2002. Fifty-nine patients (29.5%) had bilateral disease and 17 patients (8.5%) underwent bilateral same-day surgery. RESULTS: The postoperative air-bone gap was less than 10 dB on both sides in 5 of 17 (29%) and less than 20 dB in 15 of 17 (88%). The postoperative hearing level was less than 20 dB in both ears in 4 of 17 (24%), less than 30 dB in 7 of 17 (41%), and less than 40 dB in 10 of 17 (59%). The rate of closure of the ear drum was 20 of 22 (91%) in the simple underlay myringoplasty series and 9 of 12 (75%) in the conventional myringoplasty/tympanoplasty series. The rate of closure of the ear drum on both sides was successful in 4 of 5 (80%) that underwent simple underlay myringoplasty/simple underlay myringoplasty and 8 of 12 (67%) that underwent simple underlay myringoplasty/conventional myringoplasty/tympanoplasty, whereas that on at least one side was successful in 100%. CONCLUSION: Bilateral same-day surgery for bilateral perforated chronic otitis media is possible if operative indications are considered. Furthermore, it will help patients save time and money.

Usefulness of the odor stick identification test for Japanese patients with olfactory dysfunction.

The odor stick identification test (OSIT) is a new test of olfactory function recently developed for Japanese people. The purpose of the present study was to evaluate this test in relation to T&T olfactometry and the cross-cultural smell identification test (CC-SIT) by applying to 110 Japanese patients with olfactory disturbance. The averaged recognition thresholds for five odorants in T&T olfactometry, the number of correct answers in the CC-SIT and the rates of identification of 13 odorants in the OSIT were compared. The visual analogue scale (VAS) was also used to evaluate symptoms. The rate of identification of OSIT showed high and significant correlation coefficients with the averaged recognition thresholds of T&T olfactometry (-0.766, P < 0.001), with the number of correct answers in CC-SIT (0.754, P < 0.001) and with the VAS score (0.591, P < 0.001). In addition, on the identification performance measured by OSIT, we found significant differences between all pairs of four degrees of olfactory dysfunction except for one pair. Thus, we conclude that OSIT is useful for evaluating olfactory dysfunction in Japanese people.

[Tympanoplasty on only hearing ears].

The management of only hearing ears remains controversial because of the risk of postoperative hearing deterioration. We reviewed 12 cases of hearing ears alone operated on at the Hyogo College of Medicine Department of Otolaryngology from 1999 to 2002. All ears were dry at the final examination. Postoperative hearing results were evaluated based on the guideline of the Japan Otological Society (2000). An air bone gap within 15 dB was found in 9 cases (75%), hearing gain exceeding 15 dB was found in 6 cases (50%), the hearing level was within 30 dB in 4 cases (33.3%), and total successful cases numbered 10 (83.3%). Eight patients wore hearing aids before surgery, and 4 patients (50%) did not need them after the surgery. We suggest that tympanoplasty by skillful surgeons should be done to obtain a dry ear, to avoid a progressive hearing loss, to preserve or improve hearing, and to improve the quality of life. We also suggest that handling of ossicles should minimized in chronic otitis media and cholesteatoma.