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Cutting the chorda tympani: not just a matter of taste

Published online by Cambridge University Press:  07 April 2010

N Guinand ,
T Just ,
N W Stow ,
H Cao Van  and
B N Landis
N Guinand
Affiliation:
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland
T Just
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Rostock, Germany
N W Stow
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Mona Vale Hospital, Sydney, New South Wales, Australia
H Cao Van
Affiliation:
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland
B N Landis*
Affiliation:
Department of Clinical Neurosciences, Division of Otorhinolaryngology Head and Neck Surgery, University of Geneva Medical School, Switzerland Smell and Taste Clinic, Department of Otorhinolaryngology, Medical School, Technische Universität Dresden, Germany
*
Address for correspondence: Dr Basile N Landis, Department of Otorhinolaryngology, Geneva Neuroscience Center, University of Geneva Medical School, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva, Switzerland. Fax: +41 22 372 82 40 E-mail: bnlandis@yahoo.co.uk
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Abstract

Introduction:

Chorda tympani injury as a complication of middle-ear surgery has been extensively studied with regard to its effects upon taste. However, the chorda tympani also carries parasympathetic fibres to the salivary glands of the oral cavity. To date, little has been reported about the effect of chorda tympani section upon salivary function.

Setting:

Tertiary care centre.

Material and methods:

We report a case series of three patients with bilateral chorda tympani lesions. Chorda tympani function was assessed using ‘taste strips’ and unstimulated sialometry. A careful history of oral symptoms was taken.

Results:

All patients showed transient or permanent bilateral ageusia of the anterior two-thirds of the tongue, and a decreased resting salivary flow rate. In addition, all patients suffered from transient or persistent, distressing xerostomia.

Conclusion:

Taste disorders may occur after middle-ear surgery but they are mostly transient, even when the chorda tympani nerves are sectioned bilaterally. In contrast, bilateral chorda tympani lesions may lead to severe, persistent and distressing xerostomia. Based on this neglected aspect of chorda tympani function, we emphasise the importance of preserving the chorda tympani whenever possible.

Keywords

Chorda TympaniTasteFacial Nerve InjuriesOtologic Surgical Procedures
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 999 - 1002
Copyright
Copyright © JLO (1984) Limited 2010

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