Clinical implications of iatrogenic lesion in the chorda tympani nerve during otosclerosis surgery

Abstract

IntroductionDamage to the chorda tympani nerve is frequent during otologic surgery. This article studies the clinical outcomes of the nerve's section versus its conservation in otosclerosis surgery. Material and methodRetrospective observational study using our department's otosclerosis database and a validated questionnaire on symptoms associated with the chorda tympani nerve. The sample was divided into 2 groups: section and conservation (patients whose nerve was anatomically conserved). We studied the presence and duration of symptoms, the surgical technique, and the audiometric results. ResultsSeventy-eight patients (88 ears): section group (18 ears; 20%) and conservation group (70 ears; 80%). Overall, gustatory symptoms appear in 35% (39% section group; 34% conservation group). Differences between groups are not statistically significant in relation to presence and duration of symptoms, surgical technique, or audiometric results. Only 1 patient in each group reports long-term symptoms. Our results suggest there are no major clinical differences following section versus conservation of the chorda tympani nerve. A wide range of factors such as age, presence of previous middle ear pathology, cross innervation, and gastronomic culture may play a role in the appearance of symptoms. ConclusionsSymptoms appearing after iatrogenic damage to the chorda tympani nerve have, in general, little clinical relevance, especially in the long term, regardless of whether the nerve is dissected or manipulated to various degrees.