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. 2023 Sep;132(9):1068-1076.
doi: 10.1177/00034894221129911. Epub 2022 Oct 26.

Gustatory Function of Patients With and Without Cholesteatoma Undergoing Middle Ear Surgery

Aline Sophie Neumann  1 , Michael B Soyka  1 , Elisabeth J Rushing  2 , Christof Röösli  1
Affiliations

Gustatory Function of Patients With and Without Cholesteatoma Undergoing Middle Ear Surgery

Aline Sophie Neumann et al. Ann Otol Rhinol Laryngol. 2023 Sep.

Abstract

Objective: To compare measured and perceived taste function before and after surgery of patients with chronic otitis media with cholesteatoma (OMCC) to patients without cholesteatoma (patients with chronic suppurative otitis media [CSOM] and patients with lateral skull base lesions [LSB]).

Methods: This prospective cohort study included 29 patients undergoing surgery for unilateral OMCC. The chorda tympani nerve (CTN) was resected in 8 of these patients. Fourteen patients undergoing surgery for unilateral CSOM and 5 patients undergoing surgery for unilateral LSB (with CTN resection) served as the comparison group. Taste function was measured using taste strips on both sides of the tongue before surgery, 2 weeks postoperatively and 3 months postoperatively. The affected side of the tongue was compared to the unaffected side. A questionnaire on taste perception was completed at each visit.

Results: Preoperatively, cholesteatoma patients showed higher taste strip scores than non-cholesteatoma patients, indicating a larger difference between the healthy and affected sides of the tongue. Despite this difference in measured taste function few cholesteatoma patients reported taste alteration before surgery (3/29 [10.3%]). Postoperatively, patients with CTN resection (OMCC patients with CTN resection and LSB patients) showed a decreased measured taste function. Subjectively, only approximately 20% of these patients reported taste alteration 3 months postoperatively.

Conclusions: Before surgery, cholesteatoma patients displayed an impaired measured taste function compared to patients without cholesteatoma (CSOM, LSB). Subjectively this was often unnoticed. After surgery, despite removal of the CTN and consequent reduction of measured taste function, few patients reported taste alteration and subjective taste perception was seen to be improving. In regards to middle ear surgery, perceived taste function does not seem to reflect measured gustatory function.

Keywords: cholesteatoma; chorda tympani nerve; gustatory function; middle ear surgery; otology.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The number of patients per group and per visit. Abbreviations: CSOM, chronic suppurative otitis media; CTN, chorda tympani nerve; LSB, lateral skull base lesions; OMCC, chronic otitis media with cholesteatoma.
Figure 2.
Figure 2.
The preoperative taste strip scores of the cholesteatoma patients and the non-cholesteatoma patients.
Figure 3.
Figure 3.
The 2 weeks postoperative and 3 months postoperative taste strip scores of all groups. Abbreviations: CSOM, chronic suppurative otitis media; CTN, chorda tympani nerve; LSB, lateral skull base lesions; OMCC, chronic otitis media with cholesteatoma.
Figure 4.
Figure 4.
The mean taste strip scores of each group at the 3 measurement points. Abbreviations: CSOM, chronic suppurative otitis media; CTN, chorda tympani nerve; LSB, lateral skull base lesions; OMCC, chronic otitis media with cholesteatoma.
Figure 5.
Figure 5.
Biopsy showing mixed axonal and demyelinating neuropathy with extensive loss of large myelinated axons, accompanied by increased endoneurial connective tissue (¤), thinly myelinated fibers (thin arrow), and axonal atrophy (larger arrow). In addition, regeneration clusters can be seen (arrow with broken line). There is no evidence of inflammation (1 μm, toluidine blue-stained section).
See this image and copyright information in PMC

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