Correlation of Taste Sensation and Status of Chorda Tympani Nerve in Middle Ear Surgery

Introduction: To Evaluate the correlation of taste sensation and status of chorda Tympani nerve in middle ear surgery intraoperatively and taste sensation of patient was reassessed post operatively on 1st, 3rd and 6th week of follow-up. Aims and Objectives Aim: To Study the Correlation of Taste Sensation and status of Chorda Tympani nerve in middle ear surgeries. Objectives a. To observe frequency and types of chorda tympanic nerve injury during middle ear surgery. b. To Assess types of post-operative taste disturbances and their functional recovery. c. To assess the relationship between taste recovery and status of chorda Tympani nerve in middle ear surgery. Material & Methods A prospective observational study was conducted at KD Medical College Hospital & Research Centre in Mathura, Uttar Pradesh, focusing on 100 patients, assessing the chorda tympani nerve status intraoperatively and evaluating postoperative taste sensations at 1st, 3rd and 6th weeks of follow up. Based on chorda tympani nerve, patients were divided into the following groups: GROUP I - Seen but not handled. GROUP II - Handled but not stretched GROUP III - Stretched but intact. GROUP IV - Cut For taste Assessment three kinds of taste testing solutions have been prepared with varying degrees of concentration: - 1. Sour (Citric Acid at 0.01, 0.05, 0.25 gm/ml) 2. Salty (Sodium Chloride at 0.009, 0.015, 0.03 gm/ml) 3. Sweet (Dextrose at 0.05, 0.10, 0.25gm/ml) Scoring will be done to indicate when each patient recognizes a taste testing solution correctly. Scores for successful identification will be as follows: - 1. Inability to identify the taste 0 2. Highest concentration 1 3. Intermediate concentration 2 4. Lowest concentration of taste solution 3 Result Groups I and II maintained a mean taste sensation score of 3, showing no impairment. Group III exhibited significant recovery, with scores rising to 2.94, suggesting near-full taste function. Group IV, initially the most impaired, improved to 1.5 but remained the lowest. Despite some recovery, 75% of Group IV experienced taste impairment, and 7.14% showed no recovery after six weeks. Recovery was possible even after excessive stretching in Group III compared to nerve transection in Group IV. Conclusion Minimal handling and mild stretching had little impact on taste, while excessive stretching (Group III) led to impairment in 5.8% of patients. In contrast, nerve transection (Group IV) caused impairment in 75% of patients. The study found that chorda tympani nerve injuries do not always result in proportionate long-term taste disturbances, likely due to compensatory mechanisms and partial nerve recovery, while 1 patient did not recover completely in group III, 7.14% showed no recovery in group IV after six weeks. The Spearman rank correlation coefficient of –0.95 indicated a strong negative correlation between injury severity and taste function, highlighting the need for follow-up in severely affected patients.