Int. Adv. Otol. 2009; 5(3); 382-390

Taste disorder after middle ear surgery
Masafumi Sakagami (Japan),

Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan, msakaga@hyo-med.ac.jp

Because patient demand for informed consent regarding surgical complications has been increasing over the past decade,
otosurgeons have been required to explain potential complications such as taste disorder after surgery. In this article, a
series of our studies and related literature were reviewed and the following information was proven to be useful in daily practice.
(1) Taste disorder occurs more frequently with preservation of the chorda tympani nerve (CTN) than with section of CTN. (2)
With preservation of CTN, the recovery rate of CTN function is higher in younger patients than in middle-aged or older patients.
(3) Taste disorder easily occurs and persists in patients with non-inflammatory disease such as otosclerosis. (4) With unilateral
section of CTN, about 50% of patients complain of taste disorder, however taste disorder will cease within one year in most
cases. (5) Recovery of threshold of electrogustometry is not related to recovery of symptoms, and it is delayed in most cases.
(6) Even with bilateral section of CTN, patients do not complain of difficulty in tasting food within two years. (7) Elderly patients
complain of taste disorder less frequently because taste naturally deteriorates with aging. (8) Because CTN has the ability to
regenerate, it is desirable to preserve CTN during surgery or to anastomose the nerve ends if CTN is unavoidably cut. (9)
Trigeminal sensations such as tongue numbness, tingling, and metallic taste may also develop after surgery, however the
mechanism remains unclear.