Length of Nerve Gap Defects Correlates With Incidence of Nerve Regeneration But Not With Recovery of Taste Function in Patients With Severed Chorda Tympani Nerve
Length of Nerve Gap Defects Correlates With Incidence of Nerve Regeneration But Not With Recovery of Taste Function in Patients With Severed Chorda Tympani Nerve
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DOI：
10.1097/mao.0b013e31822e96d6
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发表时间：
2011-10-01
影响因子：
2.1
通讯作者：
Ito, Tetsufumi
中科院分区：
文献类型：
--
作者：
Saito, Takehisa;Narita, Norihiko;Ito, Tetsufumi
目的：探讨鼓索神经切断后神经缺损长度、神经再生率和味觉功能恢复之间的关系。研究设计：回顾性研究。地点：大学医院。患者：88例连续接受一次手术和二次手术的鼓索神经切断患者。术中对切断神经的近端和远端进行重新缝合或接近。干预：治疗。主要观察指标：手术前后，用电测仪定期评估患者的味觉功能。神经间隙分为4组：再适应组(1组)、1~3 mm组(2组)、4~6 mm组(3组)和大于7 mm组(4组)。结果：88例患者中有36例(41%)在二次手术中发现鼓室段神经再生。神经再生率：1组为100%(10/10)，2组为45%(10/22)，3组为47%(9/19)，4组为19%(7/37)。神经缺损区长度与神经再生率有显著差异(P<0.001)。36例再生CTN患者中，味觉功能恢复率第1组为60%(6/10)，第2组为50%(5/10)，第3组为56%(5/9)，第4组为43%(3/7)。然而，鼓室段再生的CTN并不总是重新支配菌状乳头。
Objective: To evaluate the relationship between the length of nerve gap defects, incidence of nerve regeneration, and recovery of gustatory function after severing the chorda tympani nerve (CTN).Study Design: Retrospective study.Setting: University hospital.Patients: Eighty-eight consecutive patients whose CTNs were severed during primary surgery and who underwent secondary surgery were included. Proximal and distal stumps of severed nerves were readapted or approximated during surgery.Intervention: Therapeutic.Main Outcome Measures: Before and after surgery, the taste function was periodically evaluated using electrogustometry. Nerve gaps were classified into 4 groups: readaptation (Group 1), 1 to 3 mm (Group 2), 4 to 6 mm (Group 3), and more than 7 mm (Group 4).Results: Regenerated nerves in the tympanic segment were detected in 36 (41%) of the 88 patients during secondary surgery. The incidence of nerve regeneration was 100% (10/10) in Group 1, 45% (10/22) in Group 2, 47% (9/19) in Group 3, and 19% (7/37) in Group 4. There was a significant difference between the length of nerve gap defects and incidence of nerve regeneration (p < 0.001). In the 36 patients with a regenerated CTN, the incidence of gustatory function recovery was 60% (6/10) in Group 1, 50% (5/10) in Group 2, 56% (5/9) in Group 3, and 43% (3/7) in Group 4. There was no significant difference between the length of nerve gap defects and incidence of taste function recovery.Conclusion: Reconstruction of a severed CTN is very important for regeneration. However, the regenerated CTN in the tympanic segment does not always reinnervate the fungiform papillae.