Download PDF
Laryngorhinootologie 2015; 94(12): 827-832
DOI: 10.1055/s-0035-1549860
Originalie
© Georg Thieme Verlag KG Stuttgart · New York

Globales und regionales Schmeckvermögen nach einseitiger Durchtrennung der Chorda tympani

Global and Spatial Gustatory Function after Proven Unilateral Transsection of the Chorda Tympani
H. Gudziol
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Jena
,
A. Schönherr
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Jena
,
T. Bitter
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Jena
,
O. Guntinas-Lichius
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Jena
› Author Affiliations
Further Information

Publication History

received 22 March 2015

accepted 03 April 2015

Publication Date:
19 June 2015 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund: Eine Unterbrechung der Chorda tympani bewirkt einen regionalen Schmeckverlust im ipsilateralen vorderen Zungenbereich. Die meisten Patienten bemerken dies nicht. Liegt das daran, dass benachbarte Areale empfindlicher werden oder ist die globale Schmeckempfindung nicht von der Größe des gereizten Areals abhängig?

Methoden: Das Schmeckvermögen wurde an 51 Patienten, bei denen die Chorda tympani durchtrennt war, und 51 gesunden Kontrollpersonen analysiert. Die Testung des globalen Schmeckvermögens erfolgte mit dem 3-Tropfen-Test nach Henkin, das regionale Schmeckvermögen mit auf 4 Zungenareale aufgepinselten Geschmackslösungen in aufsteigenden Konzentrationen.

Resultate: Das globale Schmeckvermögen der Patienten und der gesunden Kontrollgruppe unterschied sich für die einzelnen Geschmacksqualitäten nicht, lediglich beim composite score übertrafen die Gesunden die Patienten. Das regionale Schmeckvermögen war bei den Patienten in 3 gustatorischen Arealen im Vergleich zur Kontrollgruppe vermindert. Das regionale Schmeckvermögen im Versorgungsgebiet der durchtrennten Chorda tympani blieb auch bei größerem Abstand zur Operation ausgefallen. Im ipsilateralen hinteren und im vorderen kontralateralen gustatorischen Zungenareal bildete sich die Minderung des Schmeckvermögens mit zunehmendem Abstand zur Operation zurück.

Schlußfolgerungen: Es kommt auch in benachbarten gustatorischen Arealen zumindest zeitweise zu einer Reduktion des regionalen Schmeckvermögens. Untersuchungen zum regionalen Schmeckvermögen sollten deshalb mit den Schmeckwerten einer gesunden Kontrollgruppe vergleichen und nicht mit den Schmeckwerten benachbarter, vermeintlich gesunder gustatorischer Areale.

Abstract

Background: A transection of the chorda tympani results in loss of spatial gustatory function on the ipsilateral tongue. Most patients do not notice anymore this alteration. The cause is unclear. Do adjacent gustatory areas become more sensitive or is the gustatory perception rather independent of the size of stimulated area?

Methods: 51 patients with proven unilateral transection of the chorda tympani and 51 healthy subjects were tested for gustatory recognition thresholds. The methods used were the “three-drops-choice-technique” by Henkin to evaluate the whole mouth taste (global taste examination) and the “spatial taste test” to evaluate the local gustatory function on 4 areas of the tongue. The taste solutions were sweet, sour, salty and bitter with increasing concentrations.

Results: The global gustatory function of the patients and of the control group did not differ in either the 4 taste qualities but the composite score was increased within the group of patients. Most patients did not realize that. The spatial taste examination showed reduction of taste perception on 3 of the 4 gustatory areas of the tongue in the patients. The decreased gustatory function on the area of the transected chorda remained unchanged over time. The taste attenuation on the ipsilateral back area and the contralateral front area improved over time.

Conclusion: Transection of chorda tympani also leads to an attenuation of spatial gustatory function in adjacent areas. Therefore, adjacent areas cannot be taken as reference. Instead, taste function has to be compared to the results of healthy probands.

Schlüsselwörter

Schmecken - regionales Schmeckvermögen - globales Schmeckvermögen - gustatorische Erkennungsschwelle - Chorda tympani Durchtrennung

Key words

taste - spatial taste - whole-mouth-taste - gustatory recognition threshold - chorda tympani transsection
 

  • Literatur

  • 1 Bartoshuk L. Clinical evaluation of the sense of taste. Ear Nose Throat J 1989; 68: 331-337
    PubMedGoogle Scholar
  • 2 House HP. Early and late complications of stapes surgery. Arch Otolaryngol 1963; 78: 606-613
    CrossrefPubMedGoogle Scholar
  • 3 Rice JC. The chorda tympani in stapedectomy. J Laryngol Otol 1963; 77: 943-944
    CrossrefPubMedGoogle Scholar
  • 4 Henkin RI, Gill JR, Bartter FC. Studies on taste thresholds in normal man and in patients with adrenal cortical insufficiency: The role of adrenal cortical steroids and of serum sodium concentration. Journal of Clinical Investigation 1963; 42: 727-735
    CrossrefPubMedGoogle Scholar
  • 5 Gudziol H, Hummel T. Normative values for the assessment of gustatory function using liquid tastants. Acta Otolaryngol 2007; 127: 658-661
    CrossrefPubMedGoogle Scholar
  • 6 Arbeitsgemeinschaft Olfaktologie und Gustologie der Dt. Ges. f. Hals-Nasen-Ohrenheilkunde K-uH , Schmeckstörungen: Leitlinie zur Epidemiologie, Pathophysioloie, Klassifikation, Diagnose und Therapie. In: Fachgesellschaften AdWM. (ed.). Nr017/052 2007
    Google Scholar
  • 7 Gesellschaft MD. Empfehlungen zur Untersuchung des Riech- und Schmeckvermögens. HNO-Praxis 1980; 5: 62-67
    PubMedGoogle Scholar
  • 8 Saito T, Manabe Y, Shibamori Y, Yamagishi T, Igawa H, Tokuriki M, Fukuoka Y, Noda I, Ohtsubo T, Saito H. Long-term follow-up results of electrogustometry and subjective taste disorder after middle ear surgery. Laryngoscope 2001; 111: 2064-2070
    CrossrefPubMedGoogle Scholar
  • 9 Moon CN, Pullen EW. Effects of chorda tympani section during middle ear surgery. The Laryngoscope 1963; 73: 392-405
    PubMedGoogle Scholar
  • 10 Bull TR. Taste and the chorda tympani. The Journal of Laryngology & Otology 1965; 79: 479-493
    CrossrefPubMedGoogle Scholar
  • 11 Just T, Steiner S, Strenger T, Pau HW. Changes of oral trigeminal sensitivity in patients after middle ear surgery. Laryngoscope 2007; 117: 1636-1640
    CrossrefPubMedGoogle Scholar
  • 12 Landis BN, Hummel T, Hugentobler M, Giger R, Lacroix JS. Ratings of overall olfactory function. Chem Senses 2003; 28: 691-694
    CrossrefPubMedGoogle Scholar
  • 13 Marschner H. Häufigkeit und Ursachen von Riechstörungen in der Jenaer Stadtbevölkerung [Thesis]. Jena: Friedrich-Schiller-Universität; 2010: 99 p
    Google Scholar
  • 14 Oakley B, Lawton A, Riddle DR, Wu L-H. Morphometric and immunocytochemical assessment of fungiform taste buds after interruption of the chorda-lingual nerve. Microscopy Research and Technique 1993; 26: 187-195
    CrossrefPubMedGoogle Scholar
  • 15 Phillips LM, Hill DL. Novel regulation of peripheral gustatory function by the immune system. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology 1996; 271: R857-R862
    PubMedGoogle Scholar
  • 16 Saito T, Yamada T, Okamoto M, Narita N. Comparison of regeneration of the chorda tympani nerve and gustatory function recovery after severing the nerve between pediatric and adult patients. Otol Neurotol 2012; 33: 1567-1572
    CrossrefPubMedGoogle Scholar
  • 17 Kveton JF, Bartoshuk LM. The effect of unilateral chorda tympani damage on taste. Laryngoscope 1994; 104: 25-29
    PubMedGoogle Scholar
  • 18 Yanagisawa K, Bartoshuk LM, Catalanotto FA, Karrer TA, Kveton JF. Anesthesia of the chorda tympani nerve and taste phantoms. Physiol Behav 1998; 63: 329-335
    CrossrefPubMedGoogle Scholar
  • 19 Halpern BP, Nelson LM. Bulbar gustatory responses to anterior and to posterior tongue stimulation in the rat. Am J Physiol 1965; 209: 105-110
    PubMedGoogle Scholar
  • 20 Catalanotto FA, Bartoshuk LM, Östrom KM, Gent JF, Fast K. Effects of anesthesia of the facial nerve on taste. Chemical Senses 1993; 18: 461-470
    CrossrefPubMedGoogle Scholar
  • 21 Snyder DJ, Prescott J, Bartoshuk LM. Modern psychophysics and the assessment of human oral sensation. Arnold W. editor. Basel: Karger; 2006: 221-241
    Google Scholar
  • 22 Lehman CD, Bartoshuk LM, Catalanotto FC, Kveton JF, Lowlicht RA. Effect of anesthesia of the chorda tympani nerve on taste perception in humans. Physiol Behav 1995; 57: 943-951
    CrossrefPubMedGoogle Scholar
  • 23 Landis BN, Beutner D, Frasnelli J, Huttenbrink KB, Hummel T. Gustatory function in chronic inflammatory middle ear diseases. Laryngoscope 2005; 115: 1124-1127
    CrossrefPubMedGoogle Scholar
  • 24 Rotshenker S, Reichert F. Motor axon sprouting and site of synapse formation in intact innervated skeletal muscle of the frog. J Comp Neurol 1980; 193: 413-422
    CrossrefPubMedGoogle Scholar
  • 25 Pearson RC, Taylor N, Snyder SH. Tubulin messenger RNA: In situ hybridization reveals bilateral increases in hypoglossal and facial nuclei following nerve transection. Brain Res 1988; 463: 245-249
    CrossrefPubMedGoogle Scholar
  • 26 Oaklander AL, Brown JM. Unilateral nerve injury produces bilateral loss of distal innervation. Ann Neurol 2004; 55: 639-644
    CrossrefPubMedGoogle Scholar
  • 27 Hamrah P, Cruzat A, Dastjerdi MH, Zheng L, Shahatit BM, Bayhan HA, Dana R, Pavan-Langston D. Corneal sensation and subbasal nerve alterations in patients with herpes simplex keratitis: An in vivo confocal microscopy study. Ophthalmology 2010; 117: 1930-1936
    CrossrefPubMedGoogle Scholar
  • 28 Hamrah P, Cruzat A, Dastjerdi MH, Pruss H, Zheng L, Shahatit BM, Bayhan HA, Dana R, Pavan-Langston D. Unilateral herpes zoster ophthalmicus results in bilateral corneal nerve alteration: An in vivo confocal microscopy study. Ophthalmology 2013; 120: 40-47
    CrossrefPubMedGoogle Scholar
  • 29 Koltzenburg M, Wall PD, McMahon SB. Does the right side know what the left is doing?. Trends in Neurosciences 1999; 22: 122-127
    CrossrefPubMedGoogle Scholar
  • 30 Yamaguchi T, Turhan A, Harris DL, Hu K, Pruss H, von Adrian U, Hamrah P. Bilateral nerve alterations in a unilateral experimental neurotrophic keratopathy model: a lateral conjunctival approach for trigeminal axotomy. PLoS One 2013; 8: e70908
    CrossrefPubMedGoogle Scholar
  • 31 Small DM. Central gustatory processing in humans. Advances in Oto-Rhino-Laryngology 2006; 63: 191-220
    PubMedGoogle Scholar
  • 32 Pritchard TC. Gustatory system. In: Mai JK, Praxinos G. (eds.). The human nervous system. Amsterdam, Boston, Heidelberg, London, New York, Oxford, Paris, San Diego, San Francisco, Singapore, Sydney, Tokyo: Elsevier Inc.; 2012: 1187-1218
    CrossrefGoogle Scholar