​Posledice operativnega zdravljenja otoskleroze na spremembo morfologije in zaznavne funkcije jezika

Božanić Urbančič, Nina (author), Battelino, Saba (mentor)

Ozadje: Domnevali smo, da manipulacija živca horde timpani (HT) med operacijo stapesa zaradi otoskleroze negativno vpliva na zaznavanje okusa, dvotočkovno diskriminacijo in morfologijo kapilarnih zank fungiformnih papil (FP) na jeziku. Metode: Po končani operaciji stapesa zaradi otoskleroze je kirurg ocenil stopnjo manipulacije živca HT kot: (1) nemanipulirano, (2) minimalno manipulirano, (3) srednje močno manipulirano, (4) močno manipulirano ali (5) presekano. Bolniki, ki so bili operirani na stapesu zaradi otoskleroze, so bili testirani en dan pred operacijo ter en mesec in šest mesecev po operaciji. Okus smo testirali s testnimi trakovi za sladko, slano, kislo in grenko, splošni občutek za dotik pa s statično dvotočkovno diskriminacijo. Za določitev števila kapilarnih zank fungiformnih papil (Npapillae) in skupnega rezultata morfologije krvnih žil (NBItotal) smo uporabili ozkopasovno kontaktno endoskopijo (NBI). Teste smo izvajali na ipsilateralni (testni) strani jezika in na kontralateralni (kontrolni) strani jezika. Rezultati: V raziskavo smo vključili 52 bolnikov z otosklerozo. Preverjanje predpostavk pred izvedbo korelacijskih testov ni pokazalo povezanosti med podatki glede manipulacije živca HT, zato statističnih testov korelacije nismo opravili. Na testni strani jezika smo v šestmesečnem obdobju ugotovili statistično značilno zmanjšanje okusa za sladko (p = 0,003), slano (p = 0,035), kislo (p = 0,036) in grenko (p = 0,013). Statistično pomemben vpliv na prisotnost disgevzije za sladko smo ugotovili en mesec po operaciji (p < 0,005). Pooperativno zmanjšanje statične dvotočkovne diskriminacije ni bilo statistično značilno (p = 0,056). Ugotovili smo statistično značilno zmanjšanje števila kapilarnih zank fungiformnih papil Npapillae (p = 0,009) in skupnega rezultata morfologije krvnih žil NBItotal (p = 0,005). Na kontrolni strani jezika nismo zaznali statistično značilnih sprememb. Zaključki: Manipulacija živca HT poslabša zaznavanje okusa ter zmanjša gostoto kapilarnih zank fungiformnih papil in poslabša njihove morfološke lastnosti. Manipulacija živca HT ne vpliva na občutek za dotik na jeziku.

• Language: Slovenian
• Keywords: naglušnost, obrazni živec, brbončice, okušalne papile, otološke operacije, mikroskopija, endoskopija, agevzija, nevrofiziologija, denervacija, atrofija.
• Work type: Doctoral dissertation
• Organization: MF - Faculty of Medicine
• Year: 2023
• PID: 20.500.12556/RUL-146926
• Publication date in RUL: 16.06.2023

Secondary language

• Language: English
• Title: Consequences of Stapes Surgery On Tongue Morphological Characteristics and Sensory Function

Abstract

Background: We have assumed that the Chorda tympani (HT) manipulation during stapes surgery for otosclerosis has negative impact on taste sensation, two point discrimination and fungiform papillae capillary network morphology. Methods: After stapes surgery for otosclerosis, the surgeon graded the degree of manipulation of HT nerve as: (1) unmanipulated, (2) minimally manipulated, (3) moderately manipulated, (4) severely manipulated, or (5) severed. Patients undergoing stapes surgery were tested 1 day preoperatively, 1 and 6 months postoperatively. The taste was tested with taste strips for sweet, salty, sour and bitter. General sensation was tested with a static two-point discrimination. Narrow band imaging contact endoscopy (NBI) was used to determine the number of fungiform papillae (Npapillae) and the total score of blood vessel morphology (NBItotal). Tests were performed on ipsilateral (test) side of the tongue and on contralateral (control) side of the tongue. Results: In our study, 52 patients with otosclerosis were included. Prior to planned correlation tests the assumptions have been tested, revealing there is no relationship between the data regarding the manipulation of the HT nerve, so statistical correlation tests were not performed. During the follow-up, statistically significant decrease of sweet (p = 0.003), salty (p = 0.035), sour (p = 0.036), and bitter taste (p = 0.013) within the test side during the follow-up was identified. A statistically significant impact on presence of dysgeusia for sweet was found 1 month postoperatively (p < 0.005). Postoperative decrease in two-point discrimination score was not statistically significant (p = 0.056). There was a statistically significant decrease of NBItotal (p = 0.005) and Npapillae (p = 0.009). On the control side of the tongue, no statistically significant changes were detected. Conclusions: HT manipulation affects taste sensation as well as fungiform papillae capillary network density and its morphology. General sensation of the tongue is not influenced by HT manipulation.

• Keywords: hearing loss, facial nerve, taste buds, tongue papillae, otologic surgical procedures, microscopy, endoscopy, ageusia, neurophysiology, denervation, atrophy