Comparison of regeneration of the chorda tympani nerve and gustatory function recovery after severing the nerve between pediatric and adult patients.

OBJECTIVE: To compare the incidence of regeneration of the chorda tympani nerve (CTN) and taste function recovery between pediatric and adult patients after severing the CTN.

STUDY DESIGN: Retrospective study.

SETTING: University hospital.

PATIENTS: Consecutive 31 pediatric patients and 61 adult patients who underwent staged tympanoplasty (86 patients) or reoperation (6 patients) because of chronic otitis media with (89 patients) or without cholesteatoma (3 patients) and whose CTN was severed during primary surgery were included.

INTERVENTION: Therapeutic.

MAIN OUTCOME MEASURES: The severed nerves were readapted or approximated on the temporalis muscle fascia used to reconstruct the eardrum. During secondary surgery, we tried to detect regenerated CTN. Preoperative and postoperative gustatory function was assessed using electrogustometry.

RESULTS: Regenerated CTN was detected during secondary surgery in 58.1% (18/31) of pediatric patients and 31.1% (19/61) of adults (p < 0.05). However, the number of patients with preoperatively elevated electrogustometry threshold was greater in adult patients. When the subjects were limited to those with preoperatively normal taste function, there was no significant difference between the 2 groups. Among patients with CTN regeneration, the incidence of taste function recovery was higher (12/18; 66.7%) in children than that (6/19; 31.6%) in adults (p < 0.05). However, there was no significant difference when the subjects were limited to those with preoperatively normal taste function.

CONCLUSION: Chronic inflammation may not severely affect the CTN in pediatric patients, resulting in higher incidences of CTN regeneration and gustatory function recovery after severing the nerve, compared with those in adult patients.