European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Impact of surgical approach on taste dysfunction and quality of life in middle ear surgery: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Alzahrani Mohammed Atiah, Erwe Ibrahem H, Alshehri Mona Ali, Al Taza Faisal Ayed, Alenzi Meshari Mosleh G, Ardi Khalid Talat, Alahmari Yahya Dhafer
Аннотация
PURPOSE: This systematic review and meta-analysis evaluated how middle ear surgical approach and chorda tympani nerve (CTN) handling influence postoperative taste disturbance and related quality of life.
METHODS: Following PRISMA 2020 guidance, databases and grey literature were searched (2000-2025) for randomized and observational studies reporting taste outcomes after tympanoplasty, stapes surgery, cholesteatoma/mastoidectomy, or cochlear implantation. Risk of bias was assessed with RoB 2.0 and Newcastle-Ottawa scales, and certainty with GRADE. CTN manipulation was standardised using a four-level CTN Handling Severity Index (CHSI 0-3).
RESULTS: 20 studies were included. Pooled analyses suggested endoscopic approaches substantially reduced early taste disturbance compared with microscopic techniques (pooled RR ≈ 0.45), while CHSI 0-1 handling conferred markedly lower risk than CTN transection (pooled RR ≈ 0.18). Time-stratified curves showed overall disturbance falling from about 40-45% immediately post-surgery to 5-10% beyond 12 months, with slower and incomplete recovery in CHSI 2-3 injuries. Persistent symptoms were associated with measurable decrements in patient-reported oral satisfaction and HRQoL.
CONCLUSION: Surgical approach and CTN handling strongly determine the incidence, severity and persistence of taste dysfunction after middle ear surgery. The CHSI and time-based recovery model provide practical tools for nerve-sparing planning and patient counselling.
METHODS: Following PRISMA 2020 guidance, databases and grey literature were searched (2000-2025) for randomized and observational studies reporting taste outcomes after tympanoplasty, stapes surgery, cholesteatoma/mastoidectomy, or cochlear implantation. Risk of bias was assessed with RoB 2.0 and Newcastle-Ottawa scales, and certainty with GRADE. CTN manipulation was standardised using a four-level CTN Handling Severity Index (CHSI 0-3).
RESULTS: 20 studies were included. Pooled analyses suggested endoscopic approaches substantially reduced early taste disturbance compared with microscopic techniques (pooled RR ≈ 0.45), while CHSI 0-1 handling conferred markedly lower risk than CTN transection (pooled RR ≈ 0.18). Time-stratified curves showed overall disturbance falling from about 40-45% immediately post-surgery to 5-10% beyond 12 months, with slower and incomplete recovery in CHSI 2-3 injuries. Persistent symptoms were associated with measurable decrements in patient-reported oral satisfaction and HRQoL.
CONCLUSION: Surgical approach and CTN handling strongly determine the incidence, severity and persistence of taste dysfunction after middle ear surgery. The CHSI and time-based recovery model provide practical tools for nerve-sparing planning and patient counselling.