慢性中耳炎患者鼓索神经超微结构的变化

摘要

Purpose To investigate the ultrastructure of the chorda tympani nerves in chronic otitis rnmedia. Methods The tympanic segments of chorda tympani nerves were collected for ultrastructural rninvestigaions in 35 cases who underwent canal-wall-down tympanoplasty. All patients received a spatial rn(regional) taste test preoperatively and postoperatively. The extended Cochran-Mantel-Haenszel statistics was rnapplied. Results There were obvious damages in all the chorda tympani nerves, such as swelling( 100 % ),rndisarrangement (100%), vacuoles formation (83%)of myelin, the edema of Schwann cell (91%),rnintracytoplasmic vacuoles in Schwann cell (89 % ) and the proliferation of the collagen tissue ( 97 % ). Five rnpatients complained of taste change postoperatively. The gustation test showed that the taste intensities rnipsilateral to the side of tympanoplasty were not statistically significant for each stimulus to all the loci( P ＞rn0.05)comparing preoperative tests with postoperative tests. Conclusions This research implied that the rnchorda tympani nerves had pathological changes in ultrastructue in chronic otitis media who underwent canalrnwall-down tympanoplasty. The transection of chorda tympani nerve would not affect the function of taste in rnthese patients.%目的研究慢性中耳炎患者鼓索神经的超微结构。方法取35例开放式鼓室成形术中所取的鼓室段rn鼓索神经作透射电镜观察并进行区域性化学味阈的测定，统计方法为扩展Cochran-Mantel-Haenszel法。结果rn35例慢性中耳炎患者鼓索神经的超微结构均有不同程度的变化，如有髓神经纤维髓鞘肿胀(100％)、排列紊乱rn(100％)、空泡形成(83％)、Schwann细胞肿胀(91％)、细胞内空泡形成(89％)、髓鞘间胶原组织增生(97％)。35rn例患者中5例术后发生味觉障碍，手术前后每一溶液于术侧舌部和软腭引起的味觉反应的差异在统计学上无显rn著意义(P＞0.05)。结论行开放式鼓室成形术患者鼓室段鼓索神经的超微结构发生了病理性改变，手术中切rn除鼓索神经，术后不会影响患者的味觉功能。