慢性中耳炎患者鼓索神经超微结构的变化

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35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(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％)。35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，手术中切除鼓索神经，术后不会影响患者的味觉功能。

Changes of the Ultrastructure of Chorda Tympani Nervein Chronic Otitis Media

Purpose To investigate the ultrastructure of the chorda tympani nerves in chronic otitis media. Methods The tympanic segments of chorda tympani nerves were collected for ultrastructural investigaions in 35 cases who underwent canal wall down tympanoplasty.All patients received a spatial (regional)taste test preoperatively and postoperatively.The extended Cochran Mantel Haenszel statistics was applied. Results There were obvious damages in all the chorda tympani nerves,such as swelling(100%),disarrangement(100%),vacuoles formation(83%)of myelin,the edema of Schwann cell(91%),intracytoplasmic vacuoles in Schwann cell(89%) and the proliferation of the collagen tissue(97%).Five patients complained of taste change postoperatively.The gustation test showed that the taste intensities ipsilateral to the side of tympanoplasty were not statistically significant for each stimulus to all the loci( P >0.05)comparing preoperative tests with postoperative tests. Conclusions This research implied that the chorda tympani nerves had pathological changes in ultrastructue in chronic otitis media who underwent canal wall down tympanoplasty.The transection of chorda tympani nerve would not affect the function of taste in these patients.