Iatrogenic injury of the chorda tympani: a systematic review

Objective: To review the currently available literature on iatrogenic injury of the adult chorda tympani. Design: Systematic literature review. Method Five electronic databases and one search engine were used to access available English language literature on the chorda tympani, focusing on iatrogenic injury. Results: The chorda tympani is most often injured during middle-ear surgery, after which at least 15-22 per cent of patients experience symptoms, mostly changes in taste and dryness of the mouth. Numerous factors influence whether injury to the chorda tympani causes symptoms, including the extent of injury, type of surgery, age of the patient, anatomical variables and subjective adaptation. Although most patients experience gradual symptomatic recovery, complaints can be persistent and troublesome. Conclusion: Care should be taken to preserve the chorda tympani during middle-ear surgery, and to warn patients pre-operatively about this potential complication. This is particularly important if surgery is bilateral.