Assessment of Taste Sensation before and After Middle Ear Surgery: A Prospective Cohort Study Using Lateralized Taste Strips and Electrogustometry

Background: Taste disturbance after middle ear surgery is frequently under-recognized despite the vulnerability of the chorda tympani nerve (CTN), which is commonly stretched, displaced, or sacrificed during tympanoplasty, mastoid surgery, and stapes procedures. The magnitude, time course, and predictors of recovery remain clinically important for consent and technique selection. Methods: A prospective cohort study was conducted at a tertiary otology unit. Adults undergoing unilateral middle ear surgery (tympanoplasty ± mastoidectomy, stapedotomy/stapedectomy) were enrolled. Taste was measured preoperatively and postoperatively (day 7, month 1, month 3) using lateralized Taste Strips (score 0– 16 per side) and electrogustometry (EGM; µA threshold) on the ipsilateral anterior tongue. Subjective dysgeusia and xerostomia were recorded using a 10-cm visual analogue scale (VAS). Mixed-effects modeling estimated change over time and predictors of persistent dysgeusia at 3 months. Results: Eighty-four participants were analyzed (mean age 34.7±11.2 years; 52.4% male). Mean ipsilateral Taste Strips score decreased from 12.8±2.1 preoperatively to 9.1±2.8 at day 7 (adjusted mean difference −3.6; 95% CI −4.2 to −3.0; p