taste disorders after tonsillectomy

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Taste disorders after tonsillectomy

Author: Aleksandra Borovika, Riga Stradins UniversityScientific research supervisor: Dr. Gunta Sumeraga, Pauls Stradins Clinical University Hospital, Department of Otorhinolaryngology; Riga Stradins University, Department of Surgery

16.03.2016., Rīga

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Sense of taste allow us to perceive different flavors from substances that we consume as food and drink.[1]

Introduction1

http://www.hungryforchange.tv/article/what-eating-

too-much-sugar-does-to-your-brain

http://www.chemistdirect.co.uk/

chlorhexidine-mouthwash-mint/prd-gid

http://

nutritionovereasy.com/

2016/01/could-cutting-back-

on-salt-lead-to-thyroid-

problems/

https://www.organicfacts.net/health-benefits/

fruit/health-benefits-of-lemon.html

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Tonsillectomy is one of the most common surgical procedures in otolaryngology.

Introduction2

https://sites.google.com/site/

dranhtruong/bellevue-tonsillitishttp://www.drugs.com/mcd/tonsillitis

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Taste disorder is an unusual complication of tonsillectomy and in most cases transient.

Possible cause of it is direct or indirect damage to the glossopharyngeal nerve or its lingual branch during the procedure.

» The damage depends on anatomical localization of the nerve. [2]

Introduction3

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Types of taste disturbances: »Ageusia- complete taste loss

»Dysgeusia- distorted taste perception

»Hypogeusia- reduced ability to taste

»Phantogeusia- gustatory hallucination [3]

Introduction4

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Taste disorders » difficulties in detection of spoiled food or beverages

» difficulties in detection presence of food to which person have an allergy

» depression and a reduced desire to eat [4]

» weight loss and malnutrition

» harm to the immune system and worsening of other medical conditions [5]

Introduction5

https://melanomanewstoday.com/2015/03/06/researchers-discover-pathway-responsible-for-taste-loss-in-skin-cancer-

patients-under-chemotherapy-treatment/

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To prove that some patients who had undergone tonsillectomy in Pauls Stradins Clinical University Hospital’s Otolaryngology clinic can experience transient taste disorders during two weeks after the surgery.

Aim

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A prospective study was conducted, involving patients who had undergone tonsillectomy and healthy people who had not undergone tonsillectomy as a control group.

1. An anonymous survey in pre-operative period

2. An anonymous survey in second post-operative day

3. Taste test

» chlorhexidine (0.025%; 0.05%), glucose (2%; 10%), citric acid (0.5%; 7.5%) and sodium chloride (0.5%; 2.5%)

4. An anonymous telephone survey at third week after operation

Materials and Methods

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Results

55,9% (n=19) male

44.1% (n=15) female

the average age: 38 (SD 12,4)

40% (n=14) male

60% (n=21) female

the average age:29,8 (SD 15,2)

49,3% (n=34)

experimental group

50,7% (n=35)

control group

69 participants

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Taste test results: taste disorders

32.4% (11 of 34) 8.6% (3 of 35)

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Results: taste disorders at 3rd post- operative week

11,8% (4 of 34)Reported subjective taste

disorders at 3rd post-

operative week

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Survey results: subjective evaluation of sense of taste

Reported taste

disorders before

tonsillectomy

Experimental group:

» 4.3% (1 of 23) no taste disorders

» 45.5% (5 of 11) taste disorders

» 50% (2 of 4) taste disorders at 3rd post-op. week

Reported taste

disorders before

taste test

Experimental group:

» 17,4% (4 of 23) no taste disorders

» 45.5 (5 of 11) taste disorders

» 75% (3 of 4) taste disorders at 3rd post-op. week

Control group:

» 3.1% (1 of 32) no taste disorders

» 0% (0 of 3) taste disorders

before tonsillectomy after tonsillectomy

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Survey results: subjective evaluation of sense of smell

Reported smell

disorders before

tonsillectomy

Experimental group:

» 8.7% (2 of 23) no taste disorders

» 18.2% (2 of 11) taste disorders

» 25% (1 of 4) taste disorders at 3rd post-op. week

Reported smell

disorders before

taste test

Experimental group:

» 13.0% (3 of 23) no taste disorders

» 18.2% (2 of 11) taste disorders

» 25% (1 of 4) taste disorders at 3rd post-op. week

Control group:

» 6.3% (2 of 32) no taste disorders

» 0% (0 of 3)

before tonsillectomy after tonsillectomy

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Results: evaluation of sense of smell at 3rd week after operation

No one had smell disorder

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Factors that did not reveal significant difference between respondents with and without taste disorders

Upper respiratory tract infections (running nose, sore throat etc.) over the past two months

Smoking

Sinusitis over the past two months

Head or facial trauma/ surgery (middle ear surgery, oral or dental surgery etc.) over the past six months

Medications (antibiotics, antidepressants, hypotensive drugs etc.) on a long-term basis

Chronic diseases (diabetes, renal or hepatic failure, HIV, cancer etc.)

Poor oral hygiene

Oral infection or inflammation (gingivitis, oral abscess, oral candidasis etc.) over the past three months

Poisoning with any chemical agent recently

Poor nutrition

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Some patients who undergo tonsillectomy in Pauls Stradins Clinical University Hospital’s Otolaryngology clinic can experience transient taste disorders during two weeks after operation.

It is necessary to take into account that methods of study are based on patient’s subjective perceptions of his taste (annonymous survey, taste test with chemical solutions).

It is necessary to continue the study in order to get more accurate statistical results. If it is possible, use more objective method, e.g. taste test with more graded chemical solutions.

Conclusions

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[1]https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/sensation-and-perception-5/sensory-processes-38/gustation-taste-buds-and-taste-163-12698/

[2] http://www.ncbi.nlm.nih.gov/pubmed/12816225

[3] http://www.aafp.org/afp/2013/1215/p852.html

[4] http://www.masseyeandear.org/for-patients/patient-guide/patient-education/diseases-and-conditions/smell-and-taste-disorders/taste-disorders

[5] https://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=85&ContentID=P00466

Taste test: http://www.ncbi.nlm.nih.gov/pubmed/19701761

Image sources: http://www.how-to-draw-cartoons-online.com/cartoon-house.html and https://www.pinterest.com/pin/311874342924270709/

Information sources

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Thank you for attention!

Special thanks to Dr. Sabīne Atte1

for help in finding patients for experimental group

1Riga Stradins University, Pauls Stradins Clinical University Hospital, Department of Otorhinolaryngology