However, none of the patients reported persisting taste loss after TE. Most authors 10 , 11 hypothesize that taste dysfunction after TE is caused by surgical injury of the lingual branch of the glossopharyngeal nerve LBGN , which carries the gustatory fibers from the rear third of the tongue.
In a number of subjects, this nerve seemed to adhere to the inferior pole of the tonsil. In the latter cases, the LBGN adhered to the tonsillar tissue, separated only by loose connective tissue that was 1 to 2 mm thick. However, the present data indicate that TE does not result in a lasting functional damage of the LBGN in a large percentage of patients. Obviously, the presence of the LBGN in proximity to the field of operation does not necessarily mean that it will be damaged during surgery.
The results of the present study show that permanent taste disturbances after TE constitute a rare adverse effect of the surgery. None of the patients reported persisting changes or loss of gustatory function at a mean time point of approximately days after TE.
Congruently objective results of taste testing with taste strips revealed no statistically significant differences of regional gustatory sensitivity before and after TE. This raises the question of whether taste ratings also depend on attentional factors.
Thus, it may be hypothesized that the patients' ratings of taste function were influenced by the presence of postoperative pain, oral discomfort, or wound healing during the first days and weeks after TE. This may be supported by the fact that 15 patients reported dysgeusia immediately after TE, which resolved within days and weeks.
However, temporal hypogeusia might also have been caused by the lingual pressure exerted by the gag during surgery. A number of case reports and a few systematic investigations of patients experiencing taste disorders after TE have been published. Goins and Pitovski 10 described a patient who had undergone unilateral right TE and experienced loss of taste function in the right posterior area as well as phantom taste on the left side.
Electrogustometric testing revealed a detection threshold out of the range of the capacity of the electrogustometer on the posterior right side of the tongue. Moreover, no taste solution of sweet, sour, salty, or bitter quality could be detected at this site with spatial taste testing at 6 months after TE.
The taste loss was attributed to injury of the LBGN owing to considerable tissue removal at the inferior pole of the right tonsil. Moreover, a bitter solution was not perceived at this site by the patient.
The taste concerns still remained at retesting 18 months after TE. Only a few systematic studies have investigated gustatory function after TE. In accordance with the present results, an investigation by Arnhold-Schneider and Bernemann 14 detected no loss of gustatory function in patients during repeated testing 7 days after TE.
However, the method of taste testing was not reported in detail, and no taste score results were presented for the tested sites of the tongue. In an investigation conducted by Tomofuji et al, 12 3 of 35 patients reported taste disturbances a few days after TE. In only 1 patient could abnormal electrogustometric thresholds be obtained, and these returned to reference range 11 days after TE. Subjective taste sensitivity remained diminished for 25 days.
Taste function of all 3 patients recovered within 1. How often are patients found to have taste loss after TE in clinical routine? In a retrospective analysis of outpatients of a specialized taste disorder clinic over a year period, only 11 patients could be identified as having taste disorders after TE.
Compared with the present prospective data, these data indicate the rare occurrence of taste disorders after TE. In conclusion, owing to the close anatomical relationship of the LBGN to the tonsillar bed, damage or tearing and stretching of this nerve seems to be possible, resulting in taste disorders. However, based on the present results, taste loss after TE seems to be a rare complication. Correspondence: Christian A. Submitted for Publication: August 31, ; final revision received February 21, ; accepted March 15, New research findings about the prevalence and duration of post-tonsillectomy taste disorder may point to a need to rethink pre- and post-operative practices for both pediatric and adult patients.
In the initial study, published in , researchers followed over the course of four years adult patients who used a self-assessing questionnaire to report taste disorders after their tonsillectomy surgeries Laryngoscope. Of those patients, 32 percent reported suffering dysgeusia for two weeks following the surgery, and 8 percent 15 patients reported dysgeusia at the six-month mark. Depending on the literature data, possible indirect damage to the LBGN was suspected as the cause of the taste disturbance.
This symptom may be reversible within two years after tonsillectomy, but it can also be irreversible. Therefore, tonsillectomy should be performed with minimal trauma to the tonsillar bed, especially when there is an additional pathology extending into the lower pole, and such a patient should be informed of the risk of post-operative taste disturbance after tonsillectomy as being one of the rare complications of this surgery.
The research paper looked at children who underwent tonsil surgery between and Researchers have succeeded in growing mini-tumors or organoids of head and neck Print Email Share. Boy or Girl? Just a Game?
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