Pattern of Gustatory Impairment and its Recovery after Head and Neck Irradiation

Abstract

Introduction: The majority of patients receiving concurrent chemoradiotherapy frequently complain of changes in their taste perception, and other distressing symptoms affecting their quality of life. This study was undertaken to determine the pattern of gustatory impairment and its recovery in irradiated head and neck cancer patients in India.

Materials and methods: Thirty patients undergoing radical head and neck irradiation were enrolled and assessed for the four basic taste quality (sweet, salt, sour and bitter) by a forced three-choice stimulus drop technique measuring their taste recognition thresholds at baseline, weekly during radiation therapy (RT) and every month for 6 months following completion of RT.

Results: The maximum taste loss for any taste quality developed after the third week of RT. Irrespective of the taste quality, the majority of patients developed their maximum taste loss in the fourth to sixth week. The maximum taste loss was highest (100%) for the bitter taste and least (40.7%) for the sweet taste. Taste recovery for sweet, salt and sour taste qualities started from the first month onwards, but not for bitter taste. All taste qualities were severely affected in patients with primary involvement of the oral cavity and oropharynx as compared with nasopharynx, hypopharynx and laryngeal tumors.

Conclusions: Taste dysfunction is a frequently ignored adverse effect of head and neck cancer treatment, seriously affecting the patient's quality of life. Clinicians must make patients aware of this specific gustatory dysfunction and its pattern of recovery. Future efforts should be directed towards minimizing this dysfunction, specifically in tumors arising from the oral cavity and oropharynx.

Keywords: Chemoradiotherapy; Dysgeusia; Head and neck neoplasms; Quality of life; Taste threshold.