Post-tonsillectomy taste dysfunction: Myth or reality?

Abstract

Lingual branches of the glossopharyngeal nerve (CN Ⅸ) are at risk of injury during tonsillectomy due to their proximity to the muscle layer of the palatine tonsillar bed. However, it is unclear how often this common surgery leads to taste disturbances. We conducted a literature search using PubMed, Embase, Cochrane Library, Google Scholar, PsychInfo, and Ovid Medline to evaluate the available literature on post-tonsillectomy taste disorders. Studies denoting self-reported dysfunction, as well as those employing quantitative testing, i.e., chemogustometry and electrogustometry, were identified. Case reports were excluded. Of the 8 original articles that met our inclusion criteria, only 5 employed quantitative taste tests. The highest prevalence of self-reported taste disturbances occurred two weeks after surgery (32%). Two studies reported post-operative chemical gustometry scores consistent with hypogeusia. However, in the two studies that compared pre- and post-tonsillectomy test scores, one found no difference and the other found a significant difference only for the left rear of the tongue 14 days post-op. In the two studies that employed electrogustometry, elevated post-operative thresholds were noted, although only one compared pre- and post-operative thresholds. This study found no significant differences. No study employed a normal control group to assess the influences of repeated testing on the sensory measures. Overall, this review indicates that studies on post-tonsillectomy taste disorders are limited and ambiguous. Future research employing appropriate control groups and taste testing procedures are needed to define the prevalence, duration, and nature of post-tonsillectomy taste disorders.

Keywords: Ageusia; Hypogeusia; Taste; Taste disturbances; Tonsillectomy.

Fig. 1

CN Ⅸ anatomic relationship to pharyngeal constrictor muscles^a. sc – superior pharyngeal constrictor muscle; mc – middle pharyngeal constrictor muscle; sp – stylopharyngeus muscle; pg – palatoglossus muscle or anterior tonsillar pillar; pp – palatopharyngeus muscle or posterior tonsillar pillar; lp – levator veli palatini muscle; tp – tensor veli palatini muscle; cp –circumvallate papillae; at – attachment at the torus tubarius. ^aelements of the drawing were obtained from http://www.wesnorman.com.

Fig. 2

Flowchart of study selection.