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Post-tonsillectomy dysgeusia with weight loss: possible involvement of soft palate

Published online by Cambridge University Press:  30 November 2007

A Scinska ,
A Jodkowska ,
A Korkosz ,
W Kukwa  and
H Sienkiewicz-Jarosz
A Scinska*
Affiliation:
Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Warsaw, Poland Mille Medica Outpatient Clinic Warsaw, Warsaw, Poland
A Jodkowska
Affiliation:
Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Warsaw, Poland
A Korkosz
Affiliation:
Departments of Pharmacology, Warsaw, Poland
W Kukwa
Affiliation:
Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Warsaw, Poland Mille Medica Outpatient Clinic Warsaw, Warsaw, Poland
H Sienkiewicz-Jarosz
Affiliation:
Neurology I, Institute of Psychiatry and Neurology, Warsaw, Poland
*
Address for correspondence: Dr Anna Scinska, Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Stepinska 19/25 St, 00-739 Warsaw, Poland. Fax: +48 22 84 27 644 E-mail: [email protected]
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Abstract

Objective:

To demonstrate the importance of detailed, multidisciplinary examination of patients with post-tonsillectomy taste distortions, and to show that post-tonsillectomy dysgeusia may originate in the caudal part of the soft palate.

Case report:

We describe a 29-year-old man who suffered from severe post-tonsillectomy dysgeusia and phantogeusia with secondary weight loss and depression-like symptomatology. The patient had normal electrogustometric thresholds and sensitivity to touch on the posterior tongue. In contrast, elevated taste threshold and reduced sensitivity to touch was found on the caudal part of the soft palate (the palatoglossal arches). More marked elevation of electrogustometric threshold and insensitivity to touch on the right palatoglossal arch correlated with post-operative haemorrhage from the right tonsillar fossa. Psychiatric examination excluded major depression, eating disorders and drug abuse.

Conclusions:

Dysgeusia constitutes a rare but significant complication of tonsillectomy. Damage to the lingual branch of the glossopharyngeal nerve innervating the posterior tongue is thought to be a major cause of this complication. However, damage to the tonsillar branches of the glossopharyngeal nerve and the soft palate should also be considered as a cause of post-tonsillectomy dysgeusia. Further studies are needed to assess whether post-operative haemorrhage could indicate heightened risk of dysgeusia.

Keywords

TonsillectomyTasteComplicationsPalate
Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 2 , February 2008 , e5
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Colclasure, JB, Graham, SS. Complications of outpatient tonsillectomy and adenoidectomy: a review of 3,340 cases. Ear Nose Throat J 1990;69:155–60Google ScholarPubMed
2 Hilton, M. Tonsillectomy technique – tradition versus technology. Lancet 2004;364:642–3CrossRefGoogle ScholarPubMed
3 Tomita, H, Ohtuka, K. Taste disturbance after tonsillectomy. Acta Otolaryngol Suppl 2002;546:164–72CrossRefGoogle Scholar
4 Beck, CN. The glossopharyngeal nerve and tonsillectomy [in German]. Laryngorhinootologie 1979;58: 463–5Google Scholar
5 Bicknell, JM, Wiggins, RV. Taste disorder from zinc deficiency after tonsillectomy. West J Med 1988;149:457–60Google ScholarPubMed
6 Collet, S, Eloy, P, Rombaux, P, Bertrand, B. Taste disorders after tonsillectomy: case report and literature review. Acta Otol Rhinol Laryngol 2005;114:233–6CrossRefGoogle ScholarPubMed
7 Dehnen, T. Gustatory disorders following tonsillectomy [in German]. Laryngorhinootologie 1953;32:413–14Google Scholar
8 Goins, MR, Pitovski, DZ. Posttonsillectomy taste distortion: a significant complication. Laryngoscope 2004;114:1206–13CrossRefGoogle ScholarPubMed
9 Tomofuji, S, Sakagami, M, Kushida, K, Terada, T, Mori, H, Kakibuchi, M. Taste disturbance after tonsillectomy and laryngomicrosurgery. Auris Nasus Larynx 2005;32:381–6CrossRefGoogle ScholarPubMed
10 Uzun, C, Adali, MK, Karasalihoglu, AR. Unusual complication of tonsillectomy: taste disturbance and the lingual branch of the glossopharyngeal nerve. J Laryngol Otol 2003;117:314–17CrossRefGoogle ScholarPubMed
11 Scinska, A, Sienkiewicz-Jarosz, H, Kuran, W, Ryglewicz, D, Rogowski, A, Wrobel, E et al. Depressive symptoms and taste reactivity in humans. Physiol Behav 2004;82:899–904CrossRefGoogle ScholarPubMed
12 Sienkiewicz-Jarosz, H, Scinska, A, Kuran, W, Ryglewicz, D, Rogowski, A, Wrobel, E et al. Taste responses in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 2005;76:40–6CrossRefGoogle ScholarPubMed
13 Wrobel, E, Skrok-Wolska, D, Ziolkowski, M, Korkosz, A, Habrat, B, Woronowicz, B et al. Taste responses to monosodium glutamate after alcohol exposure. Alcohol Alcohol 2005;40:106–11CrossRefGoogle ScholarPubMed
14 Hummel, T, Kobal, G, Gudziol, H, Mackay-Sim, A. Normative data for the ‘Sniffin' Sticks’ including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 2007;264:237–43CrossRefGoogle ScholarPubMed
15 Odeh, M, Oliven, A. Glossopharyngeal neuralgia associated with cardiac syncope and weight loss. Arch Otolaryngol Head Neck Surg 1994;120:1283–6CrossRefGoogle ScholarPubMed
16 Griez, EJL, Faravelli, C, Nutt, D, Zohar, J, eds. Mood Disorders: Clinical Management and Research Issues. Chichester: John Wiley, 2005CrossRefGoogle Scholar
17 Gray, H. Anatomy of the Human Body, 35th edn. Philadelphia: Lea and Febiger, 1985Google Scholar
18 Rollin, H. Course of peripheral gustatory nerves. Ann Otol 1977;89:251–8Google Scholar
19 Cleaton-Jones, P. A denervation study of taste buds in the soft palate of the albino rat. Arch Oral Biol 1976;21:79–82CrossRefGoogle ScholarPubMed
20 Miller, IJ, Spangler, KM. Taste bud distribution and innervation on the palate of the rat. Chem Senses 1982;7:99–108CrossRefGoogle Scholar
21 Ikeda, M, Ikui, A, Tomita, H. Gustatory function of the soft palate. Acta Otolaryngol Suppl 2002;546:69–73CrossRefGoogle Scholar
22 Cohen, P, Pine, DS, Must, A, Kasen, S, Brook, J. Prospective associations between somatic illness and mental illness from childhood to adulthood. Am J Epidemiol 1998;147:232–9CrossRefGoogle ScholarPubMed
23 Papakostas, K, Moraitis, D, Lancaster, J, McCormick, MS. Depressive symptoms in children after tonsillectomy. Int J Pediatr Otorhinolaryngol 2003;67:127–32CrossRefGoogle ScholarPubMed
24 Schiffman, SS. Taste and smell in disease. N Engl J Med 1983;308:1275–9, 1337–43Google ScholarPubMed
25 Levenson, JL. Dysosmia and dysgeusia presenting as depression. Gen Hosp Psychiatry 1985;7:171–3CrossRefGoogle ScholarPubMed
26 Miller, SM, Naylor, GJ. Unpleasant taste – a neglected symptom in depression. J Affect Disord 1989;17:291–3CrossRefGoogle ScholarPubMed