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Hassan H, Oloyede S, Villanueva G, Zahra S, Joseph-Frederick Z, Green G, Schechter T, Zupanec S, Dupuis LL, Sung L. Brochure intervention to manage bothersome taste changes in pediatric patients receiving cancer therapy. Pediatr Blood Cancer 2024; 71:e30965. [PMID: 38514496 DOI: 10.1002/pbc.30965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Primary objective was to determine if a patient informational brochure describing potentially useful strategies could help manage specific taste changes. Secondary objective was to describe the specific strategies used and whether the strategies were perceived as being helpful. PROCEDURE This single-center study included pediatric patients with cancer or hematopoietic cell transplant recipients receiving active treatment who experienced bothersome taste changes in the last month. Participants participated in baseline and follow-up interviews conducted 14-21 days apart. A brochure that listed 16 potentially helpful strategies was provided at baseline. At follow-up, we asked about brochure use and whether it helped. At both interviews, we asked about experienced taste changes, strategies used, and whether strategy helped. RESULTS Of 100 enrolled participants, different (87%) and bad (72%) taste were most common at baseline. Following the brochure intervention, statistically significant reductions were observed in food tasting different, bad, bland, bitter, sour, and metallic. For most strategies, the proportion of patients who used specific strategies or found them helpful was not significantly different between baseline and follow-up. However, "eating foods you like" was considered helpful in significantly more participants who used the strategy in follow-up (72 out of 89, 80.9%) compared with baseline (55 out of 95, 57.9%; p = .008). Between visits, 81.2% looked at the brochure. Among participants, 53.1% found the brochure helpful, very helpful, or extremely helpful. CONCLUSIONS A brochure that offered strategies to manage changes in taste helped participants cope with them. Further research should evaluate the brochure using randomized and multicenter trials.
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Affiliation(s)
- Hadeel Hassan
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Seye Oloyede
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Gillian Villanueva
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Serena Zahra
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Zakia Joseph-Frederick
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Gloria Green
- Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tal Schechter
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sue Zupanec
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L Lee Dupuis
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto
| | - Lillian Sung
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Nin T, Tsuzuki K. Diagnosis and treatment of taste disorders in Japan. Auris Nasus Larynx 2024; 51:1-10. [PMID: 37117102 DOI: 10.1016/j.anl.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/16/2023] [Accepted: 04/05/2023] [Indexed: 04/30/2023]
Abstract
Though 270,000 patients with complaints of taste abnormalities visited medical institutions annually in 2019 survey, there are no drugs for the treatment of taste disorders that are covered by health insurance in Japan. In the survey, the number of patients with taste disorders was correlated with age, and the need for medical treatment for taste disorders is expected to increase in the future because of the super-aging society. The pathophysiology of taste disorders varies widely. There is an obvious need to decide the site and the causes of the disorder and understand the mechanism, by performing various examinations. It needs to first adjust the causative systemic diseases and medications in the treatment for taste disorder. Damage of taste cells due to zinc deficiency is the main pathophysiological mechanism of taste disorders, and zinc supplementation is a standard treatment in Japan. Oral zinc therapy is the treatment for taste disorders due to zinc deficiency or idiopathic taste disorder; though a double-blind study was conducted, it was considered low-level evidence in a clinical review. In Japan, the off-label use of polaprezinc for taste disorders was approved in 2011, and zinc acetate hydrate was approved for hypozincemia in March 2017, making it easier to use oral zinc therapy in general. In some cases, psychotherapy or herbal medicine therapy has been used with remarkable success, although its effectiveness has not been clearly tested. It might be expected to offer some help to patients. In the treatment of elderly patients with taste disorders, physicians need to consider the difference between "age-related changes in taste in healthy people" and "taste disorders in elderly persons", and they should separate them. Aggressive treatment is desirable regardless of age, because no significant difference in the efficacy of various treatments was found between patients older and younger than 65 years.
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Affiliation(s)
- Tomomi Nin
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, 1-1 Nishinomiya, Hyogo 663-8501, Japan.
| | - Kenzo Tsuzuki
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, 1-1 Nishinomiya, Hyogo 663-8501, Japan
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Savard DJ, Ursua FG, Gaddey HL. Smell and Taste Disorders in Primary Care. Am Fam Physician 2023; 108:240-248. [PMID: 37725455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Disorders of smell and taste are reported by approximately one-fifth of people 40 years and older, and one-third of people 80 years and older. These disorders affect quality of life and the ability to identify smoke and toxins. Smell and taste disorders can be early signs of dementia or Parkinson disease and are associated with increased mortality. Dysfunction may be apparent or may develop insidiously. Screening questionnaires are available, but many patients are unaware of their disorder. Most smell and taste disorders are due to sinonasal disease but also could be caused by smoking, medications, head trauma, neurodegenerative disease, alcohol dependence, or less common conditions. The differential diagnosis should guide the evaluation and include anterior rhinoscopy and an examination of the oral cavity, head, and cranial nerves. Further investigation is often unnecessary, but nasal endoscopy and computed tomography of the sinuses may be helpful. Magnetic resonance imaging of the head with contrast should be performed if there is an abnormal neurologic examination finding or if trauma or a tumor is suspected. Olfactory testing is indicated in refractory cases or for patients with poor quality of life and disease associated with smell or taste dysfunction. Smell and taste disorders may resolve when reversible causes are treated, but improvement is less likely when they are due to trauma, age, or neurodegenerative disease. Olfactory training is a self-administered mindful exposure therapy that may improve olfactory function. Physicians should encourage patients to ensure that smoke and other alarms are operational and to adhere to food expiration dates.
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Affiliation(s)
- Dillon J Savard
- David Grant Medical Center, Travis Air Force Base, California
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郑 欣, 徐 欣, 周 学, 彭 显. [Mechanisms and Management of COVID-19-Associated Taste Disorders]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:334-341. [PMID: 36949695 PMCID: PMC10409153 DOI: 10.12182/20230260306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Indexed: 03/24/2023]
Abstract
The taste buds in the human tongue contain specialized cells that generate taste signals when they are stimulated. These signals are then transmitted to the central nervous system, allowing the human body to distinguish nutritious substances from toxic or harmful ones. This process is critical to the survival of humans and other mammals. A number of studies have shown that dysgeusia, or taste disorder, is a common complication of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which can severely affect patients' nutritional intake and quality of life. Based on the physiological process of taste perception, the direct causes of dysgeusia include dysfunction of taste receptors and damage to the taste nervous system, while indirect causes include genetic factors, aging-related changes, bacterial and viral infections, and cancer treatments such as radiotherapy and chemotherapy. The pathogenic factors of dysgeusia are complicated, further research is needed to fully understand the underlying mechanisms, and some of the reported findings and conclusions still need further validation. All these form a great challenge for clinical diagnosis of the cause and targeted treatment of dysgeusia. Herein, we reviewed published research on the physiological process of taste perception, the potential mechanisms of taste disorders related to SARS-CoV-2 infection, and strategies for prevention and treatment, providing theoretical support for establishing and improving the comprehensive management of COVID-19 complicated by taste disorders.
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Affiliation(s)
- 欣 郑
- 口腔疾病研究国家重点实验室 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 欣 徐
- 口腔疾病研究国家重点实验室 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 学东 周
- 口腔疾病研究国家重点实验室 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 显 彭
- 口腔疾病研究国家重点实验室 四川大学华西口腔医院 (成都 610041)State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Chao Y, Zhang L, Chen Q, Chen B, Yu Y, Chen S. The efficacy and safety of acupuncture in the treatment of taste disorders after rehabilitation from COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31649. [PMID: 36451400 PMCID: PMC9704941 DOI: 10.1097/md.0000000000031649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Since the outbreak of the new crown pneumonia epidemic, although it has had a serious impact on people's lives and health in itself, the sequelae that accompany coronavirus disease 2019 (COVID-19) have also had a serious impact on people's mental health and quality of life. Taste disorder (TD) is one of the sequelae of COVID-19. Patients may experience reduced or even absent taste sensation, which seriously affects their real life. The efficacy of acupuncture in the treatment of taste disorders has been well reported, but there is a lack of evidence-based medical evidence. Therefore, this study set out to systematically evaluate the efficacy and safety of acupuncture in the treatment of post-COVID-19 taste disorder. METHODS According to the retrieval strategies, randomized controlled trials on the acupuncture for COVID-19 TD were obtained from Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database and the Wanfang Database, regardless of publication date, or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using Review Manager (RevMan 5.4) and StataSE 15.0 software. Ultimately, the evidentiary grade for the results will be evaluated. This systematic evaluation protocol is registered in PROSPERO under the registration ID CRD42022364653. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This meta-analysis will evaluate the effect of acupuncture and moxibustion on TD caused by sequelae of COVID-19, providing evidence as to the treatment in these patients.
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Affiliation(s)
- Yuqiao Chao
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Lili Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Qiaobin Chen
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Biwei Chen
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yannan Yu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shaozong Chen
- Institute of Acupuncture-moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- * Correspondence: Shaozong Chen, Full Postal address: Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan 250300, Shandong, China (e-mail: )
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Abstract
PURPOSE OF REVIEW Olfactory dysfunction (OD) can be a single and early prominent symptom of severe acute respiratory syndrome (SARS)-COV-2 infection unlike middle east respiratory syndrome (MERS) and SARS. OD data are very informative but many are not peer-reviewed, often inconclusive and may reveal variable and sometimes contradictory results. This is often due to incongruent data of subjective and objective OD testing. Mechanistic pathways of OD and taste dysfunction (TD) are slowly unveiling, not infrequently extrapolated from historical models of SARS and MERS and are still partly unclear. RECENT FINDINGS We reviewed the literature on OD and TD during the COVID-19 pandemic analyzing current data on pathogenesis and clinical correlates including prevalence, recovery rates, risk factors, and predictive power. Also, we evaluated various methods of subjective and objective olfactory testing and discussed challenges in management of patients with OD and rhinitis during the pandemic. SUMMARY Subjective evaluation of smell disturbances during COVID-19 pandemic likely underestimates true prevalence, severity, and recovery rates of OD when compared to objective testing. OD is predictive of COVID-19 infection, more so when associated with TD. Recognizing inherent limitations of both subjective and objective OD and TD testing enables us better to manage chemosensory dysfunction in COVID-19 patients. Besides, current mechanistic data suggest neurotropism of COVID-19 for olfactory neuro-epithelium and a potential role of transient receptor potential (TRP) channels. Future studies are needed to explore further the neurogenic inflammation in COVID-19.
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Affiliation(s)
- Philip W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Holy Spirit University of Kaslik, Eye and Ear University Hospital, Beirut, Lebanon
| | - Samar A Idriss
- Department of Otolaryngology-Head and Neck Surgery, Holy Spirit University of Kaslik, Eye and Ear University Hospital, Beirut, Lebanon
- Department of Audiology and Neurotology, Edouard Herriot Hospital, Lyon, France
| | - Jean Bousquet
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
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7
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Mainland JD, Barlow LA, Munger SD, Millar SE, Vergara MN, Jiang P, Schwob JE, Goldstein BJ, Boye SE, Martens JR, Leopold DA, Bartoshuk LM, Doty RL, Hummel T, Pinto JM, Trimmer C, Kelly C, Pribitkin EA, Reed DR. Identifying Treatments for Taste and Smell Disorders: Gaps and Opportunities. Chem Senses 2020; 45:493-502. [PMID: 32556127 PMCID: PMC7545248 DOI: 10.1093/chemse/bjaa038] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The chemical senses of taste and smell play a vital role in conveying information about ourselves and our environment. Tastes and smells can warn against danger and also contribute to the daily enjoyment of food, friends and family, and our surroundings. Over 12% of the US population is estimated to experience taste and smell (chemosensory) dysfunction. Yet, despite this high prevalence, long-term, effective treatments for these disorders have been largely elusive. Clinical successes in other sensory systems, including hearing and vision, have led to new hope for developments in the treatment of chemosensory disorders. To accelerate cures, we convened the "Identifying Treatments for Taste and Smell Disorders" conference, bringing together basic and translational sensory scientists, health care professionals, and patients to identify gaps in our current understanding of chemosensory dysfunction and next steps in a broad-based research strategy. Their suggestions for high-yield next steps were focused in 3 areas: increasing awareness and research capacity (e.g., patient advocacy), developing and enhancing clinical measures of taste and smell, and supporting new avenues of research into cellular and therapeutic approaches (e.g., developing human chemosensory cell lines, stem cells, and gene therapy approaches). These long-term strategies led to specific suggestions for immediate research priorities that focus on expanding our understanding of specific responses of chemosensory cells and developing valuable assays to identify and document cell development, regeneration, and function. Addressing these high-priority areas should accelerate the development of novel and effective treatments for taste and smell disorders.
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Affiliation(s)
| | - Linda A Barlow
- Department of Cell & Developmental Biology, Rocky Mountain Taste and Smell Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Steven D Munger
- Center for Smell and Taste, Department of Pharmacology and Therapeutics, 1200 Newell Drive, University of Florida, Gainesville, FL, USA
| | - Sarah E Millar
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Natalia Vergara
- Department of Ophthalmology, Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora, CO, USA
| | - Peihua Jiang
- Monell Chemical Senses Center, Philadelphia, PA, USA
| | - James E Schwob
- Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, MA, USA
| | - Bradley J Goldstein
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, 40 Duke Medicine Cir Clinic 1F, Durham, NC, USA
| | - Shannon E Boye
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jeffrey R Martens
- Center for Smell and Taste, Department of Pharmacology and Therapeutics, 1200 Newell Drive, University of Florida, Gainesville, FL, USA
| | - Donald A Leopold
- Division of Otolaryngology Head and Neck Surgery, University of Vermont Medical Center, Burlington, VT, USA
| | - Linda M Bartoshuk
- Department of Food Science and Human Nutrition, Center for Smell and Taste, University of Florida, Gainesville, FL, USA
| | - Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, 3400 Spruce Street, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Fetscherstrasse, Dresden, Germany
| | - Jayant M Pinto
- Section of Otolaryngology—Head and Neck Surgery, Department of Surgery, The University of Chicago, MC, Chicago, IL, USA
| | | | | | - Edmund A Pribitkin
- Department of Otolaryngology—Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA
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Abstract
PURPOSE OF REVIEW This article aims to educate clinical neurologists on the importance of taste and smell disorders in clinical neurology. These disorders commonly occur in head trauma, multiple sclerosis, seizure disorders, and neurodegenerative diseases such as idiopathic Parkinson disease and dementia, mild cognitive impairment, and Alzheimer disease, just to name a few. This article covers the basic anatomy of smell and taste, notes the important points of taking a proper history, and discusses smell and taste testing, which are inexpensive, minimally time-consuming procedures. Recurrent bad smells and tastes are not uncommon in these disorders, which cause major impairment in quality of life, including loss of appetite, decreased eating, and weight loss. The diagnosis and treatment of these disorders will also be discussed. RECENT FINDINGS Despite past widespread negative prognoses of taste and smell disorders, more recent work in the last 10 years has shown an improved prognosis for smell and taste recovery in most disorders, and recommendations for changes in food preparation have helped many patients enjoy their food and increase their appetite. Recent experimental evidence has shown that smell loss and testing can assist in separating idiopathic Parkinson disease from other parkinsonian syndromes, can suggest which patients with rapid eye movement (REM) sleep behavior disorder will more likely develop Parkinson disease, and can be predictive of the progression of cognitive impairment and Alzheimer dementia. SUMMARY This article discusses the common smell and taste disorders that a clinical neurologist will encounter in practice. The anatomy and function of smell and taste will be reviewed, followed by office evaluation and testing. The common disorders will be reviewed, along with their prognosis and management.
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Fjaeldstad A, Fernandes H, Nyengaard JR, Ovesen T. [The sense of taste in a clinical setting]. Ugeskr Laeger 2018; 180:V08170627. [PMID: 29720344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As a gatekeeper, taste buds forage chemicals to identify both nutrition and toxins. This can be the decisive difference between initiating the swallow reflex or spitting out the oral contents. In addition to this simple function the sense of taste takes part in more complex relations such as reflexes vs learning, perception vs expectation, and pleasure vs disgust. All relations, which can be perturbed into unbalance, create great discomfort in patients suffering from a dysfunctional sense of taste. This review discusses the most important mechanisms of taste function and dysfunction as well as the possible avenues for treatment of the disorders.
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10
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Abstract
BACKGROUND The sense of taste is very much essential to the overall health of an individual. It is a necessary component to enjoy one's food, which in turn provides nutrition to an individual. Any disturbance in taste perception can hamper quality of life in such patients by influencing their appetite, body weight and psychological well-being. Taste disorders have been treated using different modalities of treatment and there is no consensus for the best intervention. Hence this Cochrane Review was undertaken. This is an update of the Cochrane Review first published in November 2014. OBJECTIVES To assess the effects of interventions for the management of patients with taste disturbances. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 4 July 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017 Issue 6) in the Cochrane Library (searched 4 July 2017); MEDLINE Ovid (1946 to 4 July 2017); Embase Ovid (1980 to 4 July 2017); CINAHL EBSCO (1937 to 4 July 2017); and AMED Ovid (1985 to 4 July 2017). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for trials. Abstracts from scientific meetings and conferences were searched on 25 September 2017. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included all randomised controlled trials (RCTs) comparing any pharmacological agent with a control intervention or any non-pharmacological agent with a control intervention. We also included cross-over trials in the review. DATA COLLECTION AND ANALYSIS Two pairs of review authors independently, and in duplicate, assessed the quality of trials and extracted data. Wherever possible, we contacted trial authors for additional information. We collected adverse events information from the trials. MAIN RESULTS We included 10 trials (581 participants), nine of which we were able to include in the quantitative analyses (566 participants). We assessed three trials (30%) as having a low risk of bias, four trials (40%) at high risk of bias and three trials (30%) as having an unclear risk of bias. We only included studies on taste disorders in this review that were either idiopathic, or resulting from zinc deficiency or chronic renal failure.Of these, nine trials with 544 people compared zinc supplements to placebo for patients with taste disorders. The participants in two trials were children and adolescents with respective mean ages of 10 and 11.2 years and the other seven trials had adult participants. Out of these nine, two trials assessed the patient-reported outcome for improvement in taste acuity using zinc supplements (risk ratio (RR) 1.40, 95% confidence interval (CI) 0.94 to 2.09; 119 participants, very low-quality evidence). We meta-analysed for taste acuity improvement using objective outcome (continuous data) in idiopathic and zinc-deficient taste disorder patients (standardised mean difference (SMD) 0.44, 95% CI 0.23 to 0.65; 366 participants, three trials, very low-quality evidence). We also analysed one cross-over trial separately using the first half of the results for taste detection (mean difference (MD) 2.50, 95% CI 0.93 to 4.07; 14 participants, very low-quality evidence), and taste recognition (MD 3.00, 95% CI 0.66 to 5.34; 14 participants, very low-quality evidence). We meta-analysed taste acuity improvement using objective outcome (dichotomous data) in idiopathic and zinc-deficient taste disorder patients (RR 1.42, 95% 1.09 to 1.84; 292 participants, two trials, very low-quality evidence). Out of the nine trials using zinc supplementation, four reported adverse events like eczema, nausea, abdominal pain, diarrhoea, constipation, decrease in blood iron, increase in blood alkaline phosphatase, and minor increase in blood triglycerides.One trial tested taste discrimination using acupuncture (MD 2.80, 95% CI -1.18 to 6.78; 37 participants, very low-quality evidence). No adverse events were reported in the acupuncture trial.None of the included trials could be included in the meta-analysis for health-related quality of life in taste disorder patients. AUTHORS' CONCLUSIONS We found very low-quality evidence that was insufficient to conclude on the role of zinc supplements to improve taste acuity reported by patients and very low-quality evidence that zinc supplements improve taste acuity in patients with zinc deficiency/idiopathic taste disorders. We did not find any evidence to conclude the role of zinc supplements for improving taste discrimination, or any evidence addressing health-related quality of life due to taste disorders.We found very low-quality evidence that is not sufficient to conclude on the role of acupuncture for improving taste discrimination in cases of idiopathic dysgeusia (distortion of taste) and hypogeusia (reduced ability to taste). We were unable to draw any conclusions regarding the superiority of zinc supplements or acupuncture as none of the trials compared these interventions.
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Affiliation(s)
- Sumanth Kumbargere Nagraj
- Faculty of Dentistry, Melaka‐Manipal Medical CollegeDepartment of Oral Medicine and Oral RadiologyJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Renjith P George
- Faculty Of Dentistry, Melaka‐Manipal Medical CollegeDepartment of Oral PathologyJalan Batu HamparBukit BaruMelakaMelakaMalaysia75150
| | - Naresh Shetty
- International Medical University ‐ IMUSchool of Dentistry Oral & Maxillofacial SurgeryJalan Jalil Perkasa 19. No‐126Bukit JalilKuala LumpurMalaysia57000
| | - David Levenson
- New York University College of DentistryDepartment of Oral and Maxillofacial Pathology, Radiology and Medicine345 E 24th StreetNew YorkNew YorkUSA10010
| | - Debra M Ferraiolo
- New York University College of DentistryDepartment of Oral and Maxillofacial Pathology, Radiology and Medicine345 E 24th StreetNew YorkNew YorkUSA10010
| | - Ashish Shrestha
- College of Dentistry, BP Koirala Institute of Health SciencesCommunity DentistryGhopa Camp, Ward no: 18DharanSunsariNepal7053
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11
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Abstract
PURPOSE OF REVIEW Cancer anorexia is a negative prognostic factor and is broadly defined as the loss of the interest in food. However, multiple clinical domains contribute to the phenotype of cancer anorexia. The characterization of the clinical and molecular pathophysiology of cancer anorexia may enhance the efficacy of preventive and therapeutic strategies. RECENT FINDINGS Clinical trials showed that cancer anorexia should be considered as an umbrella encompassing different signs and symptoms contributing to appetite disruption in cancer patients. Loss of appetite, early satiety, changes in taste and smell are determinants of cancer anorexia, whose presence should be assessed in cancer patients. Interestingly, neuronal correlates of cancer anorexia-related symptoms have been revealed by brain imaging techniques. SUMMARY The pathophysiology of cancer anorexia is complex and involves different domains influencing eating behavior. Limiting the assessment of cancer anorexia to questions investigating changes in appetite may impede correct identification of the targets to address.
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Affiliation(s)
- Alessandro Laviano
- aDepartment of Clinical Medicine bDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy cCancer Metabolism Research Group, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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12
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Katayama T, Hirai S. [Two Cases of Invasive Thymoma with Taste Disorder]. Kyobu Geka 2017; 70:111-113. [PMID: 28174404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Two 50s female patients with the taste disorder of sweet taste loss and stage IV a type B2 invasive thymoma underwent surgery at our hospital. One patient with myasthenia gravis (MG) developed postoperative myasthenic crisis and recovered by the treatment with plasma apheresis and steroid pulse therapy. Her taste disorder fully recovered together with her MG symptom. The taste disorder of the other patient without MG had persisted for 3 years after the surgery. The taste disorder of sweet taste loss was reported as one of non-motor symptoms caused by MG-related autoimmune mechanisms associated with thymoma, improving with the therapy for MG. Anti-Kv 1.4 antibody was reported to be positive in nearly half patients with the taste disorder and MG and is speculated to affect selectively the sweet taste receptor.
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Affiliation(s)
- Tatsuya Katayama
- Department of Cardiovascular and Thoracic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
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Cohen EEW, LaMonte SJ, Erb NL, Beckman KL, Sadeghi N, Hutcheson KA, Stubblefield MD, Abbott DM, Fisher PS, Stein KD, Lyman GH, Pratt-Chapman ML. American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA Cancer J Clin 2016; 66:203-39. [PMID: 27002678 DOI: 10.3322/caac.21343] [Citation(s) in RCA: 363] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.
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Affiliation(s)
- Ezra E W Cohen
- Medical Oncologist, Moores Cancer Center, University of California at San Diego, La Jolla, CA
| | - Samuel J LaMonte
- Retired Head and Neck Surgeon, Former Associate Professor of Otolaryngology and Head and Neck Surgery, Louisiana State University Health and Science Center, New Orleans, LA
| | - Nicole L Erb
- Program Manager, National Cancer Survivorship Resource Center, American Cancer Society, Atlanta, GA
| | - Kerry L Beckman
- Research Analyst-Survivorship, American Cancer Society, Atlanta, GA
| | - Nader Sadeghi
- Professor of Surgery, Division of Otolaryngology-Head and Neck Cancer Surgery, and Director of Head and Neck Surgical Oncology, George Washington University, Washington, DC
| | - Katherine A Hutcheson
- Associate Professor, Department of Head and Neck Surgery, Section of Speech Pathology and Audiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael D Stubblefield
- Medical Director for Cancer Rehabilitation, Kessler Institute for Rehabilitation, West Orange, NJ
| | - Dennis M Abbott
- Chief Executive Officer, Dental Oncology Professionals, Garland, TX
| | - Penelope S Fisher
- Clinical Instructor of Otolaryngology and Nurse, Miller School of Medicine, Department of Otolaryngology, Division of Head and Neck Surgery, University of Miami, Miami, FL
| | - Kevin D Stein
- Vice President, Behavioral Research, and Director, Behavioral Research Center, American Cancer Society, Atlanta, GA
| | - Gary H Lyman
- Co-Director, Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, and Professor of Medicine, University of Washington School of Medicine, Seattle, WA
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Abstract
BACKGROUND The sense of taste is very much essential to the overall health of the individual. It is a necessary component to enjoying one's food, which in turn provides nutrition to an individual. Any disturbance in taste perception can hamper the quality of life in such patients by influencing their appetite, body weight and psychological well-being. Taste disorders have been treated using different modalities of treatment and there is no consensus for the best intervention. Hence this Cochrane systematic review was undertaken. OBJECTIVES To assess the effects of interventions for the management of patients with taste disturbances. SEARCH METHODS We searched the Cochrane Oral Health Group Trials Register (to 5 March 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2014), MEDLINE via OVID (1948 to 5 March 2014), EMBASE via OVID (1980 to 5 March 2014), CINAHL via EBSCO (1980 to 5 March 2014) and AMED via OVID (1985 to 5 March 2014). We also searched the relevant clinical trial registries and conference proceedings from the International Association of Dental Research/American Association of Dental Research (to 5 March 2014), Association for Research in Otolaryngology (to 5 March 2014), the US National Institutes of Health Trials Register (to 5 March 2014), metaRegister of Controlled Trials (mRCT) (to 5 March 2014), World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) (to 5 March 2014) and International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Clinical Trials Portal (to 5 March 2014). SELECTION CRITERIA We included all randomised controlled trials (RCTs) comparing any pharmacological agent with a control intervention or any non-pharmacological agent with a control intervention. We also included cross-over trials in the review. DATA COLLECTION AND ANALYSIS Two authors independently, and in duplicate, assessed the quality of trials and extracted data. Wherever possible, we contacted study authors for additional information. We collected adverse events information from the trials. MAIN RESULTS We included nine trials (seven parallel and two cross-over RCTs) with 566 participants. We assessed three trials (33.3%) as having a low risk of bias, four trials (44.5%) at high risk of bias and two trials (22.2%) as having an unclear risk of bias. We only included studies on taste disorders in this review that were either idiopathic, or resulting from zinc deficiency or chronic renal failure.Of these, eight trials with 529 people compared zinc supplements to placebo for patients with taste disorders. The participants in two trials were children and adolescents with respective mean ages of 10 and 11.2 years and the other six trials had adult participants. Out of these eight, two trials assessed the patient reported outcome for improvement in taste acuity using zinc supplements (RR 1.45, 95% CI 1.0 to 2.1; very low quality evidence). We included three trials in the meta-analysis for overall taste improvement (effect size 0.44, 95% CI 0.23 to 0.65; moderate quality evidence). Two other trials described the results as taste acuity improvement and we conducted subgroup analyses due to clinical heterogeneity. One trial described the results as taste recognition improvement for each taste sensation and we analysed this separately. We also analysed one cross-over trial separately using the first half of the results. None of the zinc trials tested taste discrimination. Only one trial tested taste discrimination using acupuncture (effect size 2.80, 95% CI -1.18 to 6.78; low quality evidence).Out of the eight trials using zinc supplementation, four reported adverse events like eczema, nausea, abdominal pain, diarrhoea, constipation, decrease in blood iron, increase in blood alkaline phosphatase, and minor increase in blood triglycerides. No adverse events were reported in the acupuncture trial.None of the included trials could be included in the meta-analysis for health-related quality of life in taste disorder patients. AUTHORS' CONCLUSIONS We found very low quality evidence that was insufficient to conclude on the role of zinc supplements to improve taste perception by patients, however we found moderate quality evidence that zinc supplements improve overall taste improvement in patients with zinc deficiency/idiopathic taste disorders. We also found low quality evidence that zinc supplements improve taste acuity in zinc deficient/idiopathic taste disorders and very low quality evidence for taste recognition improvement in children with taste disorders secondary to chronic renal failure. We did not find any evidence to conclude the role of zinc supplements for improving taste discrimination, or any evidence addressing health-related quality of life due to taste disorders.We found low quality evidence that is not sufficient to conclude on the role of acupuncture for improving taste discrimination in cases of idiopathic dysgeusia (distortion of taste) and hypogeusia (reduced ability to taste). We were unable to draw any conclusions regarding the superiority of zinc supplements or acupuncture as none of the trials compared these interventions.
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Affiliation(s)
- Sumanth Kumbargere Nagraj
- Department of Oral Medicine & Oral Radiology, Faculty Of Dentistry, Melaka-Manipal Medical College, Jalan Batu Hampar, Bukit Baru, Melaka, Malaysia, 75150
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15
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Epstein JB, Thariat J, Bensadoun RJ, Barasch A, Murphy BA, Kolnick L, Popplewell L, Maghami E. Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. CA Cancer J Clin 2012; 62:400-22. [PMID: 22972543 DOI: 10.3322/caac.21157] [Citation(s) in RCA: 272] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Answer questions and earn CME/CNE Oral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long-term oral health and general well-being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long-term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long-term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time.
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Affiliation(s)
- Joel B Epstein
- Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA, USA.
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16
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Becze E. Managing taste dysfunction in patients with cancer. ONS Connect 2012; 27:16-17. [PMID: 22690520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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17
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Abstract
Taste and smell are critical components to a person's overall sense of well-being and quality of life. Taste related problems can cause pain and discomfort and can hinder the maintenance of a satisfying and nutritious diet. Loss of taste interferes with pleasure derived from food and food-related activities. Many drugs can affect this special sense and contribute significantly to the morbidity of the associated illness. This article gives a brief account of this problem and emphasizes the need for more awareness of the clinicians about this problem.
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18
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Smell and taste disorders. Changes in senses can often be treated. Mayo Clin Womens Healthsource 2009; 13:1-2. [PMID: 19584799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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19
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Kawaguchi M, Shinomiya T, Fuchi K, Sawaki K. [Drug-induced taste disorder]. Nihon Rinsho 2007; 65 Suppl 8:497-503. [PMID: 18074590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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20
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Schiffman SS, Sattely-Miller EA, Taylor EL, Graham BG, Landerman LR, Zervakis J, Campagna LK, Cohen HJ, Blackwell S, Garst JL. Combination of flavor enhancement and chemosensory education improves nutritional status in older cancer patients. J Nutr Health Aging 2007; 11:439-54. [PMID: 17657366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Abnormalities in taste and smell functioning occur with elevated frequency in both older adults and patients with cancer. With the predicted increase in both of these populations in the coming decades, it is imperative to evaluate potential interventions that are designed to help older cancer patients compensate for the additive burden of this disease and its treatment on age-related taste and smell losses. OBJECTIVE The purpose of the current study was to determine if providing instruction and products for flavor enhancement of foods to elderly cancer patients in addition to nutritional information would improve their nutritional status, and, by extension, functional and immune status as well as quality of life. DESIGN One hundred and seven subjects enrolled in the study. Fifty-four subjects were in the experimental group that received flavor enhancement plus nutritional information; fifty-three control subjects received only nutritional information. Subjects were evaluated 1 month, 3 months, and 8 months after beginning chemotherapy. At every session, subjects completed taste and smell assessments as well as questionnaires related to nutritional status, activities of daily living, and quality of life. Blood samples were also obtained to determine immune parameters. RESULTS At the eight-month time point, experimental subjects had better scores on the mini nutritional assessment (MNA) and the physical function assessment of the quality of life questionnaire. Also at eight months, self-reported taste and smell perception for experimental subjects was better than that of controls as well as better than at earlier time points. Tests that assessed quantity and quality of food intake, as well as a number of immune parameters declined over time and did not differ significantly between groups. CONCLUSION The combination of flavor enhancement, chemosensory education, and nutritional information for elderly cancer patients improved their nutritional assessment on the MNA and physical function over time. On the whole, experimental subjects perceived themselves to be better functioning at eight months than did their control counterparts.
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Affiliation(s)
- S S Schiffman
- Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
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21
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Abstract
OBJECTIVE Effective treatment of obesity is extremely difficult, and taste modulation has been suggested as a feasible option. We aim at presenting dangers associated with stroke-induced taste impairment. METHODS A case report is presented with clinical and laboratory findings. We review literature on the effect of taste modulation on body weight. RESULTS Eight months after suffering stroke, a 63-year old obese woman with a nine year-old history of type 2 diabetes reported headache and poor general feeling. Physical examination revealed significantly elevated blood pressure of 190/110 mmHg. The patient had never had elevated blood pressure before nor ever been taking any antihypertensive medication. However, stroke resulted in severe persisting dysgeusia. We found out that she had been using up to 110 g of salt daily to make her meals palatable. Standard gustatory tests confirmed severe taste impairment, reflecting the lesion of the glossopharyngeal nerve. Taste loss was not associated with body weight reduction. Limiting daily salt intake to 5 g within 4 weeks resulted in lowering blood pressure to 120/70 mmHg. CONCLUSION Stroke-induced dysgeusia may lead to increased salt intake in a type 2 diabetes patient, which caused development of severe hypertension. The taste loss did not yield any weight reduction. We suggest that aiming at reducing body weight by means of taste modulation should be done with caution. Physicians must be aware that patients may try to overcome dysgeusia by additional salt intake, if not adequately informed of the risk thereof.
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Affiliation(s)
- L Czupryniak
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, Barlicki University Hospital No 1, Kopcinskiego 22, 90-153 Lodz, Poland.
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22
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Abstract
Disorders of taste and smell commonly present diagnostic dilemmas to the medical profession. This may be secondary to the lack of knowledge and understanding of these conditions. There seems to be a low level of interest in the disorders, when compared with disruption of the other senses such as sight and hearing. Nevertheless, impairment of these senses are common and may be life threatening, especially when they involve the elderly patient. The aetiology of the conditions is widespread, and extend beyond the content of this article. This article will relate only to how the ageing process may contribute to sensory dysfunction. It will focus on how the ageing process changes the normal anatomy and physiology of the senses, how this effects the person's quality of life, and the current management of these conditions.
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Affiliation(s)
- J M Boyce
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Wales, Cardiff .
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Abstract
Changes in taste perception occur in a significant proportion of cancer patients. Among cancer patients treated with radiotherapy (RT) in head and neck area, the vast majority reports an altered taste sense during and after treatments. Taste impairment starts a few weeks after the beginning of irradiation, and almost all such patients experienced loss of taste acuity at a dose of 60 Gy. Some studies investigated the four basic taste intensities (sweet, salty, sour and bitter) and the umami taste, and several of these reports identified diminished threshold sensitivity for at least one taste quality. Six months to one year after RT, taste acuity recovers to its previous level in many patients, but some patients show incomplete or no recovery even several years later. Taste impairment has profound effects on patients' quality of life because is associated with weight loss through reduced appetite and altered patterns of food intake. Damage to the major salivary glands during head and neck RT leads to disturbance in taste acuity. With the implementation of new radiation techniques, such as conformal and intensity-modulated RT in head and neck irradiation, the late-radiation effects can probably be reduced, but the remaining sequelae are still bothersome to the patients.
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Affiliation(s)
- Maria Grazia Ruo Redda
- Department of Radiation Oncology and Diagnostic Imaging, University of Turin, S. Luigi Hospital Regione Gonzole 10, 10043 Orbassano, Turin, Italy
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Abstract
Keratosis obturans is a rare condition characterized by the accumulation of desquamated keratin material in the bony portion of the external auditory canal. Classically, it is reported to present with severe otalgia, conductive deafness and global widening of the canal. A case of keratosis obturans is described in which the principal symptom was a metallic taste and the main finding was extensive erosion of the hypotympanum with exposure of the facial nerve and the annulus of the tympanic membrane. This presenting symptom and resorption pattern are atypical of keratosis obturans and have not been documented previously.
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Affiliation(s)
- Ricardo Persaud
- Department of Otolaryngology, Head and Neck Surgery, St Bartholomew's and The Royal London Hospitals, Gray's Inn Road, London, UK.
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25
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Abstract
The importance of taste has been recently evaluated from the standpoint of quality of life, but few reports exist on the clinical status of taste disturbance. We classified taste disturbance by cause and studied the effect of treatment and recovery duration. Subjects were 321 patients with taste disturbance, i.e., 131 men and 190 women (mean age: 59.9 years). Electrogustometry (EGM) and filter paper disks (FPD) were used to assess taste function in all subjects. We also asked them all about the degree of symptoms using visual analog scale (VAS). Statistical analysis was done using the unpaired t-test, with p<0.05 considered significant. Patients were treated with zinc sulfate, ferrotherapy, herbal medicine, and minor tranquilizers. Causes of taste disturbance were classified into idiopathic, post-common-cold, drug-induced, psychogenic, constitutional, and iron deficiency. Idiopathic taste disturbance was the commonest cause (125 cases, 38.9%), followed by drug-induced (62 cases, 19.3%), and post common cold (38 cases, 11.8%). Drug induced and psychogenic taste disturbance have increased. Recovery from symptoms was 79/103 (76.7%) in idiopathic taste disturbance, 24/33 (72.7%) in post-common-cold, and 14/17 (82.4%) in iron deficiency. Recovery took 22.2 weeks. Recovery was 32/50 cases (62.4%) in drug induced, taking 48 weeks. For all causes, EGM and FPD results were not associated with the degree of symptoms. Both tests tended to show delayed improvement compared to symptoms. Cases taking more than 6 months from symptom onset to medical examination showed significantly lower improvement and longer recovery time than those taking 6 months on less (p = 0.04).
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Affiliation(s)
- Tomomi Nin
- Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya
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Kruk-Zagajewska A, Nowak K, Kordylewska M, Mietkiewska D, Gawecki W. [Local changes in the oral cavity in patients after operation of malignant tumours of the tongue and bottom of the oral cavity]. Otolaryngol Pol 2006; 60:817-22. [PMID: 17357656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This study is aimed an objective and subjective evaluation of local changes after operations of malignant tumours of the tongue and the bottom of the oral cavity. THE MATERIAL AND METHODS we have examined 74 patients (70 men and 4 women) treated in Department of Otolaryngology of the University School of Medical Sciences in Poznań with recognized of malignant tumour of the tongue and floor of the mouth. On the base of subjective and objective ultrasound and x-ray examination with use of contrast and stereognostic test it was evaluated movability, alteration of articulation zones, regularity of swallowing acts, sense of taste and efficiency of stereognosion. In all of the patients we found orders in swallowing, speech and taste dependen on the kind of the operation.
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Livni D, Eliav E, Benoliel R. [Impaired sense of taste--diagnosis and treatment]. Refuat Hapeh Vehashinayim (1993) 2005; 22:15-32, 90. [PMID: 16323406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The sense of taste has great importance in health and disease. Complaints of oral discomfort associated with taste disturbances are increasingly met in the clinical setting. Altered taste perception can result from various underlying local or systemic pathology, as well as serious sensorial syndromes. Although they are not straightforward to diagnose and manage, it is important for the clinician to understand the pathphysiology of this chemosensory system, and to be able to use objective measures in order to quantify and classify the apparent symptoms, thus making the first step to correct diagnosis and treatment.
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Affiliation(s)
- D Livni
- Dept. of Oral Medocine, the Hebrew University, Hadassah School of Dental Medicine, Israel
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LeWine H. By the way, doctor. I know someone who lost her sense of taste after years of heavy prescriptions for high blood pressure. Is this a side effect you have to accept, or should my friend's doctor try prescribing a different medication? Is the loss of taste reversible? Harv Health Lett 2005; 30:8. [PMID: 16136679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Abstract
Disorders of taste and smell can present a challenge to the facial plastic surgeon. Obtaining a detailed history and examination is the key to the diagnosis and work-up of olfactory and gustatory dysfunction. Easy-to-administer tests are available for olfactory evaluation(University of Pennsylvania Smell Identification Test) and gustatory (taste sticks, tasting tablets) evaluation. The prognosis and management of olfactory and gustatory disease depend on its etiology. Despite ongoing research, the treatment of the disorders of smell and taste is limited.
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Affiliation(s)
- Bozena B Wrobel
- Department of Otolaryngology-Head and Neck Surgery, University of Nebraska, 981225 Nebraska Medical Center, Omaha, NE 68198-1225, USA
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30
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Abstract
Taste disorders can be subdivided in ageusia, which is the inability to detect any qualitative gustatory sensation and hypogeusia, which is a decreased sensitivity to all tastants. Dysgeusia or pargeusia is a distortion or perversion in the perception of a tastant in contrast to phantosmia, which is a perception of taste that occurs in the absence of a tastant. The site of lesion can usually be determined by history and clinical examination. History taking should always include the assessment of current and former medication. Conditions that interfere with access of a tastant to the taste bud are differentiated from conditions that either injure the receptor cell or damage the gustatory afferent nerves and the central pathways. Psychophysical taste evaluation includes identification of quality using sprays or taste strips and testing of intensity perception measuring threshold using the 3-drop technique. Moreover, measurement of taste in localized areas can be performed either with conventional chemicals or using an electrogustometer. Gustatory evoked potentials are not yet routinely elicited. Therapy has to be planned according to the cause of the disorder.
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Affiliation(s)
- A Welge-Lüssen
- Hals-Nasen-Ohren-Universitätsklinik, Kantonsspital Basel, Basel.
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Abstract
OBJECTIVE We have observed that, in cases of smell loss, patients often complain of taste loss as well even though they actually have normal gustatory acuity according to gustatory tests; we have defined such symptoms as "flavor disturbance". The clinical features of flavor disturbance are reported in this paper. MATERIAL AND METHODS A total of 297 patients (99 males, 198 females; mean age 55.5 years) were treated for olfactory disturbance at the hospital of Hyogo College of Medicine between July 1995 and August 2001. Sixty-six out of 297 patients (22.5%) also experienced taste disturbance, and 49 of these 66 cases were evaluated by means of smell and taste tests. These 49 patients who complained of taste and smell loss were classified into two groups according to the results of their smell and taste tests. Patients who only complained of olfactory disturbance were also reviewed. RESULTS There was no relationship between the severity of olfactory disturbance and the degree of flavor disturbance. The incidence of flavor disturbance was high in patients with sudden olfactory disturbance after upper respiratory tract infection or head trauma and low in those with slowly progressive olfactory disturbance. The symptoms of flavor disturbance improved regardless of whether smell was improved or not. CONCLUSIONS The patients with flavor disturbance tended to misrecognize that they had taste loss because of sudden smell loss, and there were more of these cases than we expected. When patients with smell and taste loss are treated, flavor disturbance should also be considered.
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Affiliation(s)
- Megumi Fujii
- Department of Otolaryngology, Meiwa Hospital, Hyogo, Japan.
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Taste and smell: your sensitive senses. Harv Mens Health Watch 2004; 8:1-4. [PMID: 15100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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What can I do to improve my senses of smell and taste? Johns Hopkins Med Lett Health After 50 2003; 15:8. [PMID: 14983796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Radwan-Oczko M, Zietek M, Markowska J. [Burning mouth syndrome]. Wiad Lek 2003; 56:328-32. [PMID: 14969159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Burning mouth syndrome (BMS) is currently described as a burning pain in the tongue or other parts of mucous cavi oris without pathological signs of mucous cavi oris and changes in laboratory blood tests. On the basis of the current literature and our patients' examinations we described the incidence, etiology, symptoms and offered model of treatment of BMS.
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Abstract
Curative radiotherapy for head and neck cancer causes very significant side effects. In addition to their considerable impact on the patient's quality of life, these effects can prejudice treatment outcome. This review looks at the management of the adverse effects of radiotherapy for head and neck cancer.
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Affiliation(s)
- R L Mendes
- Head and Neck Unit, Royal Marsden Hospital, London SW3 6JJ
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36
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Abstract
Lost or impaired smell or taste should be taken seriously, as it puts a person at higher risk for toxic exposures, such as gas leaks, smoke, and rotting food, and it also takes away the enjoyment of some of life's pleasures, such as the fragrance of flowers or the taste of good food or fine wine. In many patients, the loss follows a viral upper respiratory tract infection, and the only real treatment is to reassure patients that the problem may resolve if the damaged sensory cells regenerate. In other patients, the loss has more subtle causes and deserves a careful investigation and appropriate treatment. This article reviews the proper steps to take when investigating and treating chemosensory difficulties.
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Affiliation(s)
- Norman M Mann
- Smell and Taste Clinic, University of Connecticut Health Center, Farmington 06030-2459, USA
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Abstract
Patients with cancer frequently develop taste alterations, which are manifested by food aversions and decreased caloric intake. Many etiologies are recognized, including the effect of tumors, cancer cell mitosis, vitamin deficiencies, and cytokine involvement. Preventing or improving taste alterations in patients with cancer is challenging. Clinicians play an important role in assessing, educating, and referring (when indicated) patients experiencing potential or actual taste alterations. Directions for further nursing research include the development of assessment tools and preventative strategies.
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Affiliation(s)
- Richard D Mattes
- Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47907-1264, USA.
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Since retiring, I've enjoyed traveling and trying new foods. But over the last few months, food just hasn't tasted the same. The flavors seem dull. What might cause this? Mayo Clin Health Lett 2001; 19:8. [PMID: 11577576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
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Reiss M, Reiss G. [Taste disorders]. Praxis (Bern 1994) 2000; 89:2065-2069. [PMID: 11190848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Gustatory problems have deleterious consequences to systemic health, nutritional status and quality of life. Chemosensory dysfunction is most often secondary to one of only a few causes: viral infection, toxic chemical exposure, head trauma, as well as medication-related and idiopathic conditions. Many gustatory disorders are secondary to a wide variety of diseases. History taking may provide clues to these and other problems. Therapy should not begin until a standardized test has been given that established impairment of the sense of taste. Treatment of underlying diseases may restore chemosensory function. Reference is made to the need for adequate psychic guidance of patients with chemosensorial problems. If restoration of their sense of taste is unlikely, patient should be cautioned to take steps to ensure safety in regard to such dangers and spoiled foods.
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Affiliation(s)
- M Reiss
- HNO-Klinik, Städtisches Klinikum Görlitz GmbH, Görlitz.
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Reiss M, Reiss G. [Smell and taste disturbances]. Med Monatsschr Pharm 2000; 23:394-7. [PMID: 11147195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- M Reiss
- Städtisches Klinikum Görlitz, Moltkestr. 52, 02826
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Bromley SM. Smell and taste disorders: a primary care approach. Am Fam Physician 2000; 61:427-36, 438. [PMID: 10670508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Smell and taste disorders are common in the general population, with loss of smell occurring more frequently. Although these disorders can have a substantial impact on quality of life and may represent significant underlying disease, they are often overlooked by the medical community. Patients may have difficulty recognizing smell versus taste dysfunction and frequently confuse the concepts of "flavor" and "taste." While the most common causes of smell disturbance are nasal and sinus disease, upper respiratory infection and head trauma, frequent causes of taste disturbance include oral infections, oral appliances (e.g., dentures), dental procedures and Bell's palsy. Medications can interfere with smell and taste, and should be reviewed in all patients with reported dysfunction. In addition, advancing age has been associated with a natural impairment of smell and taste ability. A focused history and a physical examination of the nose and mouth are usually sufficient to screen for underlying pathology. Computed tomographic scanning or magnetic resonance imaging of affected areas, as well as commercially available standardized tests, may be useful in selected patients. The causes of olfactory dysfunction that are most amenable to treatment include obstructing polyps or other masses (treated by excision) and inflammation (treated with steroids). Enhancement of food flavor and appearance can improve quality of life in patients with irreversible dysfunction.
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Affiliation(s)
- S M Bromley
- University of Pennsylvania Smell and Taste Center, Philadelphia 19104-4283, USA
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Scully C, Porter S. Orofacial disease: update for the dental clinical team: 10. Halitosis and disturbances of taste, orofacial movement or sensation. Dent Update 1999; 26:464-8. [PMID: 10765792 DOI: 10.12968/denu.1999.26.10.464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article discusses halitosis, and disorders of taste, orofacial movement or sensation.
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Affiliation(s)
- C Scully
- Eastman Dental Institute for Oral Health Care Sciences, International Centre for Excellence in Dentistry, University of London
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Abstract
As with almost any aspect of medical practice, a thorough history and physical examination coupled with a good understanding of the anatomy and physiology of an organ system are the key factors in reaching a diagnosis. The information in this article is provided to assist the internist with the diagnosis of chemosensory disorders and the differentiation of malingering or other disease process as well as providing insight into the workup, prognosis, and treatment of patients with taste and smell disorders.
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Affiliation(s)
- M M Cullen
- Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins Hospital and Medical Center, Baltimore, Maryland, USA
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Abstract
Taste and smell are fundamental sensory systems essential in nutrition and food selection, for the hedonic and sensory experience of food, for efficient metabolism, and, in general, for the maintenance of a good quality of life. The gustatory and olfactory systems demonstrate a diversity of transduction mechanisms, and during the last decade, considerable progress has been made toward our understanding of the basic mechanisms of taste and smell. Understanding normal chemosensory function helps clarify the molecular events that underlie taste and smell disorders. At least 2,000,000 Americans suffer from chemosensory disorders--a number that is likely to grow as the aging segment of the population increases. Smell disorders are more frequent than taste disturbances, due to the vulnerability and anatomical distinctiveness of the olfactory system, and because a decline in olfactory function is part of the normal aging process. Common gustatory and olfactory complaints are due to a number of medications, to upper respiratory infections, to nasal and paranasal sinus diseases, and to damage to peripheral nerves supplying taste and smell. Most chemosensory complaints have an identifiable cause. Although diagnosis of taste and smell disorders has improved considerably over the last two decades, treatment of these disorders is still limited to conditions with discernible and reversible causes. Future research is needed for a better understanding of chemosensory mechanisms, establishing improved diagnostic procedures, and disseminating knowledge on chemosensory disorders among practitioners and the general public.
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Affiliation(s)
- A I Spielman
- Basic Science Division, New York University College of Dentistry, New York 10010, USA
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Inokuchi A. [Taste function tests and taste disorders]. Fukuoka Igaku Zasshi 1998; 89:195-200. [PMID: 9867481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Schiffman SS. Taste and smell losses in normal aging and disease. JAMA 1997; 278:1357-62. [PMID: 9343468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To review the scientific literature on the alterations in the senses of taste and smell in the elderly, including causes, diagnosis, prognosis, and treatment. DATA SOURCES Original reports and reviews obtained through MEDLINE searches from 1966 through June 1997 using the MeSH headings of "taste," "taste buds," "taste disorders," "taste thresholds," "smell," "odors," "aged," and "aging." Articles frequently cited in reference lists were also included. STUDY SELECTION All articles were reviewed, tabulated, and summarized. DATA EXTRACTION Criteria for extraction included data quality and validity, statistical treatment of the data, venue of publication, and relevance to clinical care. CONCLUSION Losses of taste and smell are common in the elderly and result from normal aging, certain disease states (especially Alzheimer disease), medications, surgical interventions, and environmental exposure. Deficits in these chemical senses cannot only reduce the pleasure and comfort from food, but represent risk factors for nutritional and immune deficiencies as well as adherence to specific dietary regimens. Chemosensory decrements can lead to food poisoning or overexposure to environmentally hazardous chemicals that are otherwise detectable by taste and smell. Use of flavor-enhanced food can increase enjoyment of food and have a positive effect on food intake and immune status.
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Affiliation(s)
- S S Schiffman
- Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
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Ackerman BH, Kasbekar N. Disturbances of taste and smell induced by drugs. Pharmacotherapy 1997; 17:482-96. [PMID: 9165552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We reviewed the current literature (1980-1990, 1991-1996) concerning drugs associated with anosmia, hyposmia, dysgeusia, parageusia, and ageusia, and the impact of these adverse effects. Case reports of patients with sudden and delayed onset of one of these disorders with evidence for implication of a drug were included. Disturbances of taste and smell among the elderly and chronically ill, including those with thermal injury, decreases interest in eating and secondarily impairs healing of wounds. Mechanisms involved with these sensory disturbances include deposition of silver sulfate in nerves after use of topical agents containing silver, altered influx of calcium and other ions, chelation or depletion of tissue-bound zinc, disturbed bradykinin catabolism and second messenger synthesis, catabolism, and altered prostaglandin systems. Other mechanisms, particularly prolonged chemosensory disorders after early drug discontinuation, remain unknown.
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Affiliation(s)
- B H Ackerman
- Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy and Science, Pennsylvania, USA
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Hüttenbrink KB. [Disorders of the sense of smell and taste]. Ther Umsch 1995; 52:732-7. [PMID: 7502248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Disorders of olfaction and taste are infrequent, but a complete loss of smell or taste reduces the quality of life significantly. The sensitivity of human olfaction is remarkable, even for specific stimuli: Just a few molecules are enough to induce the correct identification of sterilised and ultraheated milk. Olfaction and taste are called 'chemical senses' because in both cases the adequate stimulus consists of molecules that bind to receptors of the sensory cells. The perceptions of smell and taste are often combined. Taste differentiates only four qualities: sweet, sour, salty, and bitter. The typical flavor of food or drink is detected by olfaction. Disturbances of olfaction can be due to respiratory disorders such as nasal polyps, a deviation of the nasal septum or chronic sinusitis. Such conditions can reduce airflow through the olfactory cleft at the roof of the nasal cavity. They can be corrected by modern endoscopic surgery of the nose. Epithelial disorders involving the sensory cells are most often caused by viral infections (influenza-anosmia) or toxic destruction of the sensory epithelium (solvents or gases). Epithelial disorders can be cured only rarely by any treatment. Corticosteroids, zinc, and vitamin A are tried frequently. Neural disorders occur after frontobasal trauma and during neurological diseases such as Parkinson's or Alzheimer's disease. Disorders of olfaction can be an early sign of such neurological diseases and sophisticated examination of this sense can contribute to their early diagnosis. However, no specific treatments have yet been identified. Disorders of taste can be due to toxic, chemical or inflammatory damage to the sensory cells of the tongue.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- K B Hüttenbrink
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde der Medizinischen Fakultät Carl Gustav Carus, Technischen Universität Dresden
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Abstract
Drugs in every major pharmacological category can impair both taste and smell function and do so more commonly than presently appreciated. Impairment usually affects sensory function at a molecular level, causing 2 major behavioural changes--loss of acuity (i.e. hypogeusia and hyposmia) and/or distortion of function (i.e. dysgeusia and dysosmia). These changes can impair appetite, food intake, cause significant lifestyle changes and may require discontinuation of drug administration. Loss of acuity occurs primarily by drug inactivation of receptor function through inhibition of tastant/odorant receptor: (i) binding; (ii) Gs protein function; (iii) inositol trisphosphate function; (iv) channel (Ca++,Na++) activity; (v) other receptor inhibiting effects; or (vi) some combination of these effects. Distortions occur primarily by a drug inducing abnormal persistence of receptor activity (i.e. normal receptor inactivation does not occur) or through failure to activate: (i) various receptor kinases; (ii) Gi protein function; (iii) cytochrome P450 enzymes; or other effects which usually (iv) turn off receptor function; (v) inactivate tastant/odorant receptor binding; or (vi) some combination of these effects. Termination of drug therapy is commonly associated with termination of taste/smell dysfunction, but occasionally effects persist and require specific therapy to alleviate symptoms. Treatment primarily requires restoration of normal sensory receptor growth, development and/or function. Treatment which restores sensory acuity requires correction of steps initiating receptor and other pathology and includes zinc, theophylline, magnesium and fluoride. Treatment which inhibits sensory distortions requires reactivation of biochemical inhibition at the receptor or inactivation of inappropriate stimulus receptor binding and/or correction of other steps initiating pathology including dopaminergic antagonists, gamma-aminobutyric acid (GABA)-ergic agonists, calcium channel blockers and some orally active local anaesthetic, antiarrhythmic drugs.
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Affiliation(s)
- R I Henkin
- Taste and Smell Clinic, Center for Molecular Nutrition and Sensory Disorders, Washington, DC 20016
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