Taste and Smell Function in Head and Neck Cancer Survivors

Abstract

Survivors of head and neck squamous cell cancers (HNSCC) frequently complain of taste dysfunction long after radiation therapy is completed, which contradicts findings from most sensory evaluation studies, which predict dysfunction should resolve few months after treatment. Therefore, it remains unclear whether taste and smell function fully recovers in HNSCC survivors. We evaluated HNSCC survivors (n=40; age 63±12 years, mean ± standard deviation) who received radiation therapy between 6 months and 10 years before recruitment and compared their responses to those of a healthy control group (n=20) equivalent in age, sex, race, smoking history, and body mass index. We assessed regional (tongue tip) and whole-mouth taste intensity perception using the general Labeled Magnitude Scale and smell function using the University of Pennsylvania Smell Identification Test (UPSIT). To determine possible differences between groups in retronasal smell perception, we used solutions of sucrose with strawberry extract, citric acid with lemon extract, sodium chloride in vegetable broth, and caffeine in coffee and asked participants to rate perceived smell and taste intensities with and without nose clips. We found groups had similar UPSIT and taste intensity scores when solutions were experienced in the whole mouth. However, HNSCC survivors were less likely to identify low concentrations of bitter, sweet, or salty stimuli in the tongue tip relative to healthy controls. Our findings suggest persistent and subtle localized damage to the chorda tympani or to the taste buds in the fungiform papillae of HNSCC survivors, which could explain their sensory complaints long after completion of radiotherapy.

A longitudinal investigation of posttraumatic growth and its associated factors among head and neck cancer survivors

“…Similarly, worse sensory problems were inversely associated with PTG among HNC patients. Impaired taste and smell are commonly associated with HNC 19 . Dysgeusia and reduced olfaction can occur before and during HNC treatment (chemotherapy and radiotherapy).…”

“…Impaired taste and smell are commonly associated with HNC. 19 Dysgeusia and reduced olfaction can occur before and during HNC treatment (chemotherapy and radiotherapy). Moreover, these complications may persist even after treatment among HNC patients.…”

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“…in taste such as altered structure of taste buds and number of taste cell receptors, and detection of drug sensation via saliva [48,49]. These alterations in flavor perception have negative impacts on nutritional status and body weight [50][51][52]. Furthermore, chemotherapy induces gastrointestinal side effects including nausea and vomiting.…”

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“…Symptoms such as nausea and loss of smell or taste among those with Long‐COVID can also cause significant impairment to lifestyle and quality of life and may be associated with poor appetite and weight loss. These symptoms are not uncommon among long‐term survivors of head and neck cancer (Alfaro et al, 2021 ).…”