Taste Complaints Research Articles

Which Is More Harmful for the Oral Mucosa: Cigarettes or Hookah? A Cross-Sectional Study

Background: The popularity of hookah usage is on the rise in contemporary societies. Some individuals believe that using a hookah is less harmful than smoking traditional cigarettes. Objectives: The objective of this study was to examine the prevalence of oral mucosal lesions among individuals who use hookah and cigarettes. Methods: In a cross-sectional study conducted at Ahvaz Dental School, 102 individuals seeking examination and treatment for dental problems were recruited from spring 2022 to winter 2023 and categorized into three groups: Cigarette users (A), hookah users (B), and non-users of both (C). A thorough oral examination was performed on each patient to identify any oral mucosal lesions. If necessary, a biopsy was performed to confirm the diagnosis. The information for each patient was recorded on individual sheets and subsequently analyzed. To examine the relationship between qualitative variables, a chi-square test or Fisher's exact test was employed. Results: The most prevalent oral mucosal lesion observed in both group A (42%) and group B (27%) was hyperpigmentation of the oral mucosa. Notably, a premalignant lesion was exclusively observed in individuals belonging to group A (7%). Complaints of bad taste in the mouth were more common in tobacco users (in any form) than in non-users (P = 0.004). Conclusions: Tobacco users (of any kind) have more oral lesions than non-smokers, although most of these lesions are harmless.

Gustatory Function in Patients With Cerebellopontine Angle Masses.

To investigate the impact of cerebellopontine angle (CPA) masses on subjective and measured taste function. Retrospective cross-sectional study. Tertiary referral center. Consecutive adult patients with untreated CPA masses. Gustatory function was psychophysically measured with Taste Strips (range, 0-16) on both sides of the tongue. Subjective taste complaints were assessed using a questionnaire. Half-sided taste impairment (hemi-ageusia) was defined as side-to-side asymmetry ≥4 points with <9 points on the side of the CPA mass. We used the Koos classification for vestibular schwannomas (VS) and, in the case of facial nerve palsy, the House-Brackmann grading system. We included 135 patients (mean [standard deviation (SD)] age, 55.3 ± 14.1 yr; 62 males). The most common CPA mass was VS (77%). Overall, the measured taste function was lower on the affected compared with the healthy side of the tongue (mean score, 9.8 ± 3.3 versus 11 ± 2.9; p < 0.0001). Looking for clinically relevant one-sided taste impairment revealed 18 (13.3%) patients with hemi-ageusia, but only 4 (30.8%) of those subjectively complained of taste dysfunction. Regarding VS, Koos IV masses presented the lowest score on the affected side (mean score, 7.5 ± 3.7). Six patients presented with facial palsy. Having facial palsy did not result in a lower Taste Strips score (p = 0.23). Before any CPA mass treatment, a measurable ipsilateral decrease in gustatory function is present in many patients. Most patients do not notice this preexisting taste impairment. From a medicolegal standpoint, this warrants consideration. To avoid postoperative claims regarding taste function, a preoperative assessment may be considered.

Long-Term Taste and Smell Outcomes After COVID-19

Self-report surveys suggest that long-lasting taste deficits may occur after SARS-CoV-2 infection, influencing nutrition, safety, and quality of life. However, self-reports of taste dysfunction are inaccurate, commonly reflecting deficits due to olfactory not taste system pathology; hence, quantitative testing is needed to verify the association of post-COVID-19 condition with taste function. To use well-validated self-administered psychophysical tests to investigate the association of COVID-19 with long-term outcomes in taste and smell function. This nationwide cross-sectional study included individuals with and without a prior history of COVID-19 recruited from February 2020 to August 2023 from a social media website (Reddit) and bulletin board advertisements. In the COVID-19 cohort, there was a mean of 395 days (95% CI, 363-425 days) between diagnosis and testing. History of COVID-19. The 53-item Waterless Empirical Taste Test (WETT) and 40-item University of Pennsylvania Smell Identification Test (UPSIT) were used to assess taste and smell function. Total WETT and UPSIT scores and WETT subtest scores of sucrose, citric acid, sodium chloride, caffeine, and monosodium glutamate were assessed for groups with and without a COVID-19 history. The association of COVID-19 with taste and smell outcomes was assessed using analysis of covariance, χ2, and Fisher exact probability tests. Tests were completed by 340 individuals with prior COVID-19 (128 males [37.6%] and 212 females [62.4%]; mean [SD] age, 39.04 [14.35] years) and 434 individuals with no such history (154 males [35.5%] and 280 females [64.5%]; mean (SD) age, 39.99 [15.61] years). Taste scores did not differ between individuals with and without previous COVID-19 (total WETT age- and sex-adjusted mean score, 33.41 [95% CI, 32.37-34.45] vs 33.46 [95% CI, 32.54-34.38]; P = .94). In contrast, UPSIT scores were lower in the group with previous COVID-19 than the group without previous COVID-19 (mean score, 34.39 [95% CI, 33.86-34.92] vs 35.86 [95% CI, 35.39-36.33]; P < .001]); 103 individuals with prior COVID-19 (30.3%) and 91 individuals without prior COVID-19 (21.0%) had some degree of dysfunction (odds ratio, 1.64 [95% CI, 1.18-2.27]). The SARS-CoV-2 variant present at the time of infection was associated with smell outcomes; individuals with original untyped and Alpha variant infections exhibited more loss than those with other variant infections; for example, total to severe loss occurred in 10 of 42 individuals with Alpha variant infections (23.8%) and 7 of 52 individuals with original variant infections (13.5%) compared with 12 of 434 individuals with no COVID-19 history (2.8%) (P < .001 for all). In this study, taste dysfunction as measured objectively was absent 1 year after exposure to COVID-19 while some smell loss remained in nearly one-third of individuals with this exposure, likely explaining taste complaints of many individuals with post-COVID-19 condition. Infection with earlier untyped and Alpha variants was associated with the greatest degree of smell loss.

Prospective study to assess taste related to eating disorders during chemotherapy using a dietary app: OISHY study.

302 Background: Adverse events (AE) such as nausea, vomiting, dysgeusia, oral mucositis, and anorexia during chemotherapy can lead to eating disorders. Nutritional specialists provide supportive care by intervening based on these symptoms. However, individual patients have diverse taste complaints, making assessment difficult. Recently, dietary apps have been developed that offer dietary recommendations and enable patients to record meals based on the patient's condition. In this study, we utilized a dietary app to record meals and quantify taste. The aim was to objectively assess the details of taste for AEs related to eating disorders. Methods: Patients diagnosed with gastrointestinal cancer between March 2021 and June 2022 at our hospital who received chemotherapy were included in the study. Patients searched for food recommendations using the dietary app according to their symptoms and recorded their meals. For each meal, the amount of intake and taste were recorded. Taste was recorded on a scale of 1-100 for sweet, salty, sour, bitter, umami, and spicy, with 1 indicating the weakest flavor and 100 the strongest. AEs that could cause eating disorders were assessed using CTCAE ver. 5.0 and taste was examined for each AE. Results: A total of 18 patients (9 with esophageal cancer, 8 with colorectal cancer, and 1 with gastric cancer) were enrolled in this study. Palliative chemotherapy was given to 9 patients and preoperative chemotherapy to 9. AEs (any grade) related to chemotherapy-induced eating disorders were anorexia in 13 patients, dysgeusia in 12, nausea in 10, and oral mucositis in 7. Median food intake and taste scores for all patients were 95.7%, sweet 50.1, salty 50.6, sour 49.6, bitter 48.4, umami 52.0, and spicy 49.5. When assessed by CTCAEs, the following were found: anorexia 94.0%, sweet 49.8, salty 50.7, sour 48.5, bitter 48.0, umami 52.0, spicy 47.0; dysgeusia 95.7%, sweet 48.3, salty 51.3, sour 48.0, bitter 46.2, umami 53.2, spicy 45.6; nausea 92.0%, sweet 50.1, salty 50.6, sour 49.4, bitter 45.8, umami 50.3, spicy 46.4; and oral mucositis 94.1%, sweet 47.6, salty 50.4, sour 47.0, bitter 48.9, umami 52.0, spicy 47.0. Compared with all patients, in anorexia there were no obvious sensitivities for any tastes, but the intake amount was decreased. In dysgeusia, patients less strongly perceived sweet and spicy, but more strongly perceived salty and umami. In nausea, the patients ate less and less strongly perceived bitter, umami, and spicy. In oral mucositis, sweet and sour tastes were perceived less strongly. Conclusions: By using a dietary app, detailed taste could be quantified for chemotherapy AEs related to eating disorders. Further large-scale studies may be needed. Clinical trial information: UMIN000046647 .

Long-Term Dysfunction of Taste Papillae in SARS-CoV-2

BackgroundWe sought to determine whether ongoing taste disturbance in the postacute sequelae of coronavirus disease 2019 period is associated with persistent virus in primary taste tissue.MethodsWe performed fungiform papillae biopsies on 16 patients who reported taste disturbance lasting more than 6 weeks after molecularly determined severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Then, on multiple occasions, we rebiopsied 10 of those patients who still had taste complaints for at least 6 months postinfection. Fungiform papillae obtained from other patients before March 2020 served as negative controls. We performed hematoxylin and eosin staining to examine fungiform papillae morphology and immunofluorescence and fluorescence in situ hybridization to look for evidence of persistent viral infection and immune response.ResultsIn all patients, we found evidence of SARS-CoV-2, accompanying immune response and misshapen or absent taste buds with loss of intergemmal neurite fibers. Six patients reported normal taste perception by 6 months postinfection and were not further biopsied. In the remaining 10, the virus was eliminated in a seemingly random fashion from their fungiform papillae, but four patients still, by history, reported incomplete return to preinfection taste perception by the time we wrote this report.ConclusionsOur data show a temporal association in patients between functional taste, taste papillae morphology, and the presence of SARS-CoV-2 and its associated immunological changes. (Funded by Intramural Research Program/National Institute on Aging/National Institute of Allergy and Infectious Diseases/National Institutes of Health; ClinicalTrials.gov numbers NCT03366168 and NCT04565067.)

Association of anosmia and neutralizing antibody production in adolescents with SARS-CoV-2.

To monitor olfactory/gustatory dysfunction and its relationship to SARS-CoV-2 IgG antibody responses in an adolescent population. Adolescents with changes in olfactory/gustatory functions were enrolled in a 15-month study. The patients were evaluated with 1) SNOT-22, 2) pediatric smell wheel, and 3) SARS-CoV-2 antibody testing. The relationship between these scores and length of anosmia, and the amount of SARS-CoV-2 IgG antibodies were assessed. A brain MRI was performed in cases of persistent special sensory symptoms. Eighteen patients were identified with smell and/or taste complaints. Most of the patients were female (67%) and median age was 15 years (range 11-17). Twelve patients had prior SARS-CoV-2 PCR testing, with only five patients with a positive result. The median SNOT-22 score was 16 (range 0-52) and the median smell wheel score was 6.5 (range 1-11). Patients with taste difficulty were more likely to have a score less than eight. 78% of the patients tested positive for antibodies and there was a strong negative correlation between smell wheel score and antibody level (Spearman, ρ=-0.798, p=0.002). Five patients underwent MRI scan, and all resulted as normal olfactory bulb structures. 66% received nasal corticosteroids. 11 patients presented in follow up. Adolescents presenting to a pediatric ENT clinic during the SARS-CoV-2 pandemic were likely to have prolonged (>6 weeks) symptoms of SARS-CoV-2. The majority do not report positive PCR testing result but do report systemic symptoms including anosmia. This suggests that anosmia may be both a late and prolonged symptom of SARS-CoV-2.

Anosmia/hyposmia differences between severe acute respiratory syndrome coronavirus 2 variants; objective olfactory function evaluation

Objectives: This study aimed to investigate whether the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants cause more or less loss of smell than the wild type variant as a clinical finding that may guide physicians in addition to the increased mortality feature. Patients and Methods: In the prospective study, Connecticut Chemosensory Clinical Research Center (CCCRC) odor testing was performed on patients hospitalized for coronavirus disease 2019 (COVID-19) between May 2021 and December 2021, and variants of SARS-CoV-2 isolated from patients were analyzed. A total of 51 patients (30 males and 21 females; mean age 59.3±14.2 years; range, 29 to 88 years) were included in the study. Age, sex, and COVID-19 vaccine status of the patients were recorded. The patients were asked whether they had new-onset odor or taste complaints and whether they differently perceived smells they knew. Results: The delta variant was detected in 14 patients, the alpha variant was detected in 20 patients, and no variant of concern was detected in 17 patients. Odor disorders were present in 79.4% of all patients (13.73% anosmia, 15.69% severe hyposmia, 13.7% moderate hyposmia, and 37.2% mild hyposmia). There was no statistically significant difference between sex, age, smoking habits, presence of parosmia, degree of smell disorder, and Vicks definition results according to the variants (p&gt;0.05). A statistically significant difference was found between alpha and delta variants in terms of patients' complaints of decreased smell and taste, mean olfactory threshold value, and mean olfactory score variables (p&lt;0.05). There was no difference in terms of age and identification score. The complaints of smell and taste disorders, the mean threshold value of odor, and the mean odor score were found to be significantly lower in the delta variant than in the alpha variant. Conclusion: SARS-CoV-2 variants differ significantly in olfactory dysfunction. Future clinical and laboratory studies may show the diagnostic, clinical, and prognostic significance of olfactory nerve injury.

Black‐brown hairy tongue: An unusual adverse effect of linezolid

AbstractLinezolid‐induced black hairy tongue (BHT) is an uncommon side effect. We present a case of linezolid induced BHT and evaluate relevant literature from the home and worldwide. Its goal is to offer a secure and appropriate foundation for clinical drug usage. A 23‐year‐old male with recurrent boil infection erroneously reported by gram‐positive methicillin‐resistant Staphylococcus aureus (MRSA) by pus culture, which was misdiagnosed by a small clinic (diagnostic center) in a rural region of Bangladesh where he had previously been treated for that reoccurring boil infection. The patient was actually suffering from a different pus‐forming bacteria (Klebsiella), a gram‐negative bacterium that was just found after careful C/S report. Linezolid was administered to the patient 600 mg q12h orally in tablet after discharge from that rural clinic. On the 14th day following oral treatment, the patient presented to the hospital with BHT but no other atypical taste complaints. However, all symptoms were tolerable, and he finished the linezolid treatment period. After withdrawing from the medicine, all tongue symptoms vanished. Following a thorough study, it was determined that this patient had BHT brought on by drug linezolid. Long‐term linezolid usage is associated with neuropathies and bone marrow suppression. There is, however, little information about an uncommon adverse effect, black hairy tongue. We present here a case of linezolid induced BHT in a patient who was misdiagnosed. Also covered are the etiology, pathophysiology, diagnosis, and management of black hairy tongue.

Клинические проявления предраковых состояний желудка: особенности и предостережения

Актуальность. Хронический гастрит в значительной степени связан с клиническими проявлениями в виде диспепсии, однако часто даже в тяжелой форме протекает бессимптомно, что и обусловливает трудности его своевременной диагностики. Взаимосвязь клинических проявлений функциональной диспепсии и гастрита до сих пор вызывает ряд противоречий в связи с неопределенностью формы коморбидности. Цель исследования: изучить клинические проявления у пациентов с предраковыми состояниями слизистой желудка с учетом симптомокомплексов гастроэзофагеального рефлюкса (ГЭР) и функциональной диспепсии — синдрома эпигастральной боли (СЭБ) и постпрандиального дистресс-синдрома (ПДС). Материалы и методы. Обследовано 79 пациентов, которые по результатам морфологического исследования биоптатов разделены на группы: 1 группа (n = 13) — атрофические изменения слизистой оболочки желудка; 2 группа (n = 20) — кишечная метаплазия только в антральном отделе; 3 группа (n = 33) — диффузная кишечная метаплазия; 4 группа (n = 13) — пациенты с дисплазией. При изучении клинической картины анализировали базовые характеристики наличия, частоты и степени выраженности основных жалоб пациентов. Степень выраженности определяли по 5-балльной шкале Лайкерта. Все симптомы были сгруппированы в симптомокомплексы, характерные для ГЭР и для функциональной диспепсии с определением ПДС и СЭБ согласно Римским критериям. Результаты. Проявления функциональной диспепсии во всех случаях сочетались с клинической симптоматикой ГЭР. По интенсивности симптомов у всех обследованных доминировали симптомы функциональной диспепсии с преобладанием ПДС. Для пациентов с мультифокальной кишечной метаплазией характерной является максимальная симптоматика ГЭР, что в три раза больше, чем у пациентов с атрофией (р &lt; 0,05). Также при мультифокальной кишечной метаплазии наблюдается максимальная частота симптомов как ПДС (71,4 %), так и СЭБ (63,6 %). При дисплазии ведущее значение имеют проявления ПДС — максимальное количество симптомов у 63,6 %, при этом частота СЭБ значительно меньше, чем у пациентов других групп (45,4 %). Для пациентов с дисплазией характерна максимальная интенсивность жалобы на горечь во рту по сравнению с пациентами с кишечной метаплазией в антральном отделе (р &lt; 0,01) и максимальная выраженность тошноты, что достоверно больше по сравнению с пациентами с кишечной метаплазией в антральном отделе (р &lt; 0,01) и с мультифокальной метаплазией (р &lt; 0,01). У пациентов с дисплазией выражена интенсивность негативного влияния симптомов на выполнение работы днем, которая была достоверно выше, чем у пациентов с атрофией (р &lt; 0,05) и мультифокальной кишечной метаплазией (р &lt; 0,01). Выводы. Клиническая симптоматика у пациентов с предраковыми состояниями и изменениями слизистой желудка характеризуется многообразием клинических проявлений функциональной диспепсии и не исключает проявлений ГЭР, что ставит под сомнение оценку состояния пациента без проведения эзофагогастродуоденоскопии и гистологического исследования для должной верификации диагноза. Особого внимания требуют пациенты с симптомами ГЭР, которые не исключают атрофических и перестроечных процессов в слизистой оболочке желудка.

The association between changes of gustatory function and changes of salivary parameters: A pilot study.

The aim of the pilot study was to explore which of the salivary parameters best reflects improvement or deterioration of taste function. A total of 14 patients were included. Taste ability was measured using taste strips and patients rated their symptom strength using visual analogue scales. Salivary parameters (flow rate, total proteins, proteolysis, catalase, total anti-oxidative capacity [TAC], carbonic anhydrase VI [caVI], and pH) were determined and the Beck Depression Inventory (BDI) was administered. All these parameters were measured twice with a one-year interval to acquire the changes of data. Patients with decreased taste function exhibited a decrease in salivary proteolysis and caVI, and an increase in salivary total protein. Patients with increased taste function also showed an increase in salivary total protein. Δ Salivary flow rate was negatively correlated with Δ taste strip scores. Δ Salivary pH was significantly lower in patients with increased taste function compared to patients with decreased taste function. Δ BDI was positively correlated with both Δ symptoms ratings. Across all patients, symptom ratings decreased while salivary total protein increased; salivary flow rate, proteolysis and caVI decreased significantly compared with baseline. The present longitudinal results suggest that changes of both taste function and taste complaints were accompanied by changes in salivary parameters, indicating that salivary parameters have the potential to be useful in the diagnosis of patients with qualitative taste disorders.

The addition of silver nitrate cautery to antiseptic nasal cream for patients with epistaxis: A systematic review and meta-analysis

ObjectiveTo compare the outcomes of the addition of silver nitrate cautery versus antiseptic cream alone in paediatric patients with recurrent epistaxis. MethodsA systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and a search of electronic information was conducted to identify all Randomised Controlled Trials (RCTs) and non-randomised studies comparing the outcomes of the addition of silver nitrate cautery versus antiseptic cream alone in paediatric patients with recurrent epistaxis. Treatment success and persistence of bleeding were primary outcome measures. Secondary outcome measures included treatment side effects. Fixed effects modelling was used for the analysis. ResultsFour studies enrolling 240 patients were identified. There was no significant difference between silver nitrate cautery group and antiseptic cream alone group in terms of complete resolution (Odds Ratio [OR] = 1.07, P = 0.81), the partial resolution (OR = 1.02, P = 0.96) and persistence of bleeding (OR = 0.91, P = 0.71). For secondary outcomes, antiseptic nasal cream was associated with few side effects such as rash in one case and several complaints of bad smell or taste. ConclusionsThe addition of silver nitrate cautery is not superior to the use of antiseptic cream alone in paediatric patients with recurrent epistaxis as it does not improve treatment success or persistence of bleeding.

Clinical Characteristics and Gustatory Profiles in Patients with Subjective Taste Complaints

Other SectionsAbstractINTRODUCTIONMATERIALS AND METHODSRESULTSDISCUSSIONSupplementary MaterialCONFLICT OF INTERESTFigureTableReference

Etiology of subjective taste loss.

Taste complaints are commonly encountered in clinical practice. Although changes in taste function may arise from varied etiologies, numerous other factors may impact patients' taste perceptions, the most common of which is olfactory dysfunction. Thus, patients with taste complaints may or may not have measurable deficits in taste function. This poses a challenge to providers faced with evaluation of patients with taste disorders, and may delay diagnosis and management. We retrospectively examined records of 1108 patients evaluated at the Virginia Commonwealth University Health System Smell and Taste Clinic and compared patients' subjective taste complaints with results of objective testing of the senses of taste and smell. A total of 358 patients had a subjective taste complaint and results from both gustatory and olfactory function tests. Patients were grouped by subjective complaint as "taste only" (n = 63) or "taste and smell" (n = 295). Of patients reporting a "taste-only" complaint, 25.4% had abnormal gustatory function, whereas 44.4% had abnormal olfactory function. For those reporting taste-and-smell complaints, only 9.5% had abnormal gustatory function, whereas 86.8% had abnormal olfactory function. This study supports the hypothesis that patients who present with a taste complaint are more likely to have an underlying olfactory than gustatory impairment. However, those with a taste-only complaint are more likely to have objective gustatory deficits than those with a taste-and-smell complaint. These findings may prove useful to healthcare providers who evaluate patients presenting with complaints of taste loss.

Physicochemical parameters affecting the perception of borehole water quality in Ghana.

Rural Ghanaian communities continue using microbiologically contaminated surface water sources due in part to undesirable organoleptic characteristics of groundwater from boreholes. Our objective was to identify thresholds of physical and chemical parameters associated with consumer complaints related to groundwater. Water samples from 94 boreholes in the dry season and 68 boreholes in the rainy season were analyzed for 18 parameters. Interviews of consumers were conducted at each borehole regarding five commonly expressed water quality problems (salty taste, presence of particles, unfavorable scent, oily sheen formation on the water surface, and staining of starchy foods during cooking). Threshold levels of water quality parameters predictive of complaints were determined using the Youden index maximizing the sum of sensitivity and specificity. The probability of complaints at various parameter concentrations was estimated using logistic regression. Exceedances of WHO guidelines were detected for pH, turbidity, chloride, iron, and manganese. Concentrations of total dissolved solids (TDS) above 172mg/L were associated with salty taste complaints. Although the WHO guideline is 1000mg/L, even at half the guideline, the likelihood of salty taste complaint was 75%. Iron concentrations above 0.11, 0.14 and 0.43mg/L (WHO guideline value 0.3mg/L) were associated with complaints of unfavorable scent, oily sheen, and food staining, respectively. Iron and TDS concentrations exhibited strong spatial clustering associated with specific geological formations. Improved groundwater sources in rural African communities that technically meet WHO water quality guidelines may be underutilized in preference of unimproved sources for drinking and domestic uses, compromising human health and sustainability of improved water infrastructure.

Disgeusia: a propósito de um caso clínico

Introduction: The distortion of the sense of taste (dysgeusia), transient or permanent, may have significant impact on the lives of patients. It may be associated with weight loss, anorexia, malnutrition, depressive symptoms, and a significant reduction in quality of life. Dysgeusia can have several causes. One surgical cause is tonsillectomy. Case description: A 38 year-old female patient, with dysgeusia is presented. She had a history of bilateral chronic tonsillitis and a cold blade tonsillectomy was performed with electrocautery of tonsillar hemorrhages without complications. After surgery she complained of dysgeusia characterized by lack of taste discrimination, stating that all foods seemed bitter. Six months after surgery, at a follow-up consultation, her gustatory function was evaluated with taste strips. This revealed changes in taste discrimination. She experienced a bitter taste, even when stimulated with sour, sweet or salty stimuli. The patient began daily gustatory rehabilitation, working on mental associations with sensory stimuli. She repeated the gustometry one year after surgery. The patient improved, although selective dysgeusia persisted with a bitter sensation in the presence of salt at low concentration. Comment: Dysgeusia is a rare complication of tonsillectomy, but can have great impact on the lives of patients. The surgical procedure can damage sensory nerves responsible for taste, directly or indirectly. There are few therapeutic options. Cases are under reported in the literature, and tend to be benign. Dysgeusia can have various causes, such as antihypertensive drugs, poor oral hygiene, surgery, infection, smoking, diabetes, autoimmune diseases, anti-microbial agents, and anti-inflammatory drugs. In primary health care, taste complaints often have no obvious explanation at the initial presentation. In Portugal there is no data on their incidence. It is important to sensitize clinicians to this disease. Patients’ complaints about changes in taste should be addressed because of the impact that it has on the quality of life and possible treatable causes. Patients with dysgeusia require assessment, advice and treatment.

Subtotal glossectomy preserving half the tongue base prevents taste disorder in patients with tongue cancer

Most patients diagnosed with tongue carcinoma undergo surgical resection and reconstructive surgery to preserve tongue mobility and swallowing functions. Twenty-four patients who underwent a total or subtotal glossectomy and surgical reconstruction were evaluated for residual taste sensation. The graded filter paper test for all four tastes (sweet, salt, sour, and bitter) was performed on the posterior wall of the oropharynx and on tongue remnants if they were visible from the mouth. Eleven of the 24 patients were aware of their taste disorder after surgery. Four patients with more than 1/2 residual tongue base had no taste complaints, whereas seven of 14 patients with less than 1/3 residual tongue base reported taste abnormalities. Patients who could only tolerate a poor diet or tube feeding tended to have taste complaints (P=0.017). The taste test showed that the taste threshold of the residual tongue was significantly lower compared to controls. The taste threshold was significantly correlated with the remaining volume of tongue base. Patients with >1/2 the tongue base remaining had good taste sensation, whereas those with <1/3 residual tissue had impaired taste. This study suggests that glossectomy strategies aimed at preserving at least half the tongue base may substantially reduce dysgeusia in the patients.

Oral findings in postmenopausal women attending dental hospital in western part of India.

Objectives: To know the nature, incidence and severity of oral manifestations occurring in postmenopausal women. Study design: Oral changes were observed in 365 postmenopausal women and 365 age matched male individuals attending the department of Oral Medicine and Radiology. The patients were asked about complaints of dry mouth, taste and breath changes, mucosal and facial pain and were examined for oral changes such as ulceration, white and red lesions. The results obtained from the study were then correlated with various other similar studies. Results: The important oral findings in postmenopausal women were mucosal burning/pain (25.8%), dry mouth (27.1%), altered taste (3.6%), altered breath (6.3%) and facial pain (3.6%). Oral submucous fibrosis (OSMF) was significantly more common in males (5.5%) as compared to postmenopausal females (1.9%). Conclusion: Results from the present study reveal that oral symptoms are common problems in postmenopausal women. Postmenopausal patients showed significantly more oral changes than the control. These changes could be related to the hormone alterations. Therefore, dentists need to refer postmenopausal women with oral symptoms to a gynaecologist for more careful examinations and medical interventions if necessary. Key words:Menopause; postmenopause; xerostomia; pallor; oral changes.

Evaluation of gustatory function in HIV‐infected subjects with and without HAART

Alteration in gustatory function among patients with human immunodeficiency virus (HIV) infection is sparsely studied and provides contradictory findings. The objectives of the study were to evaluate taste perversion in HIV-infected subjects and compare taste acuity between patients with and without Highly active antiretroviral therapy (HAART). Fifty HIV-infected subjects aged 25-55 years were selected and divided into two subgroups: patients with HAART and patients without HAART. Control group included 50 healthy, age-, sex-, gender-, and socioeconomic status-matched individuals. Taste complaints were recorded on a structured questionnaire, and formal taste testing was carried out with triadic forced choice whole-mouth, above-threshold taste test for four tastants - sweet, salt, sour, and bitter. Taste identification, detection threshold, and intensity of tastant were recorded. Twenty-four (48%) among study group complained of taste perversion when compared to none among the control group (P < 0.001). During taste testing, identification and intensity scores were lower, while detection threshold scores for four tastants were higher in study group than in control group (P < 0.05). Among those patients with taste complaints, 16 were with HAART, while eight were without HAART (P = 0.043). Formal taste testing revealed greater taste perversion for sour and bitter tastants among patients with HAART medication. The results document significant taste losses in HIV-infected subjects, and HAART contributes considerably to such taste perversion.

Colitis in Elderly: An Atypical Presentation of Collagenous Colitis in an Elderly Female

Purpose: Background: 87 y/o Caucasian female with history of Hypertension, Hyperlipidemia, Vitamin D deficiency, osteoporosis, NSAID use, GERD, eczema was first seen in GI clinic 6 months ago for complaints of sour taste, dry mouth, intermittent watery non-bloody diarrhea, anorexia, fatigue, significant weight loss for the last 4 months. Abdominal exam was unremarkable. Methods: Lab profile including stool studies, thyroid function tests, amoeba antibody, serum transglutaminase/endomysial antibodies was negative. EGD revealed gastric atrophy and biopsy results were significant for Candidal esophagitis, H. pylori negative gastritis and duodenitis. Colonoscopy was suggestive of pancolitis mimicking ulcerative colitis, but the pathology was found to be consistent with collagenous colitis. A presumptive diagnosis of collagenous colitis versus IBD was entertained and patient was prescribed Loperamide, Mesalamine, Alendronate, Fluconazole, Prednisone and Azathioprine added later on as steroid sparing agent. Her treatment course was complicated by repeated admissions for recurrent flares on weaning steroids, Clostridium difficile colitis, compression vertebral fracture and prolonged use of steroids. Results: The case illustrates an atypical presentation of collagenous colitis in an elderly woman with evidence of pancolitis on colonoscopy. Conclusions: Collagenous colitis and lymphocytic colitis are clinically categorized under microscopic colitis with a predominant female sex predisposition. Most affected patients present in fourth decade of life and hence is more clearly documented in young adults. These patients typically have normal colonoscopies and diagnosis is made only on pathology. Our patient is atypical because of her late presentation in the eighth decade and colonoscopy findings of pancolitis suggestive of Inflammatory Bowel Disease.Figure: Friable, erythematous, edematous, loss of normal vasculature throughout with scattered superficial ulcerations.

Double Stellate Tongue Reduction

Although multiple methods of tongue reduction have been described, recent literature suggests that the central reductions may be more favorable in patients with Beckwith-Wiedemann syndrome (BWS). In this case series, we review our experience with macroglossia associated with BWS, and we offer a new technique of central tongue reduction. Between 1993 and 2007, a retrospective chart review was conducted to include all patients with a diagnosis of BWS who have undergone stellate or double stellate tongue reduction at the Children's Hospital of Wisconsin. A total of 7 patients met all inclusion criteria. All patients had good tongue mobility at 1-year follow-up. One patient required speech therapy for persistent articulation errors postoperatively. A total of 2 patients required secondary procedures for recurrent macroglossia. There were no complaints of abnormal taste or sensation. The stellate and double stellate tongue reductions provide effective treatment in macroglossia associated with BWS.