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Patients with Oropharyngeal Cancer Report Taste Changes Following TORS

by Linda Kossoff •

CLINICAL QUESTION

How prevalent are taste disorders (TDs) following transoral robotic surgery (TORS) in patients with oropharyngeal cancer as compared to healthy controls?

BOTTOM LINE

Self-reported taste changes in patients with oropharyngeal cancer who have had TORS are frequent; suspension time and glossopharyngeal nerve injury (GNI) are unlikely to cause symptomatic TDs.

BACKGROUND: TDs are common in patients with head and neck cancer (HNC) following chemotherapy (CT) and/or radiation therapy (RT). The TORS procedure for oropharyngeal squamous cell carcinoma (OPSCC) can involve GNI and longer tongue retraction from suspension, possible causes of TDs. The effects of surgery on taste are understudied.

STUDY DESIGN: Cohort study.

SETTING: Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St. Louis, Mo.

SYNOPSIS: Researchers conducted a study of pre- and post-TORS nested within a larger cohort study of patients receiving treatment for new oropharyngeal cancer compared to healthy controls. They recruited 37 patients with oropharyngeal cancer (91.9% male, mean age 61.4 years) who were receiving TORS and 32 healthy controls (71.9% male, mean age 63.8 years). Participants underwent posterolateral and whole-mouth psychophysical taste tasting at baseline and at two weeks postoperatively (patients) or follow-up (controls). A Clinical Global Impression (CGI) of taste symptoms was completed at each session. Most participants (65/69) had normal baseline taste. Postoperatively, approximately two-thirds of tumor patients reported worsened taste. Compared with controls, patients with tumors had decreased taste identification on the tumor-ipsilateral side of the tongue. Suspension time and GNI were not associated with worsened taste. Patients with GNI had lower rates of phantogeusia than those without, suggesting that taste symptoms after surgery are not caused by distal glossopharyngeal nerve transection or tongue retraction. Study limitations included the short follow-up time.

CITATION: Tharakan T, Piccirillo JF, Miller B, et al. Acute taste dysfunction in oropharyngeal cancer patients after transoral robotic surgery. Laryngoscope. 2023;133:3520–3528.