Assessment of the gustatory function in patients with advanced oral cavity and oropharyngeal cancer

Abstract

Purpose: The changes in gustatory function resulting from oncological treatment occur mainly after radiotherapy. However, the head and neck tumors, because of the anatomical location of the lesion, can themselves trigger significant changes in the feeding-related functions - including taste. To assess the gustatory function in patients diagnosed with advanced oral cavity and oropharyngeal cancer. Method: This descriptive cross-sectional study comprised 31 individuals with advanced oral cavity and oropharyngeal cancer, referred for oncological treatment with radiotherapy, either alone or in combination with chemotherapy. The “taste strips” test was applied; it consists of inserting solutions with four different concentrations each for salty, sweet, and sour tastes, and three concentrations for the bitter taste, on the tongue. Results: Most of the individuals were diagnosed with oropharyngeal cancer. Approximately half of the sample already had taste-related complaints, and more than 80%, swallowing-related complaints. The overall frequency of hypogeusia was 38.7%, in which the bitter taste stood out in its isolated assessment. The association of change in gustatory function proved to be significant in patients in stage T4. Conclusion: The decrease in gustatory function in individuals with oral cavity and oropharyngeal cancer was evidenced in this study, especially when associated with tumors in stage T4. Regarding feeding, most of them reported complaints of dysphagia, suggesting the importance of the speech-language-hearing assessment and follow-up, even before the oncological treatment, to minimize the risks of dysphagia.

Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review

“…Diagnosis of dysgeusia can be obtained by objective and subjective methods. The objective methods used are chemical gustometry [6,10,13,18,35] and electrogustometry (EGM). The first can be performed through paper strips or aqueous solutions.…”

“…Smoking, altering the gustatory function, affects taste differentiation. This suggests that the smokers' gustatory recognition is lower than non-smokers, making it necessary to increase the concentration of the proposed stimulus for proper recognition of taste [13]. The toxicity of multimodal treatments significantly affects the gustatory acuity of OSCC and OPSCC patients.…”

“…Their side effects include a wide range of acute and late toxicities, such as orofacial pain, oral fibrosis and/or mucositis, dysphagia, dysgeusia, xerostomia, salivary impairments, osteonecrosis of the jaws, nausea, fatigue, and dermatitis. These alterations can become chronic issues and negatively influenced patients' quality of life (QOL) [6][7][8][9][10][11][12][13]. Taste disorders include hypogeusia (reduced taste sensation), ageusia (loss of taste sensation), dysgeusia (altered taste sensation), phantogeusia (taste alteration without external stimulus) and parageusia (distortion to a specific stimulus).…”

“…Each taste bud contains 40-120 cells, classified into taste receptor cells, support cells, and precursor cells. Taste buds are mainly located on the tongue dorsum, but can also be found on the buccal mucosa, floor of the mouth, oropharynx, epiglottis, pharynx, larynx, and in the upper third of esophagus [6,7,13,15,16]. Some taste cells were estimated to have a half-life of 8-12 days, while others reached a 24-day half-life [15,16].…”

“…The proprioceptive sensitivity carries the touch, thermic and positional sensations, as well as the gustatory impressions that enable us to appreciate food taste and quality. Although the oral phase of swallowing is voluntary, it depends on the integration of mechanical (through contact of foods) and chemical (through smell and taste) stimuli, preparing the entire gastrointestinal system to receive the food [13]. Therefore, taste impairment significantly reduces QOL in cancer patients, worsening their dysphagia and their nutritional status, leading to failed healing and postoperative complications.…”