Olfactory and gustatory functions after free flap reconstruction and radiotherapy for oral and pharyngeal cancer: a prospective follow-up study

Lilja, Markus; Markkanen‐Leppänen, Mari; Viitasalo, Sanna; Saarilahti, Kauko; Lindford, Andrew; Lassus, Patrik; Mäkitie, Antti

doi:10.1007/s00405-018-4883-x

Cited by 11 publications

(17 citation statements)

References 18 publications

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“…HNC surgery may also cause significant oral cavity or upper gastrointestinal tract swelling during first postoperative days inhibiting oral food intake [1]. It is also reported recently by Lilja et al that HNC free flap surgery affecting oral cavity may impair taste sensation which affects negatively oral food intake [20]. Moreover, growing HNC tumor may develop upper gastrointestinal tract obstruction which causes difficulties in swallowing and furthermore induces patients to eat less than without the illness [11].…”

Section: Discussionmentioning

confidence: 93%

Causes of nutrition deficit during immediate postoperative period after free flap surgery for cancer of the head and neck

Nurkkala

Lahtinen

Kaakinen

et al. 2020

Eur Arch Otorhinolaryngol

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The aim of the present of study was to examine nutrition deficit during the immediate postoperative in-hospital period following free flap surgery for cancer of the head and neck (HNC). Underfeeding and malnutrition are known to be associated with impaired short-and long-time recovery after major surgery. Methods This single-center retrospective cohort study included 218 HNC patients who underwent free flap surgery in Oulu University Hospital, Finland between the years 2008 and 2018. Nutrition delivery methods, the adequacy of nutrition and complication rates were evaluated during the first 10 postoperative days. Results A total of 131 (60.1%) patients reached nutritional adequacy of 60% of calculated individual demand during the follow-up period. According to multivariate analysis, nutrition inadequacy was associated with higher ideal body weight (OR 1.11 [1.04-1.20]), whereas adequate nutrition was associated with higher number of days with oral food intake (OR 0.79 [0.67-0.93]). Conclusion Inadequate nutrition is common after HNC free flap surgery. The present results suggest that more adequate nutrition delivery might be obtained by the early initiation of oral food intake and close monitoring of nutrition support.

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Section: Discussionmentioning

confidence: 93%

Causes of nutrition deficit during immediate postoperative period after free flap surgery for cancer of the head and neck

Nurkkala

Lahtinen

Kaakinen

et al. 2020

Eur Arch Otorhinolaryngol

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“…440 titles and abstracts were screened with 33 papers reviewed at the full text stage. Two full-text studies were excluded; the first paper mixed patients from both a surgical and RT cohort [9] and the second had no structured protocol [10] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Association between taste loss and diminished appetite, sweet taste loss and use of sweeteners, salt taste loss and use of spices. Zheng [9] 2002 Recognition threshold and suprathreshold taste intensity performance using the whole-mouth taste method for 4 basic tastes Pre-RT, at 10 Gy intervals and at 6 months or Pre-RT, at 30 Gy and 6 months 6 months post-RT Taste loss worst at 30 Gy, beginning to recover by 50 Gy, fully recovered by 6 months. Bitter most affected.…”

Section: Monthmentioning

confidence: 99%

Taste dysfunction following radiotherapy to the head and neck: A systematic review

Gunn

Gilbert²,

Nenclares

et al. 2021

Radiotherapy and Oncology

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Background: An intact sense of taste provides pleasure, supports sustenance and alerts the body to toxins. Head and neck cancer (HNC) patients who receive radiotherapy (RT) are high-risk for developing radiation-induced taste dysfunction. Advances in RT offer opportunities for taste-preserving strategies by reducing dose to the gustatory organs-at-risk. Methods: PubMed, Medline and EMBASE were searched for publications reporting on taste, RT and HNC. Randomised trials, cohort studies and cross-sectional studies were included. Results: 31 studies were included in this review. Meta-analysed prevalence of acute taste dysfunction following RT was approximately 96% (95% CI 64 to 100%) by objective measures and 79% (95% CI 65 to 88%) by subjective measures, with the majority of patients showing at least partial recovery. Long-term dysfunction was seen in~25% of patients. Taste dysfunction was associated with sequalae including weight loss and reduced quality-of-life (QoL). Taste dysfunction was more common when the oral cavity, and specifically the anterior two-thirds of the tongue, was irradiated, suggesting a dose constraint for taste preservation might be feasible. Proton beam therapy and customised bite blocks reduced dose to the gustatory field and subsequent loss of taste. Conclusions: Taste dysfunction following RT is common and negatively affects patients' nutritional status and QoL. Decisions about treatment strategies, including choice of RT modality, dose distribution across the gustatory field and the use of adjuncts like bite blocks may be beneficial. However, evidence is limited. There is a pressing need for randomised studies or large prospective cohort studies with sufficient adjustment for confounders.

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“…After eliminating, based on a review of titles and abstracts, 58 non-head, and neck references (N= 41 (>80% breast)), references addressing salvage flap 59 surgery after prior radiotherapy (N= 25), and neoadjuvant radiotherapy and delayed 60 reconstruction (N= 5), there remained 15 articles. These included three case reports in English 61 or other language (N=1) (evidence-based grade C), five retrospective series of 13 to 100 62 patients [24,25,32-34] (grade C) and seven prospective series of 12 to 44 patients [33,[35][36][37][38][39][40], 63 addressing flap changes (N=2) or functional and quality of life outcomes (N=5)(grade B). 64…”

Section: Materials and Methods 52mentioning

confidence: 99%

Recommendations for postoperative radiotherapy in head & neck squamous cell carcinoma in the presence of flaps: A GORTEC internationally-reviewed HNCIG-endorsed consensus

Carsuzaa

Lapeyre

Grégoire

et al. 2021

Radiotherapy and Oncology

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Olfactory and gustatory functions after free flap reconstruction and radiotherapy for oral and pharyngeal cancer: a prospective follow-up study

Cited by 11 publications

References 18 publications

Causes of nutrition deficit during immediate postoperative period after free flap surgery for cancer of the head and neck

Causes of nutrition deficit during immediate postoperative period after free flap surgery for cancer of the head and neck

Taste dysfunction following radiotherapy to the head and neck: A systematic review

Recommendations for postoperative radiotherapy in head & neck squamous cell carcinoma in the presence of flaps: A GORTEC internationally-reviewed HNCIG-endorsed consensus

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