Sunday, April 04, 2010

Taste disturbances following tonsillectomy

Introduction:
Tonsillectomy is a commonly performed surgical procedures these days. Even though it has its
own set of complications, disturbance in taste following surgery should be considered rare.
This article tries to dwell into the possible causes of taste disturbance following tonsillectomy.

Tonsillectomy is a commonly performed surgery these days. It is a reasonable safe surgical procedure
of course with its own set of complications. Certain complications like taste disturbance following tonsillectomy
is very rare. Seiichi Tomofuji et all managed to study the incidence of taste disturbance following tonsillectomy.
They devised a questionnaire to be answered by all tonsillectomy patients as given below:

1. Do you have taste disturbance after surgery ? (yes / no)

2. If the answer is yes what taste is blunted ? (sweet, salt, sour, bitter, umami, and all)

3. Do you feel any change in taste after surgery ? (yes / No)

4. If yes what change you feel ?

5. Do you feel thirsty ? (yes / no)

6. Are you able to eat ?

Based on this questionnaire they came to the conclusion that 1% of all tonsillectomy patients
had some disturbance in taste.

Causes of taste disturbances following tonsillectomy:

1. Injury to the lingual branch of glossopharyngeal nerve when the inferior pole of tonsil is snared

2. Due to pressure of mouth gag on the tongue

3. Zinc deficiency due to poor intake after surgery

4. Possible side effects of post op medicines (certain drugs chelate zinc antibiotics and analgesics)


Phantom taste should always be taken into consideration if lingual branch of glossopharyngeal nerve is
damaged on one side only.

Taste disorders include:

a. Hypogeusia

b. Ageusia

c. Dysgeusia

d. Phantogeusia

Patients usually ignore quantitative taste disorders. It is only the qualitative taste disorder like
persistent bitter / metallic taste that troubles a patient.

Postoperative zinc supplements in these patients may be of help. This is actually the consensus of opinion.

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