Taste Disorders

Abstract

Α 42-year-old female was seen at the ENT outpatient clinic on her first follow up after a combination of chemotherapy and radiotherapy treatment for a T3N0M0 SCC of the palate. She had her last radiotherapy treatment completed about 1 month ago, and following that, she reported a constant “metallic taste” and a general disordered sense of taste. Quoting the patient’s description, “everything tasted flavorless, indifferent, flat, and slightly metallic and only when excessive salt was added, there was a very light pinch of flavor.” Although taste impairment reduced her appetite, the patient reported only minimal weight loss. History taking included detailed questions on potential olfactory loss, yet the patient denied any symptoms from her perspective. Clinical examination revealed evidence of dried oral mucosa (xerostomia) with no presence of ulcers or mucositis; however, a slightly erythematous appearance of the tongue surface was noted. Bimanual examination of salivary glands revealed moderately decrease saliva flow. Dental hygiene was satisfactory, and the rest of the head and neck examination did not show remarkable findings. The patient was reassured as she was communicated that usually 6 months to 1 year after radiotherapy, taste sensation recovers to its previous level. Self-coping strategies were suggested including increasing water intake, frequent teeth brushing, mouth rinse before meals with salt-water or ginger ale, avoid smoking, and selecting foods with strong flavors including lemon, spices or pickled foods. As taste changes can impact the enjoyment of eating or drinking and potentially lead to malnutrition, small, frequent meals and snacks, attractive presentation of foods and preferring enjoyable high calories strong-flavored puddings, sauces or gravies were also encouraged. The patient was also referred to a cancer center dietitian for help with food selections. On her following follow-up appointments, the patient reported satisfactory gradual improvement.