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Taste and smell disorders can worsen the nutritional status of patients receiving chemotherapy and potentially affect drug treatment. However, there is limited knowledge on antineoplastic agents that induce taste and smell disorders. Therefore, we used the U.S. Food and Drug Administration Adverse Event Reporting System database to analyze the characteristics of patients and antineoplastic agents in relation to taste and smell disorders. No gender differences related to the onset of taste and smell disorders were found, whereas older age was identified as a possible risk factor. Among the antineoplastic agent classes, protein kinase inhibitors appeared to be particularly likely to induce taste and smell disorders. According to the cluster and principal component analyses, antineoplastic agents were deemed to induce taste or smell disorders. In addition, antineoplastic agents that decreased or changed these sensations could be classified. These findings might be useful in selecting drugs for patients experiencing similar side effects. [ABSTRACT FROM AUTHOR]

Background/Objectives: Taste disorders have a negative impact on meal enjoyment, which is essential for maintaining adequate nutrition and quality of life. Japan is a rapidly aging society with an increasing number of individuals with taste disorders. However, despite the increasing prevalence of taste disorders, the correlation between oral frailty and taste sensitivity remains largely unknown. The objective of this study was to assess the relationship between oral health status and taste sensitivity among the Japanese population. Methods: Participants were recruited from Kanagawa Dental University Hospital Medical–Dental Collaboration Center between 2018 and 2021. The exclusion criteria were severe systemic infections, pregnancy, or lactation. Clinical examinations, oral function assessments, and taste tests were conducted using tap water and 1% sweet, 0.3% salty, 0.03% umami, and 0.1% umami tastants. The relationships between oral function, systemic indicators, and taste sensitivity were statistically evaluated. Results: Of the 169 participants included in this cross-sectional study, 39.6% were male and 60.4% were female (median age, 68 years). Participants with low taste sensitivity showed a decline in tongue–lip motor function, independent of age, sex, or smoking status. A multiple logistic regression analysis conducted using two age categories—younger than 65 years and older than 65 years—revealed an association between tongue–lip motor function and taste sensitivity among participants younger than 65 years. Conclusions: Decreased taste sensitivity is associated with tongue–lip motor function. Therefore, the early maintenance of oral function and taste sensitivity may be beneficial for optimal tongue–lip motor function. [ABSTRACT FROM AUTHOR]

Background: Although patients with advanced pancreatic cancer (PC) often experience dysgeusia with zinc deficiency during chemotherapy, data on zinc supplementation for dysgeusia and its effects on nutritional status are scarce. We aimed to examine the efficacy of zinc supplementation in patients with advanced PC. Methods: Thirty-three patients with unresectable PC who presented with dysgeusia and zinc deficiency during chemotherapy and received zinc acetate hydrate between January 2018 and December 2022 were included. We evaluated the changes in serum zinc levels and the improvement in dysgeusia. Among the 26 patients who received zinc supplementation for 12 weeks, we also compared patient characteristics and changes in serum zinc and albumin levels between patients who showed improvement in dysgeusia (effective group) and those who did not (non-effective group). Results: The serum zinc level increased significantly after zinc supplementation (median: 60 µg/dL at baseline, 99.5 µg/dL at 4 weeks, 101 µg/dL at 8 weeks and 101 µg/dL at 12 weeks). The rate of improvement in dysgeusia increased over time (18.2% at 4 weeks, 33.3% at 8 weeks, and 42.4% at 12 weeks). Comparing the effective group and non-effective group revealed that while the median serum albumin level of the effective group did not change, the non-effective group showed a significant decrease from baseline to 12 weeks (3.2 g/dL to 3.0 g/dL, p = 0.03). Conclusion: Zinc supplementation significantly increased serum zinc levels, improving dysgeusia. Zinc supplementation might also contribute to maintaining nutritional status in patients with unresectable PC. [ABSTRACT FROM AUTHOR]

Prevention and treatment protocols for taste changes observed during hematopoietic cell transplantation (HCT) are not well‐established. The purpose of this study was to assess the efficacy of photobiomodulation (PBM) in relieving taste changes and preventing lingual papillae atrophy. HCT patients received PBM (n = 42) on the tongue dorsum using an InGaAIP laser (660 nm, 100 mW, 1.1 W/cm2, 8.8 J/cm2). During the HCT conditioning (T0), severe neutropenia (T1), and after neutrophil engraftment (T2), taste acuity for sweet, bitter, sour, and salty solutions, and clinical appearance of lingual papillae were compared with those of a placebo group (n = 43). PBM significantly reduced hypogeusia, ageusia, and parageusia at T1 and T2, and also successfully prevented papillae atrophy during all the analyzed HCT periods. In conclusion, PBM enhanced taste acuity during HCT. The decrease in papillae atrophy indicated a potential regenerative effect of this therapy on tongue mucosa. [ABSTRACT FROM AUTHOR]

Introduction This study aims to assess the relationship between use of tobacco products and taste and smell disorders. Methods A secondary dataset analysis of cross-sectional data from the National Health Interview Survey (NHIS) 2021 survey cycle, a nationally representative annual cross-sectional interview of non-institutionalized US civilians, was used. Participants' senses of smell and taste are assessed using self-reported questions. Participants were categorized into five groups based on their tobacco use: nontobacco users; cigarettes only; e-cigarettes only; cigar, pipe, or smokeless tobacco; and poly-tobacco product users. Disorders were defined as any self-reported difficulty in smelling, tasting, or reporting unpleasant odors or persistent tastes. Weighting procedures were used to estimate the national prevalence of taste, smell, and other disorders, stratified by tobacco products used. Adjusted logistic regression models were used to determine the association between tobacco products used and taste or smell compared to non-tobacco users. Results A total of 40.2 million US adults reported experiencing smell or taste disorders. Nearly one in 10 adults reported a taste disorder (9.8%), and 13.4% indicated a smell disorder. The prevalence of taste or smell disorder was higher among females (17.5%), Hispanics (19.5%), individuals identified as ‘other’ racial minorities (21.1%), and lower income groups (21%). Compared to non-tobacco users, the highest odds of experiencing smell or taste disorders were among poly-tobacco product users (adjusted odds ratio, AOR=1.44; 95% CI: 1.31–1.58), followed by e-cigarette-only users (AOR=1.38; 95% CI: 1.02–1.87), cigarette-only smokers (AOR=1.17; 95% CI: 1.04–1.32), and users of cigars, pipes, or smokeless tobacco (AOR=1.15; 1.00; and 1.33; respectively). Conclusions Tobacco product use was associated with an increased risk of smell and taste disorders. The rising use of e-cigarettes among adolescents and young adults is particularly concerning given the limited understanding of the sensory effects of e-cigarettes and their growing popularity among younger populations. The study findings highlight the need for interventions aimed at reducing tobacco use of all kinds.

INTRODUCTION This study aims to assess the relationship between use of tobacco products and taste and smell disorders. METHODS A secondary dataset analysis of cross-sectional data from the National Health Interview Survey (NHIS) 2021 survey cycle, a nationally representative annual cross-sectional interview of non-institutionalized US civilians, was used. Participants' senses of smell and taste are assessed using self-reported questions. Participants were categorized into five groups based on their tobacco use: nontobacco users; cigarettes only; e-cigarettes only; cigar, pipe, or smokeless tobacco; and poly-tobacco product users. Disorders were defined as any self-reported difficulty in smelling, tasting, or reporting unpleasant odors or persistent tastes. Weighting procedures were used to estimate the national prevalence of taste, smell, and other disorders, stratified by tobacco products used. Adjusted logistic regression models were used to determine the association between tobacco products used and taste or smell compared to non-tobacco users. RESULTS A total of 40.2 million US adults reported experiencing smell or taste disorders. Nearly one in 10 adults reported a taste disorder (9.8%), and 13.4% indicated a smell disorder. The prevalence of taste or smell disorder was higher among females (17.5%), Hispanics (19.5%), individuals identified as 'other' racial minorities (21.1%), and lower income groups (21%). Compared to non-tobacco users, the highest odds of experiencing smell or taste disorders were among poly-tobacco product users (adjusted odds ratio, AOR=1.44; 95% CI: 1.31-1.58), followed by e-cigarette-only users (AOR=1.38; 95% CI: 1.02-1.87), cigarette-only smokers (AOR=1.17; 95% CI: 1.04-1.32), and users of cigars, pipes, or smokeless tobacco (AOR=1.15; 1.00; and 1.33; respectively). CONCLUSIONS Tobacco product use was associated with an increased risk of smell and taste disorders. The rising use of e-cigarettes among adolescents and young adults is particularly concerning given the limited understanding of the sensory effects of e-cigarettes and their growing popularity among younger populations. The study findings highlight the need for interventions aimed at reducing tobacco use of all kinds. [ABSTRACT FROM AUTHOR]

Though 270,000 patients with complaints of taste abnormalities visited medical institutions annually in 2019 survey, there are no drugs for the treatment of taste disorders that are covered by health insurance in Japan. In the survey, the number of patients with taste disorders was correlated with age, and the need for medical treatment for taste disorders is expected to increase in the future because of the super-aging society. The pathophysiology of taste disorders varies widely. There is an obvious need to decide the site and the causes of the disorder and understand the mechanism, by performing various examinations. It needs to first adjust the causative systemic diseases and medications in the treatment for taste disorder. Damage of taste cells due to zinc deficiency is the main pathophysiological mechanism of taste disorders, and zinc supplementation is a standard treatment in Japan. Oral zinc therapy is the treatment for taste disorders due to zinc deficiency or idiopathic taste disorder; though a double-blind study was conducted, it was considered low-level evidence in a clinical review. In Japan, the off-label use of polaprezinc for taste disorders was approved in 2011, and zinc acetate hydrate was approved for hypozincemia in March 2017, making it easier to use oral zinc therapy in general. In some cases, psychotherapy or herbal medicine therapy has been used with remarkable success, although its effectiveness has not been clearly tested. It might be expected to offer some help to patients. In the treatment of elderly patients with taste disorders, physicians need to consider the difference between "age-related changes in taste in healthy people" and "taste disorders in elderly persons", and they should separate them. Aggressive treatment is desirable regardless of age, because no significant difference in the efficacy of various treatments was found between patients older and younger than 65 years. [ABSTRACT FROM AUTHOR]

Aim: The study aims to research the incidence of olfactory and gustatory symptoms in coronavirus disease 2019 (COVID-19) patients. Materials and methods • Study design: Cross-sectional study • Setting: Tertiary care hospital in Karnataka, India • Subjects: A total of 100 patients diagnosed with COVID-19 infection by reverse transcription polymerase chain reaction (RT-PCR) were included in the study. • Taste was examined using solutions of salty, sour, bitter, and sweet taste. Two or more wrong answers were considered abnormal. The smell was evaluated using cardamom, soap, talcum powder, cinnamon, onion, mango, rose, paint thinner, lemon and orange. A score of more than 6 was considered normosmia, 6 or less as hyposmia, and 2 or less as anosmia. Results: In this study, 25% (n = 25) of patients had smell disturbance out of which 10 patients had anosmia and 15 had hyposmia. No case of parosmia was seen. A total of 21 patients had complaints of taste disturbance. Among those, 19 (90.5%) presented with ageusia/hypogeusia, and 2 (9.5%) with dysgeusia. The incidence of taste and smell disturbance in this study was statistically significant. A total of 15 patients had both symptoms; 10 patients had isolated smell disturbance and 6 patients had isolated taste disturbance. Conclusion: Coronavirus disease 2019 is continuing to be a health threat in many cities of India. Many of the patients had olfactory and gustatory dysfunction as one of the earliest symptoms, presenting even before testing. This can be made use of by doctors for early diagnosis and management of COVID-19. Clinical significance: This study gives us the statistics of olfactory and gustatory dysfunction in the South Indian population. Early recognition of these symptoms will help otorhinolaryngologists to diagnose and treat COVID-19 in its early stage, hence reducing the complications. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate subjective symptoms and expression of receptors for sweet, umami, and bitter tastes after brachytherapy in patients with tongue cancer. Methods: Post‐brachytherapy changes in taste were investigated both subjectively (visual analog scale [VAS] score) and objectively (expression of taste receptors) through 37 examinations on 10 patients who received brachytherapy for treatment of tongue cancer at our hospital. The VAS was scored on a scale of 0–100. A VAS score of ≥90 was considered to indicate restoration of taste. For taste receptor expression, taste cells were collected from the brachytherapy (BRT) and non‐brachytherapy (non‐BRT) sides of the tongue, which were separated in the middle of the dorsum of the tongue, and evaluated by the ratio of the expression level of one side to the other. The mRNA expression levels of taste receptors were classified into three groups according to the number of days after BRT: ≤99, 100–299, and ≥300 days. Results: The number of days to a post‐brachytherapy VAS score of 90 or more was 284, 308, and 308 days for sweet, umami, and bitter tastes, respectively. Taste receptor expression was compared in three groups by number of days after radiotherapy: ≤99, 100–299, and ≥300, and no statistically significant differences were found among the tastes. Conclusion: The VAS scores showed that these tastes recovered approximately 300 days after brachytherapy. The ratio of taste receptor expression levels varied widely, and no specific indications of changes in taste receptor expression over time were obtained. [ABSTRACT FROM AUTHOR]

Taste and smell disorders can worsen the nutritional status of patients receiving chemotherapy and potentially affect drug treatment. However, there is limited knowledge on antineoplastic agents that induce taste and smell disorders. Therefore, we used the U.S. Food and Drug Administration Adverse Event Reporting System database to analyze the characteristics of patients and antineoplastic agents in relation to taste and smell disorders. No gender differences related to the onset of taste and smell disorders were found, whereas older age was identified as a possible risk factor. Among the antineoplastic agent classes, protein kinase inhibitors appeared to be particularly likely to induce taste and smell disorders. According to the cluster and principal component analyses, antineoplastic agents were deemed to induce taste or smell disorders. In addition, antineoplastic agents that decreased or changed these sensations could be classified. These findings might be useful in selecting drugs for patients experiencing similar side effects.

Abstract Objective This study aimed to investigate the clinical features of long COVID cases presenting with upper respiratory symptoms, a topic not yet fully elucidated. Study Design Prospective cohort study. Setting A multicenter study involving 26 medical facilities in Japan. Methods Inclusion criteria were patients aged ≥18 years old with a confirmed COVID‐19 diagnosis via severe acute respiratory syndrome coronavirus 2 polymerase chain reaction or antigen testing, who were hospitalized at the participating medical facilities. Analyzing clinical information and patient‐reported outcomes from 1009 patients were analyzed. The outcome measured the degree of initial symptoms for taste or olfactory disorders and assessed the likelihood of these symptoms persisting as long COVID, as well as the impact on quality of life if the upper respiratory symptoms persisted as long COVID. Results Patients with high albumin, low C‐reactive protein, and low lactate dehydrogenase in laboratory tests tended to experience taste or olfactory disorders as part of long COVID. Those with severe initial symptoms had a higher risk of experiencing residual symptoms at 3 months, with an odds ratio of 2.933 (95% confidence interval [CI], 1.282‐6.526) for taste disorders and 3.534 (95% CI, 1.382‐9.009) for olfactory disorders. Presence of upper respiratory symptoms consistently resulted in lower quality of life scores. Conclusion The findings from this cohort study suggest that severe taste or olfactory disorders as early COVID‐19 symptoms correlate with an increased likelihood of persistent symptoms in those disorders as long COVID.

Drug-induced taste disorders are a serious problem in an aging society. This study investigated the mechanisms underlying taste disturbances induced by diclofenac, a non-steroidal anti-inflammatory drug that reduces pain and inflammation by inhibiting the synthesis of prostaglandins by cyclooxygenase enzymes (COX-1 and COX-2). RT-PCR analyses demonstrated the expression of genes encoding arachidonic acid pathway components such as COX-1, COX-2 and prostaglandin synthases in a subset of mouse taste bud cells. Double-staining immunohistochemistry revealed that COX-1 and cytosolic prostaglandin E synthase (cPGES) were co-expressed with taste receptor type-1 member-3 (T1R3), a sweet/umami receptor component, or gustducin, a bitter/sweet/umami-related G protein, in a subset of taste bud cells. Long-term administration of diclofenac reduced the expression of genes encoding COX-1, gustducin and cPGES in mouse taste buds and suppressed both the behavioral and taste nerve responses to sweet and umami taste stimuli but not to other tastants. Furthermore, diclofenac also suppressed the responses of both mouse and human sweet taste receptors (T1R2/T1R3, expressed in HEK293 cells) to sweet taste stimuli. These results suggest that diclofenac may suppress the activation of sweet and umami taste cells acutely via a direct action on T1R2/T1R3 and chronically via inhibition of the COX/prostaglandin synthase pathway inducing down-regulated expression of sweet/umami responsive components. This dual inhibition mechanism may underlie diclofenac-induced taste alterations in humans. [ABSTRACT FROM AUTHOR]

Objective: While researchers have posited various factors, the precise etiology of anosmia in coronavirus disease 2019 (COVID-19) patients remains elusive. We aimed to investigate the relationship between the status of the nasal olfactory mucosal area and medical and demographic variables in patients with COVID-19-related olfactory dysfunction. Methods: In a retrospective analysis, we scrutinized data from 65 adult COVID-19 patients who exhibited olfactory impairment, excluding those with specific medical histories or age-related criteria. Our assessment comprised the analysis of paranasal sinus computed tomography scans to assess inflammation within the nasal olfactory mucosa. Olfactory testing was not employed in this study. We conducted a comprehensive investigation to explore potential associations with gender, age, septal deviation status, taste disorders, and the timing of the onset of olfactory dysfunction. Results: The average age of the patients was 31.6 ± 12.4 years, with 18 (27.7%) male and 47 (72.3%) female patients. Of 65 patients, 43 (66.2%) reported olfactory dysfunction simultaneously with COVID-19, while 22 (33.8%) experienced it after testing positive. Taste abnormalities were present in 49 patients (75.4%). Thirty-seven patients (56.9%) had a nasal septum deviation. Inflammation in the olfactory mucosal region was found in 8 patients (12.3%). The study did not find any significant association between inflammation in the olfactory mucosa and factors like age, gender, taste disorders, or the type of olfactory dysfunction. Still, a significant correlation was found between inflammation in the olfactory mucosal region and nasal septal deviation (P = .009). Conclusion: In COVID-19 patients with olfactory dysfunction, nasal septal deviation was the most common accompanying factor with olfactory mucosal area inflammation, suggesting it may be a potential risk factor. [ABSTRACT FROM AUTHOR]

Abstract Objective Loss of taste (ageusia) is a symptom observed following recovery from COVID-19 infection. The loss of taste and smell sensation may negatively affect patients’ quality of life (QoL). The present study aimed to evaluate the effectiveness of the Diode Laser in managing loss of taste sensation in patients with post-COVID syndrome versus the placebo. Material and method The study sample was 36 patients who complained of persistent loss of taste sensation following COVID-19. The patients were randomly assigned to one of the two groups according to the received treatment: Group I (laser treatment) and Group II (light treatment), with each patient receiving a diode laser treatment or placebo from the same operator. Taste sensation was subjectively measured after treatment for four weeks. Results The results demonstrated a significant difference between both groups regarding taste restoration after one month (p = 0.041), with Group II having a significantly higher percentage of cases 7 (38.9%) with partial taste restoration. In contrast, a significantly higher proportion of Group I 17 cases (94.4%) had complete taste restoration (p

Abstract Objectives Chorda tympani nerve (CTN) function may be damaged more by two‐stage than by one‐stage surgery for middle ear cholesteatoma. However, few studies have reported the relationship between two‐stage cholesteatoma surgery and CTN function. This study aimed to investigate CTN function after two‐stage surgery for cholesteatoma. Methods In this prospective study, 35 patients underwent two‐stage canal wall up tympanoplasty (CWUT). Perioperative CTN function was assessed using questionnaires and electrogustometry (EGM). Participants were categorized into minor, major, and section groups, based on the degree of CTN manipulation during surgery. Results In the first‐stage surgery, posterior tympanotomy with an intact canal wall reduced the degree of CTN manipulation. The incidence of taste disorder after the first‐stage surgery was 71.4%. Postoperative taste disorder and the EGM threshold improved early in the minor manipulation group. In the second‐stage surgery, no new CTN damage occurred, even if this surgery involved removal of residual cholesteatoma. The incidence of taste disorder after second‐stage surgery was less than that after first‐stage surgery, independent of CTN preservation. However, the recovery rate of the EGM threshold after second‐stage surgery was significantly lower in the section group than in those with CTN preservation. Conclusion CTN function, including symptoms and EGM threshold, can be preserved during two‐stage cholesteatoma surgery if care is taken to preserve the CTN in both the first‐ and second‐stage surgeries. A two‐stage CWUT, ensuring an intact bony annulus, may be effective to facilitate CTN preservation. Level of Evidence 2b.

Abstract Aim Alterations in taste are distressing side effects for cancer patients receiving chemotherapy. The Center for Gastrology (Belgium) developed a self‐care intervention based on taste control. This intervention contains an assessment of the individual taste and food hedonics. It provides recipes based on the individual assessed hedonics profile, so patients can self‐prepare personalized meals. This study aims to describe the experiences of oncologic patients with the home baking of personalized bread. Design A qualitative, descriptive design with individual semi‐structured interviews was used. Methods In August 2018, eleven face‐to‐face interviews were conducted until data saturation. Results The analysis of the interviews revealed five major themes: “Stepping out of your role,” “Having something positive to do,” “gaining insight,” “receiving recognition” and “practical limitations.”

Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, treating taste and saliva secretory disorders associated with coronavirus disease 2019 (COVID-19) has become a critical issue. The aim of the present study was to update information on treatments applicable to such oral symptoms and discuss their pathogenic mechanisms. The literature search indicated that different treatments using tetracycline, corticosteroids, zinc, stellate ganglion block, phytochemical curcumin, traditional herbal medicine, nutraceutical vitamin D, photobiomodulation, antiviral drugs, malic acid sialagogue, chewing gum, acupuncture, and/or moxibustion have potential effects on COVID-19-associated ageusia/dysgeusia/hypogeusia and xerostomia/dry mouth/hyposalivation. These treatments have multiple modes of action on viral cellular entry and replication, cell proliferation and differentiation, immunity, and/or SARS-CoV-2 infection-induced pathological conditions such as inflammation, cytokine storm, pyroptosis, neuropathy, zinc dyshomeostasis, and dysautonomia. An understanding of currently available treatment options is required for dental professionals because they may treat patients who were infected with SARS-CoV-2 or who recovered from COVID-19, and become aware of their abnormal taste and salivary secretion. By doing so, dentists and dental hygienists could play a crucial role in managing COVID-19 oral symptoms and contribute to improving the oral health-related quality of life of the relevant patients. [ABSTRACT FROM AUTHOR]

Objective: Loss of taste (ageusia) is a symptom observed following recovery from COVID-19 infection. The loss of taste and smell sensation may negatively affect patients' quality of life (QoL). The present study aimed to evaluate the effectiveness of the Diode Laser in managing loss of taste sensation in patients with post-COVID syndrome versus the placebo. Material and method: The study sample was 36 patients who complained of persistent loss of taste sensation following COVID-19. The patients were randomly assigned to one of the two groups according to the received treatment: Group I (laser treatment) and Group II (light treatment), with each patient receiving a diode laser treatment or placebo from the same operator. Taste sensation was subjectively measured after treatment for four weeks. Results: The results demonstrated a significant difference between both groups regarding taste restoration after one month (p = 0.041), with Group II having a significantly higher percentage of cases 7 (38.9%) with partial taste restoration. In contrast, a significantly higher proportion of Group I 17 cases (94.4%) had complete taste restoration (p < 0.001). Conclusion: The present study concluded that using a Diode laser 810 nm aided in a more rapid recovery from loss of taste dysfunction. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) results from upper airway remodeling, which has been suggested to alter sensory and motor neuron function due to hypoxia or snore vibration. This study investigated whether OSA was associated with the risk of flavor disorder (FD). Materials and methods: Seven thousand and eight hundred sixty-five patients with OSA and 7865 propensity score-matched controls without OSA were enrolled between 1999 and 2013 through a nationwide cohort study. The propensity score matching was based on age, sex, comorbidities including hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD), asthma, ankylosing spondylitis, and Charlson comorbidity index, and co-medications during the study period, including statins and angiotensin-converting enzyme (ACE) inhibitors. The adjusted hazard ratio (aHR) of incident FD following OSA was derived using a Cox proportional hazard model. A log-rank test was used to evaluate the time-dependent effect of OSA on FD. Age, sex, comorbidities, and co-medications were stratified to identify subgroups susceptible to OSA-associated FD. Results: Patients with OSA were at a significantly great risk of FD (aHR = 1.91, 95% CI = 1.08–3.38), which was time-dependent (log-rank test p = 0.013). Likewise, patients with hyperlipidemia were at a significant great risk of FD (aHR = 2.99, 95% CI = 1.33–6.69). Subgroup analysis revealed that female patients with OSA were at higher risks of FD (aHR = 2.39, 95%CI = 1.05–5.47). Conclusions: Patients with OSA were at significantly great risk of incident FD during the 15-year follow-up period, especially in female patients with OSA. Clinical relevance: Timely interventions for OSA may prevent OSA-associated FD. [ABSTRACT FROM AUTHOR]

Taste disorder in the elderly is not only a disorder of one of the five senses but also important from the viewpoint of frailty prevention for healthy longevity. However, treatment of this disorder has changed little over time with zinc replacement therapy as the sole established method. A detailed review of the literature of polaprezinc for idiopathic and zincdeficient taste disorders provides insufficient evidence for its efficacy. In recent years, treatment with zinc acetate hydrate containing more zinc than does polaprezinc has emerged, and is expected to be more effective than polaprezinc. Ethyl loflazepate was also reported as an alternative to zinc supplementation. Serum zinc levels are an essential test item in clinical trials of taste disorders, but there are many points to be noted in its measurement and evaluation. Appropriate evaluation of serum zinc levels is necessary based on a thorough understanding of these factors. In this review, I will outline the problems of serum zinc levels, changes in zinc replacement therapy for taste disorders, and discuss future treatments. [ABSTRACT FROM AUTHOR]

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In this review, we collated evidence relating to taste change and zinc deficiency in relation to bariatric surgery (BS) and effects of zinc replacement on taste perception and speculate on the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted (33 studies, N = 3264). We showed that taste change and zinc deficiency are frequent complications after BS, which both typically occurred at 6 months post-surgery. Our analysis did not support a causal link between the two, but similar onset of incidences indirectly indicates a link. Supplementation with 45–50 mg of zinc sulphate, higher than current recommendation, was effective in improving taste. Further studies are required to establish the causal link between the two in the context of BS. [ABSTRACT FROM AUTHOR]

Background: Impaired taste sensation not only diminishes the pleasures of life, but it can also lead to health problems. Therefore, we retrospectively analyzed the clinical characteristics of taste disorders in 419 patients. Methods: The subjects were 146 males and 273 females who visited our facility from 2008 through 2020. The patients ranged in age from 16 to 90 years, with 81.4% of the patients > 50 years. Results: The most frequent cause of taste disorders was zinc deficiency (n = 148, 35.3%), followed by drug-induced (n = 63, 15.0%), systemic disease (n = 51, 12.2%), idiopathic (n = 39, 9.3%), postcommon cold (n = 27, 6.4%), psychogenic (n = 19, 4.5%) and dry mouth (n = 18, 4.3%). Zinc replacement therapy was administered to 309 (73.9%) patients. In 174 (56.3%) of those patients, 34 mg/day of zinc was sufficient to achieve a normal serum zinc level within 2 months, but 128 (41.9%) patients needed a higher dose. Prognoses of good, better and unchanged were seen for 206 (49.0%) patients, 87 (20.8%) patients and 126 (30.1%) patients. Patients with a duration of symptoms of ≤ 6 months showed a significantly better prognosis. Patients with zinc deficiency also showed a better prognosis, whereas psychogenic taste disorders revealed a significantly poor prognosis. Conclusion: The patients with taste disorders should be starting to treat within months of onset.

Objectives: Chorda tympani nerve (CTN) function may be damaged more by two‐stage than by one‐stage surgery for middle ear cholesteatoma. However, few studies have reported the relationship between two‐stage cholesteatoma surgery and CTN function. This study aimed to investigate CTN function after two‐stage surgery for cholesteatoma. Methods: In this prospective study, 35 patients underwent two‐stage canal wall up tympanoplasty (CWUT). Perioperative CTN function was assessed using questionnaires and electrogustometry (EGM). Participants were categorized into minor, major, and section groups, based on the degree of CTN manipulation during surgery. Results: In the first‐stage surgery, posterior tympanotomy with an intact canal wall reduced the degree of CTN manipulation. The incidence of taste disorder after the first‐stage surgery was 71.4%. Postoperative taste disorder and the EGM threshold improved early in the minor manipulation group. In the second‐stage surgery, no new CTN damage occurred, even if this surgery involved removal of residual cholesteatoma. The incidence of taste disorder after second‐stage surgery was less than that after first‐stage surgery, independent of CTN preservation. However, the recovery rate of the EGM threshold after second‐stage surgery was significantly lower in the section group than in those with CTN preservation. Conclusion: CTN function, including symptoms and EGM threshold, can be preserved during two‐stage cholesteatoma surgery if care is taken to preserve the CTN in both the first‐ and second‐stage surgeries. A two‐stage CWUT, ensuring an intact bony annulus, may be effective to facilitate CTN preservation. Level of Evidence: 2b. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of the study were to investigate the long‐term prevalence of taste disorder (TD) and olfactory disorder (OD) and associated risk factors in the non‐hospitalized southeastern Brazil population of COVID‐19 patients. Methods: This cross‐sectional open survey evaluated possible long‐term OD and TD in non‐hospitalized patients who had been diagnosed with COVID‐19 for more than 30 days, through an online self‐report questionnaire. Demographic data, comorbidities, symptoms, and the intensity of OD and TD at the time of diagnosis and at the time of completing the questionnaire were evaluated. Results: Three hundred five responses were included. The reported prevalence of OD and TD was 72.9% and 67.4%, respectively, in the moment of diagnosis; after a mean follow‐up period of 179 days, 45% and 50% still had some degree of the symptoms. There was a positive correlation between age and the high prevalence of OD (p = 0.02). However, there was no correlation between age and TD (p = 0.961) and weight in relation to OD/TD (p = 0.500 and p = 0.636, respectively). Conclusion: This study observed a high long‐term prevalence of OD and TD associated with COVID‐19, with a low recovery rate during the study period. There was a positive association between older participants and the prevalence of OD. [ABSTRACT FROM AUTHOR]

Aim: Alterations in taste are distressing side effects for cancer patients receiving chemotherapy. The Center for Gastrology (Belgium) developed a self‐care intervention based on taste control. This intervention contains an assessment of the individual taste and food hedonics. It provides recipes based on the individual assessed hedonics profile, so patients can self‐prepare personalized meals. This study aims to describe the experiences of oncologic patients with the home baking of personalized bread. Design: A qualitative, descriptive design with individual semi‐structured interviews was used. Methods: In August 2018, eleven face‐to‐face interviews were conducted until data saturation. Results: The analysis of the interviews revealed five major themes: "Stepping out of your role," "Having something positive to do," "gaining insight," "receiving recognition" and "practical limitations." [ABSTRACT FROM AUTHOR]

Purpose: Decreased olfactory and gustatory functions are present in various systemic autoimmune diseases. However, little is known about the chemosensory functions of patients with inflammatory bowel disease (IBD). The present study aimed to investigate olfactory and gustatory functions in patients with IBD and their correlation with clinical disease activity. Methods: A total of 103 patients with IBD were included (52 men, 51 women, mean age 40.3 ± 1.2 years) in the present study. Chemosensory functions were assessed utilizing the "Sniffin' Sticks" olfactory function test and "taste sprays" gustatory function test. The clinical disease activity of patients was graded as remission, mild, and moderate–severe. In addition, inflammatory markers (fecal calprotectin, C-reactive protein and blood leucocyte count) were recorded. Results: In total, 70% of IBD patients were normosmic, 30% were hyposmic, and none of them was functionally anosmic; 6% of the patients showed signs of hypogeusia. Patients with moderate–severe IBD reached a higher olfactory threshold score compared with patients with remission (p = 0.011) and mild IBD (p < 0.001). The BMI of IBD patients was inversely correlated with their olfactory threshold (r = −0.25, p = 0.010). Olfactory and gustatory function in IBD patients did not correlate with duration of disease, blood leucocyte count, CRP level, or fecal calprotectin level. However, patients' olfactory function significantly increased after 4 months of TNF-α inhibitor treatment (p = 0.038). Conclusions: IBD patients are more likely to present with hyposmia. Olfactory thresholds were mainly affected. They were significantly associated with clinical disease activity and BMI. As shown in a subgroup, treatment with TNF-α inhibitors appeared to improve olfactory function. [ABSTRACT FROM AUTHOR]

Purpose: Several atypical presentations of COVID-19 like anosmia, conjuctivitis, and gastrointestinal findings are seen in the literature. The purpose of this study was to investigate the common and atypical symptoms of COVID-19 among the patients admitted to the otorhinolaryngology (ENT) outpatient clinic. Materials and Methods: This case series was conducted with 49 patients who applied to hospital between April 1, 2020 and April 30, 2020. Common and atypical otolaryngological findings were recorded. Sociodemographic findings and blood parameters were also evaluated. Results: Of the patients, 59.18% were aged 40 and over, 46.94% were of the A blood group, 55.10% were male and 24.49% were smokers, 51.02% had a chronic disease. Among typical symptoms; fever (71.43%), a dry cough (46.94%), shortness of breath (42.86%) was seen. Diarrhea (48.98%), runny nose (51.02%), nasal congestion (42.85%), sore throat (22.44%), headaches (32.65%), 18.36% olfactory disorder, 26.53% gustatory disturbance were noted. Olfactory and gustatory disturbances are found to be related to good prognosis and mild clinical course. The difference between Hg and D–dimer levels of the female and male patients were found to be statistically significant. The D-dimer levels determined in the present study were higher than those reported in the literature. Conclusion: While COVID-19 present with common symptoms, sometimes atypical symptoms can be the only finding during initial application to the hospital. Olfactory and gustatory disturbances point to the effects of COVID-19 on neurons. Neuronal effects like olfactory and gustatory disturbances should be closely monitored in COVID-19 patients in long term.

Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, treating taste and saliva secretory disorders associated with coronavirus disease 2019 (COVID-19) has become a critical issue. The aim of the present study was to update information on treatments applicable to such oral symptoms and discuss their pathogenic mechanisms. The literature search indicated that different treatments using tetracycline, corticosteroids, zinc, stellate ganglion block, phytochemical curcumin, traditional herbal medicine, nutraceutical vitamin D, photobiomodulation, antiviral drugs, malic acid sialagogue, chewing gum, acupuncture, and/or moxibustion have potential effects on COVID-19-associated ageusia/dysgeusia/hypogeusia and xerostomia/dry mouth/hyposalivation. These treatments have multiple modes of action on viral cellular entry and replication, cell proliferation and differentiation, immunity, and/or SARS-CoV-2 infection-induced pathological conditions such as inflammation, cytokine storm, pyroptosis, neuropathy, zinc dyshomeostasis, and dysautonomia. An understanding of currently available treatment options is required for dental professionals because they may treat patients who were infected with SARS-CoV-2 or who recovered from COVID-19, and become aware of their abnormal taste and salivary secretion. By doing so, dentists and dental hygienists could play a crucial role in managing COVID-19 oral symptoms and contribute to improving the oral health-related quality of life of the relevant patients.

Purpose: Dysgeusia is an adverse event caused by chemotherapy. Although retrospective studies have shown zinc administration improves dysgeusia, there have been no prospective studies. The present study examined effects of zinc therapy on dysgeusia in patients with gastrointestinal cancer.Methods: This multicenter, prospective, observational study enrolled patients with dysgeusia during chemotherapy treatment. Patients received no intervention (control), polaprezinc p.o., or zinc acetate hydrate p.o., and serum zinc levels were measured at 0 (baseline), 6, and 12 weeks. Dysgeusia was assessed using CTCAE v5.0 and subjective total taste acuity (STTA) criteria using questionnaires at baseline and 12 weeks.Results: From February 2020 to June 2021, 180 patients were enrolled from 17 institutes. There were no differences in mean baseline serum zinc levels among the groups (67.3, 66.6, and 67.5 μg/dL in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. P = 0.846). The changes in mean serum zinc levels after 12 weeks were - 3.8, + 14.3, and + 46.6 μg/dL, and the efficacy rates of dysgeusia were 33.3%, 36.8%, and 34.6% using CTCAE and 33.3%, 52.6%, 32.7% using STTA in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. The STTA scores improved in all groups, with significant improvement observed in the polaprezinc group compared with the no intervention group (P = 0.045).Conclusion: There was no significant correlation between the degree of serum zinc elevation and improvement in dysgeusia, suggesting that polaprezinc, but not zinc acetate hydrate, was effective in improving chemotherapy-induced dysgeusia.Trial Registration: UMIN000039653. Date of registration: March 2, 2020. [ABSTRACT FROM AUTHOR]

Background: Taste disorders often occur in the elderly, which can have serious consequences on their health status. Zinc and saliva volume have a role in maintaining taste acuity, especially in the elderly. Purpose: This study was to determine the correlation between salivary zinc levels, salivary volume, and taste disorders in elderly patients. Methods: This was a cross-sectional research. Elderly patients with and without taste disorders were included in this study. Salivary zinc levels were measured using the Atomic Absorption Spectrometry (AAS) method. Salivary volume was measured using the spitting method. The correlation between salivary zinc levels, salivary volume, and taste disorders was analysed using the chi-square test. Multivariate analysis was performed to control for confounding variables with logistic regression. Results: Based on our findings, no significant correlation was determined between the levels of zinc in saliva and taste disorders. However, there was a significant correlation between salivary volume and taste disorders. Salivary volume and smoking were determined to be associated with taste disorders. Conclusion: This research showed that salivary zinc levels were not correlated with taste disorders; on the contrary, salivary volume was correlated with taste disorders. Smoking was determined to be a confounding variable on taste disorders in elderly patients.

Syndrome of the trephined, or sinking skin flap syndrome, is a rare complication following craniectomy, showing a variety of neurological symptoms that improve after cranioplasty. Taste disorders can be induced by a variety of causes, while those due to central lesions are rare. We report a case of syndrome of the trephined that developed a taste disorder as a sole manifestation. A 61-year-old man underwent enlarged left craniectomy due to bacterial infection after surgical resection of a convexity meningioma. In six weeks, the patient complained of taste abnormalities. Visual analog scale score, electrogustometry, and a whole-mouth gustatory test revealed impairment of taste perception. As other possible causative factors were excluded, and the symptom improved after the cranioplasty, we made the diagnosis of syndrome of the trephined. Gustatory information from one side of the tongue enters the nucleus of the solitary tract of the medulla, and reaches insular-operculum ipsilaterally through the ventroposterior medial nucleus of the thalamus. Additionally, it is speculated that gustatory information from the left side of the tongue directly reaches the left insula, while information from the right side may also reach the left insula through the right insula. Disturbance of the left hemisphere including the insula due to a skull defect may have caused impairment of taste perception. A taste disorder should bear in mind in the treatment of central nervous system diseases and taken into account as a manifestation of syndrome of the trephined.

Background/Aim: Smell and taste disorders are among the most common symptoms of COVID-19. However, the relationship between smell and taste disorders and systemic symptoms is not fully understood in Japan. Patients and Methods: Questionnaires were mailed to 105 of 111 COVID-19 patients who were hospitalized at our hospital between March and July 2020 in Japan. Results: A total of 74 patients (response rate: 70.5%) completed the survey. Of these, six patients (8.1%) presented with smell disorders only, 16 (21.6%) presented with taste disorders only, and 17 (23.0%) presented with both smell and taste disorders. The mean Visual Analog Scale for smell and taste was 0.5 and 20, respectively, at the time of the most severe symptoms. Conclusion: Among COVID-19 patients in Japan, smell and taste disorders are often followed by fever and may not be the first symptoms. Sense of smell is particularly impaired. These symptoms often improve, although they sometimes persist for a long time as sequelae. [ABSTRACT FROM AUTHOR]

Background and Objectives: Smell disorder such as dostorted olfaction (parosmia) is one of the most common symptoms of COVID-19. Therefore, this study aimed to investigate the improvement of symptoms of parosmia in patients with COVID-19 in 2020. Material and Methods: This cross-sectional study was conducted in summer and spring of 2020 using a data collection form which was validated with Cronbach's alpha of r=0.826. The study was done in an international health center in Tehran. To report descriptive results, mean, standard deviation, absolute frequency and absolute frequency percentage, and for analysis, independent t-test and chi-square test were used using SPSS software version 16 and the significance level was considered to be 0.05. Results: In total ,350 patients participated in the study, the prevalence of parosmia in patients was 15.14% and the mean and age deviation of patients was 32.71 ± 10.93 years. There was not a significant relationship between parosmia and gender (p value=0.317), age (p value=0.271), previous history of allergic symptoms (p value=0.083), family history of the disease (p value=0.638), taste disorder (p-value=0.768), and smoking (p-value=0.558). 31 cases (58.49 % of Patients) with parosmia had complete remission within 4-6 weeks. Conclusion: Due to the high prevalence of olfactory disorders, especially parosmia in patients with COVID-19, parosmia and other olfactory disorders can be used to screen and triage patients with COVID-19, especially moderate and mild patients. Patients with parosmia should be followed for at least 4 to 6 weeks and if they do not recover for up to 12 weeks, they should be referred to ENT specialists for more specific measures.

Abstract Background Taste disorder is a common symptom in the general population. Several studies have shown that patients with neurological disorders, such as amyotrophic lateral sclerosis and Parkinson’s disease, develop taste disturbance. Facial onset sensory and motor neuronopathy (FOSMN) is a rare disease characterized by sensory disturbance and weakness spreading from the face to the limbs caudally. We describe a patient with FOSMN who showed taste disorder as the sole initial symptom. Case presentation A 49-year-old man who smoked cigarettes developed taste disturbance. Despite using zinc supplements, an herbal medication, and an ointment, his taste disorder worsened. 4 years later, a tingling feeling emerged at the tip of his tongue and gradually spread to his entire lips. At 55 years of age, he showed difficulty in swallowing, followed by facial paresthesia, muscle atrophy, and weakness in the face and upper limbs without apparent upper motor neuron sign. Cessation of smoking did not improve his taste disturbance, and he was unable to discriminate different tastes on the entire tongue. In an electrogustometric study, electrical stimulation did not induce any type of taste sensation. Blink reflex showed delayed or diminished R2 responses. Needle electromyography revealed severe chronic neurogenic changes in the tongue and masseter muscles. Mild chronic neurogenic changes were also observed in the limbs. In the thoracic paraspinal muscles, active neurogenic changes were detected. Findings of hematological and cerebrospinal fluid analyses, and magnetic resonance images of the brain and spinal cord were unremarkable. One cycle of intravenous immunoglobulin therapy did not improve his symptoms. We diagnosed him as having FOSMN with the sole initial symptom of taste disorder. Nine years after the onset of taste disorder, he developed impaired sensation of touch in the right upper limb and required tube feeding and ventilator support. Conclusion Taste disorder can be the initial manifestation of FOSMN and might involve the solitary nucleus.

Depression is associated with taste disorders; however, the mechanisms by which mental stress affects taste perception are not well understood. This study aimed to elucidate the effects of psychosocial stress on peripheral taste-sensing systems using a mouse depression model. Male mice were subjected to subchronic and mild social defeat stress (sCSDS). Results showed that sCSDS significantly increased body weight, food and water intake, and social avoidance behavior and that sCSDS did not change reward-seeking behavior on sucrose preference but tended to decrease pheromonal preference for female urine. Furthermore, sCSDS downregulated the mRNA levels of sweet and umami taste receptor subunits, i.e., sweet taste receptor type 1 members 2 and 3 (T1R2 and T1R3), but not the umami taste receptor subunit, i.e., taste receptor type 1 member 1 (T1R1), in the circumvallate papillae of mice. It is known that sucrose preference is mediated by the gut–brain axis without taste perception; thus, it was considered that sCSDS affected the peripheral taste-sensing systems, rather than the central reward systems, which mediate sucrose preference. This is the first study to report that psychosocial stress affects peripheral sweet and umami taste-sensing systems. • The effects of mild psychosocial stress on taste-sensing systems were studied. • sCSDS increased body weight, food and water intakes, and social avoidance behavior. • sCSDS did not change reward-seeking behavior on sucrose preference. • sCSDS tended to decrease reward-seeking behavior on female urine sniffing. • sCSDS significantly reduced peripheral expression of T1R2 and T1R3 , but not T1R1. [ABSTRACT FROM AUTHOR]

Abstract Background Taste disorder is a common problem in patients with chronic kidney disease and end-stage renal disease. Specifically, salty taste disorder is associated with excess salt intake. Many factors affect taste activity; however, data focused on peritoneal dialysis (PD) patients are limited. This study aimed to investigate the distribution of the gustatory threshold for salty taste and to clarify its relevant contributing factors in PD patients. Methods In this retrospective cross-sectional study, we enrolled 22 PD patients who were assessed for their detection and recognition thresholds for salty taste using salt-impregnated test strips. We investigated the distribution of the detection and recognition thresholds and analyzed their relevant factors. Results In PD patients, detection and recognition threshold for salty taste were both high. Especially, most of the PD patients could not recognize salty taste even at the highest concentration level. The high detection threshold was associated with young age, long duration of PD, high serum phosphorus, and high transferrin saturation. The high recognition threshold was associated with long duration of PD, high serum phosphorus, high creatinine, high serum β2 microglobulin, low renal Kt/V, and high peritoneal Kt/V. Partition analysis showed that high serum phosphorus was related with high detection threshold and low renal Kt/V was related with high recognition threshold. Conclusions This study demonstrated that the gustatory threshold for salty taste was increased in PD patients. In addition, high detection threshold was related with high serum phosphorus and high recognition threshold was related to low renal Kt/V. Based on these findings, we consider that it is important to assess the gustatory threshold for salty taste in PD patients, particularly those with high serum P and low renal Kt/V.

Julia von Grundherr,1 Barbara Koch,1 Donata Grimm,2 Jannike Salchow,1 Luzia Valentini,3 Thomas Hummel,4 Carsten Bokemeyer,5 Alexander Stein,1 Julia Mann1 1Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumour Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 3Department of Agriculture and Food Sciences, Section of Dietetics University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany; 4Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany; 5Department of Oncology, Hematology and Bone Marrow Transplant, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Purpose: Two-thirds of cancer patients report taste disorders during and after chemotherapy. Taste disorders impact on nutritional status which is highly relevant for treatment efficacy and overall prognosis. Improvement of taste disorder is of particular importance for cancer patients’ outcomes, thus the TASTE trial was conducted to improve taste disorders with a taste and smell training.Methods: In this trial, patients undergoing chemotherapy were screened for taste disorders. Subsequently, patients were allocated based on the detection of taste disorders (≤8 taste strips points) to an intervention group with a taste and smell training at baseline and week 3–5 or were only followed up, if no taste disorder was detected (≥9 taste strips points) (non-intervention group). At baseline, all patients received a nutritional counseling. The primary endpoint was the minimal clinically relevant improvement of taste strips score by 2 taste strips points in at least 50% of the patients with taste disorders.Results: The trial included 62 patients (48 women [77%], 14 male [23%], age 54.5±11.6 years) who had gastrointestinal (n=29), breast (n=31), or lung cancer (n=2). Taste disorders were more frequent in gastrointestinal than in breast cancer patients. Out of 62 patients screened, 30 patients showed taste disorders. The primary endpoint was met with 92% (n=23 of 25) of the patients completing the intervention. In the intervention group, the patients’ taste significantly improved from baseline (median taste strips: 7.0 points) to week 12 (median taste strips: 10.0 points) (P≤0.001). Patients of the non-intervention group who completed the reassessment (n=27 of 32) experienced no change in taste perception in the 3-month follow-up (P=0.897).Conclusion: Intensified nutritional counseling with taste and smell training may improve taste perception of patients undergoing chemotherapy. A confirmatory randomized trial is planned. Keywords: cancer patients, taste disorders, taste and smell training, nutritional intervention, nutritional counseling, malnutrition

The aim of this study was to investigate the correlation between psychological distress and taste and sense of smell dysfunctions on healthcare workers (HCW) who contracted the COVID-19 infection in the midst of the disease outbreak. Reports of sudden loss of taste and smell which persist even after recovery from COVID-19 infection are increasingly recognized as critical symptoms for COVID-19 infections. Therefore, we conducted a cross-sectional study on COVID-19 HCW (N = 104) who adhered to respond to a phone semistructured interview addressing the virus symptoms and associated psychological distress. Data were collected from June to September 2020. Findings confirm the association between experienced taste/olfactory loss and emotional distress and suggest that dysfunctions of taste and smell correlate positively with anxiety and depression. Furthermore, their psychological impact tends to persist even after the recovery from the disease, suggesting the need for appropriate psychological interventions to prevent people from developing more serious or long-lasting psychological disorders and, as far as HCW, to reduce the risk of work-related distress.

Abstract Background and Aim Approximately five percent of the general population are suffering from taste disorders. Usually, subjective loss of taste is caused by smell disorders; thus, isolated loss of the sense of taste is relatively rare. Despite the influence on quality of life, isolated taste disorders (ITD) are sparsely represented in literature and clinical research. In particular, there is need for sufficient diagnostic and treatment algorithms. Aim of study is to add further information to the sparse literature on ITD and suggest an appropriate diagnostic algorithm for ITD. Methods We present a retrospective study on patients with ITD diagnosed at the Flavour clinic, ENT department, Regional Hospital West Jutland, between 2017 and 2020. All patients underwent a thorough rhinolaryngological and otoneurologic examination, including olfactory and gustatory assessment, and a wide spectrum of biochemical, microbiological, and radiological examinations. Results In total, 522 patients referred due to smell and/or taste disorders, 423 (81%) complained of a subjective taste disorder, only 19 (3.4%) patients were diagnosed with ITD. According to etiology, the patients were categorized in following groups: medicine‐related (25%), mixed (21%), iatrogenic (21%), idiopathic (11%), radiotherapy‐related (11%), and autoimmune/inflammatory (11%). Based on etiology, individualized treatment was recommended with very discouraging results. Interpretation Diagnostics of taste disorders is a delicate and expertise demanding task. The mechanisms underlying isolated loss of taste are heterogeneous. ENT and otoneurologic examination, and specific olfactory and gustatory testing are required in all patients, whereas biochemical, microbiological, and radiological examinations are only necessary on an individual basis.

Objective: The Covid-19 pandemic continues to threaten the whole world. Early diagnosis of patients is very important to prevent the spread of the virus. Sudden loss of taste and smell is a common early symptom in patients. Therefore, it is thought that revealing the pathogenesis of the symptom will help both in early diagnosis and in predicting the prognosis. Materials and Methods: The age, gender, predominant symptoms during Covid, length of stay at home/hospital, and smoking status of patients who had Covid and had loss of taste and smell between July 2020 and December 2020 were evaluated retrospectively. Results: Patients with loss of taste and smell were significantly younger than those who did not. The majority were female patients, non-smokers, and patients needing significantly less hospitalization and receiving treatment at home. Among the accompanying symptoms, GIS symptoms were also significantly more common in this group. Conclusion: Loss of taste and smell is an important symptom in Covid-19 infection. Revealing the demographic and clinical characteristics associated with this symptom is valuable in terms of early diagnosis of the disease, predicting the prognosis and reducing the contagiousness. [ABSTRACT FROM AUTHOR]

Purpose: Several atypical presentations of COVID-19 like anosmia, conjuctivitis, and gastrointestinal findings are seen in the literature. The purpose of this study was to investigate the common and atypical symptoms of COVID-19 among the patients admitted to the otorhinolaryngology (ENT) outpatient clinic. Materials and Methods: This case series was conducted with 49 patients who applied to hospital between April 1, 2020 and April 30, 2020. Common and atypical otolaryngological findings were recorded. Sociodemographic findings and blood parameters were also evaluated. Results: Of the patients, 59.18% were aged 40 and over, 46.94% were of the A blood group, 55.10% were male and 24.49% were smokers, 51.02% had a chronic disease. Among typical symptoms; fever (71.43%), a dry cough (46.94%), shortness of breath (42.86%) was seen. Diarrhea (48.98%), runny nose (51.02%), nasal congestion (42.85%), sore throat (22.44%), headaches (32.65%), 18.36% olfactory disorder, 26.53% gustatory disturbance were noted. Olfactory and gustatory disturbances are found to be related to good prognosis and mild clinical course. The difference between Hg and D–dimer levels of the female and male patients were found to be statistically significant. The D-dimer levels determined in the present study were higher than those reported in the literature. Conclusion: While COVID-19 present with common symptoms, sometimes atypical symptoms can be the only finding during initial application to the hospital. Olfactory and gustatory disturbances point to the effects of COVID19 on neurons. Neuronal effects like olfactory and gustatory disturbances should be closely monitored in COVID-19 patients in long term. [ABSTRACT FROM AUTHOR]

Background and Aim: Approximately five percent of the general population are suffering from taste disorders. Usually, subjective loss of taste is caused by smell disorders; thus, isolated loss of the sense of taste is relatively rare. Despite the influence on quality of life, isolated taste disorders (ITD) are sparsely represented in literature and clinical research. In particular, there is need for sufficient diagnostic and treatment algorithms. Aim of study is to add further information to the sparse literature on ITD and suggest an appropriate diagnostic algorithm for ITD. Methods: We present a retrospective study on patients with ITD diagnosed at the Flavour clinic, ENT department, Regional Hospital West Jutland, between 2017 and 2020. All patients underwent a thorough rhinolaryngological and otoneurologic examination, including olfactory and gustatory assessment, and a wide spectrum of biochemical, microbiological, and radiological examinations. Results: In total, 522 patients referred due to smell and/or taste disorders, 423 (81%) complained of a subjective taste disorder, only 19 (3.4%) patients were diagnosed with ITD. According to etiology, the patients were categorized in following groups: medicine‐related (25%), mixed (21%), iatrogenic (21%), idiopathic (11%), radiotherapy‐related (11%), and autoimmune/inflammatory (11%). Based on etiology, individualized treatment was recommended with very discouraging results. Interpretation: Diagnostics of taste disorders is a delicate and expertise demanding task. The mechanisms underlying isolated loss of taste are heterogeneous. ENT and otoneurologic examination, and specific olfactory and gustatory testing are required in all patients, whereas biochemical, microbiological, and radiological examinations are only necessary on an individual basis. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the oral environment and the taste function of Japanese HIV-infected patients treated with antiretroviral therapy. Their median age of 73 patients taking anti-HIV drugs was 46 years. The median period of taking anti-HIV drugs was 30 months. The oral condition was evaluated by measurement of oral moisture, amount of saliva secretion, the number of oral bacteria, presence of oral candida, a taste test, and the number of missing teeth. The levels of oral moisture and secreted saliva were significantly lower in the HIV-infected group than in the healthy volunteer (control) group. The HIV-infected group showed a more robust decrease in taste sensation than the control group. The number of missing teeth was significantly higher in the HIV-infected group than in the control group. Furthermore, all of the evaluated oral conditions were worse in the HIV-infected patients whose CD4+ T lymphocyte counts were less than 500/mm3 than in the control group. It became clear that the patients taking anti-HIV drugs, especially the CD4+ count < 500/mm3 group, had a deteriorated oral environment and dysgeusia, suggesting that the management of oral hygiene is necessary to maintain oral health, which leads to systemic health. [ABSTRACT FROM AUTHOR]

Objective: To investigate risk factors for dysgeusia after tonsillectomy.Methods: A retrospective survey of medical records identified 318 patients (163 male and 155 female subjects aged 12-75 years, average 41.7±16.1 years) who underwent tonsillectomy.Results: Thirty three patients (10.4%) and seven patients (2.2%) reported suffering from dysgeusia three and six months after tonsillectomy, respectively. Average age, serum level of Zn and operation time were not significantly different between positive and negative findings of dysgeusia. Women with positive findings of dysgeusia (72.7%) was significantly higher than men (27.3%) (Odds ratio: 3.276, 95% CI: 1.441-7.450, p<0.005). A chi-square test of independence was calculated comparing the frequency of dysgeusia in under 60 years old group (13-59 years-old) and 60 years old and over group (60-75 years-old). A significant interaction was found (χ2 (1)=5.238. p<0.05).Conclusions: Women and under 60 years old patients had a significantly higher rate of dysgeusia after tonsillectomy. It is recommended that patients are informed of the potential postoperative complication of dysgeusia. [ABSTRACT FROM AUTHOR]

Background: Taste disorder is a common symptom in the general population. Several studies have shown that patients with neurological disorders, such as amyotrophic lateral sclerosis and Parkinson's disease, develop taste disturbance. Facial onset sensory and motor neuronopathy (FOSMN) is a rare disease characterized by sensory disturbance and weakness spreading from the face to the limbs caudally. We describe a patient with FOSMN who showed taste disorder as the sole initial symptom.Case Presentation: A 49-year-old man who smoked cigarettes developed taste disturbance. Despite using zinc supplements, an herbal medication, and an ointment, his taste disorder worsened. 4 years later, a tingling feeling emerged at the tip of his tongue and gradually spread to his entire lips. At 55 years of age, he showed difficulty in swallowing, followed by facial paresthesia, muscle atrophy, and weakness in the face and upper limbs without apparent upper motor neuron sign. Cessation of smoking did not improve his taste disturbance, and he was unable to discriminate different tastes on the entire tongue. In an electrogustometric study, electrical stimulation did not induce any type of taste sensation. Blink reflex showed delayed or diminished R2 responses. Needle electromyography revealed severe chronic neurogenic changes in the tongue and masseter muscles. Mild chronic neurogenic changes were also observed in the limbs. In the thoracic paraspinal muscles, active neurogenic changes were detected. Findings of hematological and cerebrospinal fluid analyses, and magnetic resonance images of the brain and spinal cord were unremarkable. One cycle of intravenous immunoglobulin therapy did not improve his symptoms. We diagnosed him as having FOSMN with the sole initial symptom of taste disorder. Nine years after the onset of taste disorder, he developed impaired sensation of touch in the right upper limb and required tube feeding and ventilator support.Conclusion: Taste disorder can be the initial manifestation of FOSMN and might involve the solitary nucleus. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the clinical features of long COVID cases presenting with upper respiratory symptoms, a topic not yet fully elucidated., Study Design: Prospective cohort study., Setting: A multicenter study involving 26 medical facilities in Japan., Methods: Inclusion criteria were patients aged ≥18 years old with a confirmed COVID-19 diagnosis via severe acute respiratory syndrome coronavirus 2 polymerase chain reaction or antigen testing, who were hospitalized at the participating medical facilities. Analyzing clinical information and patient-reported outcomes from 1009 patients were analyzed. The outcome measured the degree of initial symptoms for taste or olfactory disorders and assessed the likelihood of these symptoms persisting as long COVID, as well as the impact on quality of life if the upper respiratory symptoms persisted as long COVID., Results: Patients with high albumin, low C-reactive protein, and low lactate dehydrogenase in laboratory tests tended to experience taste or olfactory disorders as part of long COVID. Those with severe initial symptoms had a higher risk of experiencing residual symptoms at 3 months, with an odds ratio of 2.933 (95% confidence interval [CI], 1.282-6.526) for taste disorders and 3.534 (95% CI, 1.382-9.009) for olfactory disorders. Presence of upper respiratory symptoms consistently resulted in lower quality of life scores., Conclusion: The findings from this cohort study suggest that severe taste or olfactory disorders as early COVID-19 symptoms correlate with an increased likelihood of persistent symptoms in those disorders as long COVID., Competing Interests: None., (© 2024 The Authors. OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)