Tonsillectomy is one of the most common surgeries in the United States, with more than 11,400 procedures performed on children and adults in hospital settings in 2009, according to the National Center for Health Statistics, and an increasing number being performed in outpatient clinics as well.
Explore this issue:December 2012
For most of the thousands of children and adults who undergo tonsillectomy each year, post-operative pain, bleeding, swelling and discomfort last a few days, or a few weeks at most. But, for a slim minority of patients, the complication of post-tonsillectomy taste disorder can linger much longer. New research findings about the prevalence and duration of post-tonsillectomy taste disorder may point to a need to rethink pre- and post-operative practices for both pediatric and adult patients.
Taste Disorders Rare, but Present
In the initial study, published in 2010, researchers followed over the course of four years 223 adult patients who used a self-assessing questionnaire to report taste disorders after their tonsillectomy surgeries (Laryngoscope. 2010;120(10):2119-2124). “We wanted to look at qualitative taste disorders: the sensation of having a bitter, salty, sweet or metallic taste in your mouth,” said lead author Clemens Heiser, MD, with the department of otorhinolaryngology-head and neck surgery at Technical University in Munich, Germany. “And, we wanted to figure out how long the sensation lasted.” (see “Patient Taste Questionnaire,” below).
Of those 223 patients, 32 percent reported suffering dysgeusia for two weeks following the surgery, and 8 percent (15 patients) reported dysgeusia at the six-month mark. Additionally, almost 30 percent of the original 223 patients reported post-operative bleeding, 10 percent reported long-lasting post-operative pain and 20 percent reported foreign body sensation.
“A few studies about taste disorder after tonsillectomy can be found in the literature…but most of the clinical trials report that taste disorders are a very rare complication or something that disappears quickly,” said Dr. Heiser. Knowing this, the results surprised him, particularly the fact that 8 percent of patients reported taste disturbance after six months. “That’s almost one in 10 patients, and that’s a pretty high number,” Dr. Heiser said. “That is something that can really lower one’s quality of life.”
Indeed, most research describes transient post-tonsillectomy dysgeusia lasting a few weeks as an occasional patient complaint (J Fam Practice. 2010;59(10):E4-E9; Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(1):e11-e14). And, at least two studies report the incidence of long-term taste disturbance complications as rare (Ear Nose and Throat J. 1990;69:155-160; Head Neck Surg. 1999;121:303-304).