Post-Tonsillectomy Taste Disorders Rare but Present

A similar study, which surveyed patients who claimed that taste disturbance was affecting their ability to sense bitterness, sweetness, sourness and saltiness in different foods, concluded that “difficulty in detecting true taste problems…likely reflects…the relatively low prevalence of taste deficits in the general population and the tendency of patients to confuse loss of olfaction-related flavor sensations with taste bud-mediated deficits” (Laryngoscope. 2008;118(4):611-617).

“One of the things that happens, particularly with an adult tonsillectomy, is that it’s a rather traumatic experience for some patients, producing considerable post-operative pain during swallowing and eating, said Dr. Doty. “During this time, the flavor of foods can be greatly diminished, and airflow needed to stimulate the olfactory receptors is reduced from lack of normal swallowing or mastication.”

Rare in Pediatric Patients

Despite the fact that the majority of tonsillectomies are performed on pediatric patients, assessment of post-surgery dysgeusia in pediatric patients seldom occurs. The complication of post-tonsillectomy taste dysgeusia among pediatric patients hasn’t been studied and documented as frequently as it has been in adults. Otolaryngologists attribute this lack of information to difficulty in getting valid responses from young children about taste dysfunction.

“How do you ask a 5-year-old, ‘So, do you have a metallic taste in your mouth?” said Laura J. Orvidas, MD, FACS, associate professor of otorhinolaryngology at the Mayo Clinic in Rochester, Minn. “[Taste disturbance] could be more prevalent than we see or are hearing about, but kids just don’t know what to say, or it doesn’t bother them enough.”

“I’ve never had a kid come back and complain that their taste was off, nor a teenager for that matter,” said Dr. Orvidas. “Young people tend to tolerate things better; they recover better; they’re better healers; they have better blood supply. That could be part of the reason that they don’t experience [dysgeusia], or if they do, it goes away fast enough that they don’t ever think about it again.”

Most follow-up questions for post-tonsillectomy patients revolve around bleeding, pain, swallowing and voice changes. However, given the latest research findings about the prevalence and persistence of taste disorder, Dr. Orvidas suggests it might be time to ask about it, and to counsel patients pre-surgery.

“We have a post-op tonsillectomy survey that we do about four to six weeks after the operation,” said Dr. Orvidas. “We ask them standard questions: Is there any bleeding, are there voice issues, things like that. But, we don’t specifically ask about taste distortion. Unless a child said to mom, ‘Boy, my food tastes funny’ or ‘This doesn’t taste right,’ you wouldn’t know,” she added. “I’ve never heard a parent say that to me, and usually they’re on top of things. But, [the study] does make me think we should ask.”