Olfactory and taste disorders in COVID-19: a cross-sectional study in primary health care

SUMMARY OBJECTIVE: The objective of this study was to describe the occurrence of self-reported olfactory and taste disorders in non-hospitalized Brazilian adults who presented severe acute respiratory syndrome-related coronavirus 2 infection symptoms and attended primary health care. METHODS: This cross-sectional study was based on a routine standardized diagnostic screening questionnaire applied in a Brazilian primary care facility. The olfactory and taste disorder occurrence was compared between severe acute respiratory syndrome-related coronavirus 2-positive and severe acute respiratory syndrome-related coronavirus 2-negative cases and described by age and sex. RESULTS: Severe acute respiratory syndrome-related coronavirus 2-positive patients had a higher proportion of self-reported olfactory and taste disorders, as compared with severe acute respiratory syndrome-negative (50.7%, vs. 20.6%, p<0.0001). Of all individuals with self-reported olfactory and taste disorder cases, 69% presented both olfactory and taste impairments, 13% olfactory only, and 17% taste only. In severe acute respiratory syndrome-related coronavirus 2-positive cases, the frequency of olfactory and taste disorders was significantly higher among females as compared with males (71% vs. 34%). Additionally, people with olfactory and taste disorders were significantly younger in the severe acute respiratory syndrome-related coronavirus 2-positive group. CONCLUSION: Self-reported olfactory and taste disorders are highly common among non-hospitalized severe acute respiratory syndrome-related coronavirus 2-positive Brazilian people who attended the Family Health Care Unit. The co-occurrence of both self-reported olfactory and taste disorders was more frequent than self-reported olfactory or taste disorders alone.

Research progress on clinical manifestations and mechanism of radiation-induced taste dysfunction in head and neck cancers / 中华放射肿瘤学杂志

Taste is a critical sensory function for human as it supports sustenance and alerts the body to toxins. Taste dysfunction is a common side effect of radiotherapy for the head and neck cancers, which is often accompanied by oral mucositis in the early stage. It is associated with anorexia, anxiety and depression, leading to declined quality of life and treatment tolerance. The incidence of radiation-induced taste dysfunction is high, and its clinical manifestations include increased taste threshold, tastelessness, and persistent bitter, sour or metallic taste, which exert significant effect upon the quality of life. At present, effective therapeutic measures for radiation-induced taste dysfunction are still lacking. In this article, research progresses on clinical characteristics and the potential mechanisms of radiation-induced taste dysfunction were reviewed, aiming to provide reference for the mechanism, prevention and treatment for taste dysfunction.

Taste perception in complete denture wearers / Percepção do sabor em usuários de prótese dentária total

ABSTRACT Purpose: to assess the recognition of salty, sweet, and citrus tastes in complete denture wearers. Methods: the study included toothless individuals (experimental group) who had been using, for at least 3 months and at the most 5 years, acrylic resin removable bimaxillary complete dentures in good condition and with adequate maxillo-mandibular relationship. The same assessment was performed in the control group, which had 26 toothed individuals. Volunteers had no difficulties ingesting any type of food. Salty, sweet, and citrus tastes were assessed with filter paper strips soaked in such solutions and placed on the tongue dorsum. Assessments were performed in duplicate and in random order. Results: the percentage rate of errors was similar between the control (9.6±13.5%) and experimental groups (10.5±15.5%) (p=0.80). There was no difference in the frequency of correct perception of tastes between denture wearers and toothed individuals. Conclusion: individuals who wore acrylic resin removable bimaxillary complete dentures perceived salty, sweet, and citrus tastes like toothed individuals did.

RESUMO Objetivo: avaliar o reconhecimento dos sabores salgado, doce e cítrico em usuários de prótese dentária total. Métodos: foram incluídos indivíduos desdentados (grupo experimental) usuários de prótese total removível bimaxilar confeccionada em resina acrílica, com tempo mínimo de uso de três meses e máximo de cinco anos, em bom estado de conservação e com adequada relação maxilo-mandibular. Como grupo controle, a mesma avaliação foi realizada em 26 indivíduos dentados. Os voluntários não tinham dificuldade na ingestão de nenhum tipo de alimento. Os sabores salgado, doce e cítrico foram testados com fitas de papel filtro embebidas nas soluções e colocadas na parte dorsal da língua. As avaliações foram realizadas em duplicata e em ordem ao acaso. Resultados: a taxa percentual de erros foi igual entre os grupos controle (9,6±13,5%) e experimental (10,5±15,5%) (p=0,80). Não houve diferenças na frequência de percepção correta dos sabores entre indivíduos usuários de prótese e indivíduos dentados. Conclusão: usuários de prótese total removível bimaxilar confeccionada em resina acrílica têm a mesma percepção dos sabores salgado, doce e cítrico que indivíduos dentados.

Changes in olfaction and taste in patients hospitalized for COVID-19 and their relationship to patient evolution during hospitalization

Abstract Objectives: During the COVID-19 pandemic, several cases of changes in olfaction and taste associated with the infection have been reported. Therefore, otolaryngologists are frequently the first medical professionals sought by patients. The aim of this study was to evaluate the frequency of olfaction and taste disorders in patients hospitalized with COVID-19, and their association with other clinical manifestations and patient evolution during hospitalization. Methods: 248 patients, admitted to three public hospitals in Belo Horizonte, Minas Gerais, Brazil, were prospectively included: Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG), Hospital Júlia Kubitschek (HJK) and Hospital Eduardo de Menezes (HEM), who, upon admission to hospital, presented with Severe Acute Respiratory Syndrome due to COVID-19. Clinical and laboratory variables and outcomes during hospitalization were prospectively collected from the electronic medical records. The collection of sociodemographic and symptomatology data during the acute phase was carried out prospectively in electronic medical records and confirmed with the patients at a subsequent outpatient visit. Results: The most frequently reported symptoms were dyspnea (77.4%), cough (69.8%) and fever (55.2%). During the acute phase of the disease, 95 (38.3%) and 87 (35.1%) patients reported taste and olfaction disorders, respectively. There was a lower prevalence of dysosmia among patients with previous comorbidities (p < 0.05). Both symptoms were associated with less need for intensive care admission (p = 0.001 for dysgeusia and p = 0.021 for dysosmia) and a negative correlation with length of hospital stay (dysosmia: r= −0.175, p < 0.05; dysgeusia: r = −0.29, p < 0.001) and length of stay in the ICU (dysosmia: r = −0.136, p < 0.05; dysgeusia: r = −0.215, p < 0.05). The absence of taste disorders was also associated with a greater need for mechanical ventilation (p < 0.001). Conclusion: Changes in taste and olfaction were reported by a large number of patients in the acute phase of COVID-19. In this study, both were markers of better clinical patient evolution. Level of evidence: 1B.

Avaliação da Disfunção Endotelial em Casos de COVID-19 com Dilatação Fluxo-Mediada / Evaluation of Endothelial Dysfunction in COVID-19 With Flow-Mediated Dilatation

Resumo Fundamento: Sabe-se que a inflamação desempenha um papel crucial em muitas doenças, incluindo a COVID-19. Objetivo: Utilizando a dilatação fluxo-mediada (DFM), objetivou-se avaliar os efeitos da inflamação na função endotelial de pacientes com COVID-19. Métodos: Este estudo foi realizado com um total de 161 indivíduos, dos quais 80 foram diagnosticados com COVID-19 nos últimos seis meses (48 mulheres e 32 homens com idade média de 32,10±5,87 anos) e 81 eram controles saudáveis (45 mulheres e 36 homens com idade média de 30,51±7,33 anos). Os achados do ecocardiograma transtorácico e da DFM foram analisados em todos os indivíduos. Resultados com p<0,05 foram considerados estatisticamente significantes. Resultados: O ecocardiograma e a DFM do grupo COVID-19 foram realizados 35 dias (intervalo: 25-178) após o diagnóstico. Não houve diferença estatisticamente significativa nos parâmetros ecocardiográficos. Em contraste, a DFM (%) foi significativamente maior no grupo controle (9,52±5,98 versus 12,01±6,18; p=0,01). Na análise multivariada com o modelo stepwise progressivo, a DFM foi significativamente diferente no grupo controle em relação ao grupo COVID-19 (1,086 (1,026-1,149), p=0,04). O teste de correlação de Spearman indicou que a DFM (r=0,27; p=0,006) apresentou correlação positiva fraca com a presença de COVID-19. Conclusão: Os achados deste estudo apontam para disfunção endotelial induzida por COVID-19, avaliada por DFM, na fase inicial de recuperação.

Abstract Background: Inflammation is known to play a crucial role in many diseases, including COVID-19. Objective: Using flow-mediated dilatation (FMD), we aimed to assess the effects of inflammation on endothelial function in COVID-19 patients. Methods: This study was conducted with a total of 161 subjects, of whom 80 were diagnosed with COVID-19 within the last six months (comprising 48 women and 32 men with a mean age of 32.10 ± 5.87 years) and 81 were healthy controls (comprising 45 women and 36 men with a mean age of 30.51 ± 7.33 years). We analyzed the findings of transthoracic echocardiography and FMD in all subjects. All results were considered statistically significant at the level of p < 0.05. Results: The echocardiography and FMD of the COVID-19 group were performed 35 days (range: 25-178) after diagnosis. There was no statistically significant difference in echocardiographic parameters. Differently, FMD (%) was significantly higher in the control group (9.52 ± 5.98 vs. 12.01 ± 6.18, p=0.01). In multivariate analysis with the forward stepwise model, FMD was significantly different in the control group compared to the COVID-19 group (1.086 (1.026 - 1.149), p=0.04). A Spearman's correlation test indicated that FMD (r=0.27, p=0.006) had a weak positive correlation with the presence of COVID-19. Conclusion: Our findings point to COVID-19-induced endothelial dysfunction, as assessed by FMD, in the early recovery phase.

Trastornos del gusto: actualización y aproximación clínica / Taste disorders: update and clinical approach

Resumen Los trastornos del gusto constituyen un grupo de alteraciones relativamente frecuentes en la práctica clínica. Son de etiología diversa, pudiendo afectar la vía gustativa en distintos niveles, manifestándose, clínicamente, con alteraciones cuantitativas y/o cualitativas de la sensibilidad gustativa. En gran parte de los casos se puede lograr un diagnóstico etiológico con una anamnesis adecuada, examen físico y exploraciones complementarias básicas. No obstante, existe poco entendimiento de su patogénesis, así como limitadas opciones terapéuticas, lo que implica la falta de algoritmos de diagnóstico y tratamiento completamente validados. El objetivo de la presente revisión es otorgar una actualización y un abordaje práctico de los trastornos del gusto.

Abstract Taste disorders represent a group of alterations relatively frequent in clinical practice. They have a diverse etiology, and they can affect the gustatory pathway at different levels, clinically manifesting with quantitative/qualitative alterations on taste sensitivity. In most of cases it is possibly to achieve an etiologically diagnosis with appropriate anamnesis, physical exploration, and basic complementary tests. However, their pathogenesis is not well understood, and they have limited therapeutic options, which determines a lack of well-validated diagnosis and treatment algorithms. The objective of this review is to provide and update and a practical approach to taste disorders.

Research progress on oral characterization of Corona Virus Disease 2019 / 口腔疾病防治

@#Corona Virus Disease 2019 (Corona Virus Disease 2019,COVID-19) has become a public health emergency that has attracted global attention because of its large-scale outbreak resulting in numerous human infections and deaths. COVID-19 is a highly contagious respiratory disease caused by novel coronavirus 2019-nCoV. Due to a large number of infections and fast transmission speed, it's significant to diagnose the infected people quickly and detect the asymptomatic infected people as soon as possible. At present, the preliminary screening is judged by the clinical manifestations of the patients, mainly involving the respiratory system, but recent studies have found that the patients infected with COVID-19 have unique oral manifestations, such as taste disturbance, xerostomia, halitosis, inflammation of salivary glands, necrotizing periodontal disease and some of them are earlier than typical symptoms such as dry cough, fever, etc. Paying attention to the oral manifestations of patients can further improve the COVID-19 screening procedure. At present, symptomatic treatment is mainly used for these oral symptoms.

Características clínicas y epidemiológicas de pacientes con la COVID-19 y trastornos quimiosensoriales

RESUMEN Introducción: Los trastornos quimiosensoriales se han identificado como síntomas típicos de la COVID-19. Objetivo: Caracterizar a pacientes con la COVID-19 y trastornos quimiosensoriales referidos. Métodos: Se incluyeron 152 pacientes hospitalizados, positivos a la COVID-19, con trastornos quimiosensoriales referidos. Se estudiaron variables clínicas y epidemiológicas, marcadores de inflamación, radiografía de tórax y tratamiento empleado. Resultados: La edad promedio fue 40,2 años, el sexo femenino 59,2 % y predominó el antecedente, contacto de caso confirmado (62,5 %), con anosmia (95,7 %), ageusia (93,3 %), sin comorbilidades (53,3 %) y ausencia de síntomas acompañantes (36,8 %). En pacientes con fuente de infección indeterminada, la confirmación fue tardía (3,89 días); no hubo diferencias significativas entre quienes presentaron uno o ambos trastornos (p= 0,053), ni entre quienes presentaron o no síntomas asociados (p= 0,14). En el 2 % el índice de neutrófilos fue mayor de 4; el 3,3 % presentó conteo absoluto de linfocitos inferior a 1500 x 109/L y el 68,4 % no mostró alteración radiológica. Requirió antimicrobianos el 5,9 % e inmunomoduladores, el 5,3 %; el 1,3 % ingresó en cuidados intensivos. La mayoría (95,4 %) egresó de alta clínica y el 1,3 % falleció. Conclusiones: Predomina el sexo femenino, con ageusia o anosmia; quienes no tienen el antecedente epidemiológico, se diagnostican con dilación. No hay diferencias al buscar atención, por uno o ambos trastornos, ni por síntomas acompañantes. Los trastornos quimiosensoriales se refieren más en ausencia de complicaciones y cuadros graves. Quienes los refieren espontáneamente, son generalmente personas saludables y oligosintomáticas.

ABSTRACT Introduction: Chemosensory disorders have been identified as typical symptoms of COVID-19. Objective: To characterize patients with COVID-19 and referred chemosensory disorders. Methods: One hundred and fifty-two hospitalized patients, positive for COVID-19, with referred chemosensory disorders were included. Clinical and epidemiological variables, inflammation markers, chest X-ray and treatment used were studied. Results: The average age was 40.2 years, the female sex 59.2%. The antecedent of confirmed case contact (62.5 %), anosmia (95.7 %), ageusia (93.3 %), and the absence of comorbidities (53.3 %) and accompanying symptoms (36.8 %), prevailed. In patients with an indeterminate source of infection, confirmation was late (3.89 days); there were no significant differences between those who presented one or both disorders (p = 0.053), nor between those who did or did not present associated symptoms (p = 0.14). In 2 % the neutrophil index was greater than 4; 3.3 % had an absolute lymphocyte count lower than 1500x106/L and 68.4 % did not show radiological alteration. Antimicrobials were required in 5.9 % and immunomodulators in 5.3 %; 1.3 % were admitted to intensive care. Most (95.4 %) were discharged from the clinic and 1.3 % died. Conclusions: The female sex predominates, with ageusia or anosmia; those who do not have an epidemiological background are diagnosed with delay. There are no differences in seeking care, for one or both disorders, or for accompanying symptoms. Chemosensory disorders are more referred in the absence of complications and severe disease. Those who refer them spontaneously are generally healthy and oligosymptomatic people.

Dysgeusia and COVID-19: the Importance of the Dentist in the Diagnostic

ABSTRACT: Dysgeusia is understood as changes in the perception of taste in patients infected with COVID-19 and has been frequently observed in the early stages of the disease. Along with the causes of dysgeusia, we can mention the correlation with infectious conditions, being of importance for the differential diagnosis. Dysgeusia can be considered one of the first manifestations of COVID-19, being an important contribution in the search for solutions regarding early diagnosis and treatment, in addition to its hospital and laboratory application.

RESUMEN: La disgeusia se entiende como cambios en la percepción del gusto en pacientes infectados por COVID-19 y se ha observado con frecuencia en las primeras etapas de la enfermedad. Junto a las causas de la disgeusia, podemos mencionar la correlación con patologías infecciosas, siendo de importancia para el diagnóstico diferencial. La disgeusia se puede considerar como una de las primeras manifestaciones del COVID-19, siendo un aporte importante en la búsqueda de soluciones en cuanto al diagnóstico y tratamiento precoces, además de su aplicación hospitalaria y de laboratorio.

Olfactory dysfunction in the scenario of COVID-19 pandemic in patients screened by the telemonitoring / Distúrbio do olfato no cenário da pandemia de COVID-19 em pacientes triados por telemonitoramento

ABSTRACT Objective To assess the clinical and epidemiological profile of patients with olfactory dysfunction in the scenario of COVID-19 pandemic. Methods The study selected patients with loss of smell, previously screened by telemonitoring system of the Municipal Health Department of Goiânia (GO), Brazil, who agreed to answer a questionnaire about COVID-19 symptoms and findings of exams. The interviews were conducted by six otolaryngologists, who applied the specific questionnaire, over the phone. Results A total of 13,910 patients underwent telemonitoring, and 627 (4.51%) had olfactory loss complaints. Out of them, 330 were included in the survey. We observed a higher prevalence of altered smell in women (67%), and in patients aged under 50 years (86%). In most cases the manifestations had a sudden onset (70%), and in the first 5 days of illness (80%). The most prevalent associated symptom was a change in taste (89%), and only 2.7% of interviewed patients required hospitalization. Conclusion Anosmia in COVID-19 is more prevalent in females and individuals aged under 50 years. It is a relevant initial symptom predictive of the disease, together with dysgeusia.

RESUMO Objetivo Avaliar o perfil clínico-epidemiológico dos pacientes com distúrbios olfatórios no cenário de pandemia da COVID-19. Métodos Foram selecionados pacientes com queixa de perda de olfato, previamente triados pelo sistema de telemonitoramento da Secretaria Municipal de Saúde de Goiânia (GO), Brasil, que concordaram em responder um questionário sobre sintomas e achados de exame em relação à COVID-19. As entrevistas foram realizadas por seis médicos otorrinolaringologistas que, via telefonema, submeteram os participantes a questionário específico. Resultados Dos 13.910 pacientes em telemonitoramento, 627 (4,51%) apresentavam queixas de alteração do olfato, e, destes, 330 foram incluídos na pesquisa. A maior prevalência de alteração do olfato se deu em mulheres (67%), e em pacientes com menos de 50 anos (86%). Na maioria dos casos, as manifestações ocorreram de forma súbita (70%), e nos primeiros 5 dias de doença (80%). O sintoma associado mais prevalente foi alteração do paladar (89%), e houve necessidade de internação hospitalar somente em 2,7% dos pacientes entrevistados. Conclusão A anosmia na COVID-19 é mais prevalente no sexo feminino e em pacientes com menos de 50 anos. Juntamente da disgeusia, trata-se de importante sintoma inicial preditivo da doença.

Post-tonsillectomy dysgeusia: A case report

@#The authors report a case of post-tonsillectomy dysgeusia and discuss the pathogenesis, diagnostics, as well as treatment options done in several reported cases. A 37-year-old man who was diagnosed with recurrent tonsillitis underwent bilateral palatine tonsillectomy, and on the second post-operative day, post-tonsillectomy hemorrhage ensued which required emergency hemostasis at the operating room. Intra-operative findings include active bleeding on the left tongue base, wherein hemostasis was achieved via electrodissection. After the procedure, patient noted a disturbance to taste that persisted for several months. Dysgeusia is an unusual complication of tonsillectomy, occurring in 0.3% to 9% of cases.

Olfactory and taste disorders in COVID-19: a systematic review / Desordens olfativas e gustativas na COVID-19: uma revisão sistemática

Abstract Introduction: The SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases. Objective: To identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19. Methods: A systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine and Reasearch Gate. Inclusion criteria: (1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions. Exclusion criteria: (1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale. Results: Six articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders. Conclusion: Olfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.

Resumo Introdução: O vírus SARS-CoV-2 causa a COVID-19 e é responsável pela maior pandemia desde o surto de influenza H1N1 de 1918. Os sintomas clássicos da doença já foram bem definidos pela Organização Mundial da Saúde; entretanto, distúrbios olfativo-gustativos têm sido relatados em alguns estudos, mas ainda com várias lacunas no entendimento e no consenso sobre a condução clínica desses casos. Objetivo: Identificar evidências na literatura científica sobre os distúrbios olfativo-gustativos acerca da apresentação clínica, prevalência e possíveis tratamentos específicos associados à COVID-19. Método: Revisão sistemática de artigos publicados até 25 de abril de 2020 nas bases de dados: Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus e Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine e Research Gate. Foram critérios de inclusão: 1) Estudos com indivíduos com COVID-19; 2) Registro dos sinais/sintomas da COVID-19 e das funções olfativo-gustativa. Foram critérios de exclusão: 1) Estudos sobre coronavírus não humano; 2) Artigos de revisão; 3) Estudos experimentais (em animais ou in vitro); 4) Distúrbios olfativos-gustativos iniciados previamente à infecção pelo SARS-CoV-2. A avaliação de risco de viés dos estudos selecionados foi feita por meio da escala de Newcastle-Ottawa. Resultados: Seis artigos dos 1.788 registros foram selecionados. Um total de 1.457 pacientes de diversas etnias foi avaliado; desses, 885 (60,7%) apresentaram perda do olfato e 822 (56,4%) perda do paladar, sendo as mulheres as mais afetadas. Os distúrbios olfativo-gustativos estiveram presentes mesmo sem obstrução nasal/rinorreia e com início mesmo antes dos sinais/sintomas clínicos da COVID-19; a recuperação do olfato/paladar, quando ocorre, geralmente se dá nas duas primeiras semanas após a resolução da doença. Há evidências de que os distúrbios olfativo-gustativos sejam fortes preditores de infecção pelo SARS-CoV-2, podendo-se recomendar o isolamento do paciente, já a partir da consulta médica, para evitar a disseminação do vírus. Não foram identificadas evidências científicas para tratamentos eficazes para qualquer dos distúrbios. Conclusão: Podem ocorrer distúrbios olfativo-gustativos em intensidades variáveis e prévios aos sintomas gerais da COVID-19, devem ser considerados como parte dos sintomas da doença, mesmo em quadros leves. Não há ainda evidências científicas de tratamentos específicos para tais distúrbios na COVID-19.

Assessment of the gustatory function in patients with advanced oral cavity and oropharyngeal cancer / Avaliação da função gustativa em pacientes com câncer de cavidade oral e orofaringe avançado

Abstract: Purpose: The changes in gustatory function resulting from oncological treatment occur mainly after radiotherapy. However, the head and neck tumors, because of the anatomical location of the lesion, can themselves trigger significant changes in the feeding-related functions - including taste. To assess the gustatory function in patients diagnosed with advanced oral cavity and oropharyngeal cancer. Method: This descriptive cross-sectional study comprised 31 individuals with advanced oral cavity and oropharyngeal cancer, referred for oncological treatment with radiotherapy, either alone or in combination with chemotherapy. The "taste strips" test was applied; it consists of inserting solutions with four different concentrations each for salty, sweet, and sour tastes, and three concentrations for the bitter taste, on the tongue. Results: Most of the individuals were diagnosed with oropharyngeal cancer. Approximately half of the sample already had taste-related complaints, and more than 80%, swallowing-related complaints. The overall frequency of hypogeusia was 38.7%, in which the bitter taste stood out in its isolated assessment. The association of change in gustatory function proved to be significant in patients in stage T4. Conclusion: The decrease in gustatory function in individuals with oral cavity and oropharyngeal cancer was evidenced in this study, especially when associated with tumors in stage T4. Regarding feeding, most of them reported complaints of dysphagia, suggesting the importance of the speech-language-hearing assessment and follow-up, even before the oncological treatment, to minimize the risks of dysphagia.

Abstract: Purpose: The changes in gustatory function resulting from oncological treatment occur mainly after radiotherapy. However, the head and neck tumors, because of the anatomical location of the lesion, can themselves trigger significant changes in the feeding-related functions - including taste. To assess the gustatory function in patients diagnosed with advanced oral cavity and oropharyngeal cancer. Method: This descriptive cross-sectional study comprised 31 individuals with advanced oral cavity and oropharyngeal cancer, referred for oncological treatment with radiotherapy, either alone or in combination with chemotherapy. The "taste strips" test was applied; it consists of inserting solutions with four different concentrations each for salty, sweet, and sour tastes, and three concentrations for the bitter taste, on the tongue. Results: Most of the individuals were diagnosed with oropharyngeal cancer. Approximately half of the sample already had taste-related complaints, and more than 80%, swallowing-related complaints. The overall frequency of hypogeusia was 38.7%, in which the bitter taste stood out in its isolated assessment. The association of change in gustatory function proved to be significant in patients in stage T4. Conclusion: The decrease in gustatory function in individuals with oral cavity and oropharyngeal cancer was evidenced in this study, especially when associated with tumors in stage T4. Regarding feeding, most of them reported complaints of dysphagia, suggesting the importance of the speech-language-hearing assessment and follow-up, even before the oncological treatment, to minimize the risks of dysphagia.

Alteraciones en el olfato y el gusto asociadas con la infección por SARS-CoV-2: una revisión / Olfactory and taste disorders associated with SARS-CoV-2 infection: a review

Los sentidos químicos, como el olfato y el gusto, son determinantes en la calidad de vida y el desempeño de algunas labores de la vida diaria, ya que desempeñan un papel fundamental tanto en la rutina como en las relaciones interpersonales. Existen múltiples patologías que alteran estos sentidos, entre estas las enfermedades por infección viral. A través de los últimos meses, se ha demostrado que el virus responsable de la pandemia actual (SARS-CoV-2) puede generar cambios en el olfato y en el gusto secundarios a la infección por este, siendo estas alteraciones, en ocasiones, las primeras manifestaciones. En esta revisión se busca recopilar la información encontrada en la literatura médica y resaltar la importancia de tener en cuenta estas alteraciones al momento de examinar a un paciente y generar una alerta en cuanto a las posibles medidas de aislamiento y/o tratamiento de estos pacientes.

Chemical senses such as smell and taste are decisive in the quality of life and performance of some tasks of daily life. They are senses that play a fundamental role in everyday life and in interpersonal relationships. There are multiple pathologies that alter these senses, including viral infection diseases. Over the last few months, it has been shown that the virus responsible for the current pandemic (SARS-CoV-2) can generate changes in smell and taste secondary to its infection, these alterations being sometimes the first demonstrations. This review seeks to compile the information found in the medical literature and conclude the importance of taking these alterations into account when examining a patient and generating an alert regarding the possible isolation and / or treatment measures for these patients.

Tobacco Influence on Taste and Smell: Systematic Review of the Literature

Abstract Introduction In Brazil, estimates show that 14.7% of the adult population smokes, and changes in smell and taste arising from tobacco consumption are largely present in this population, which is an aggravating factor to these dysfunctions. Objectives The objective of this study is to systematically review the findings in the literature about the influence of smoking on smell and taste. Data Synthesis Our research covered articles published from January 1980 to August 2014 in the following databases: MEDLINE (accessed through PubMed), LILACS, Cochrane Library, and SciELO.We conducted separate lines of research: one concerning smell and the other, taste. We analyzed all the articles that presented randomized controlled studies involving the relation between smoking and smell and taste. Articles that presented unclear methodologies and those whose main results did not target the smell or taste of the subjects were excluded. Titles and abstracts of the articles identified by the research strategy were evaluated by researchers. We included four studies, two of which were exclusively about smell: the first noted the relation between the perception of puff strength and nicotine content; the second did not find any differences in the thresholds and discriminative capacity between smokers and nonsmokers. One article considered only taste and supports the relation between smoking and flavor, another considered both sensory modalities and observes positive results toward the relation immediately after smoking cessation. Conclusion Three of the four studies presented positive results for the researched variables.

Percepção gustativa: fator de risco ou proteção para dependentes durante a cessação do uso de drogas / Taste perception: risk factor or protection for dependents during drug use cessation

O aumento no apetite e, por consequência, no peso corporal, evidenciado na maioria dos dependentes químicos em tratamento, pode estar relacionado ao paladar, uma vez que o uso pesado de drogas pode acarretar alterações das papilas gustativas. Este estudo teve por objetivo investigar a existência de associação entre a percepção gustativa e o estado nutricional de dependentes químicos em tratamento. O estudo foi realizado em duas comunidades terapêuticas de Chapecó/SC, com 39 homens dependentes químicos maiores de 18 anos. Foram coletados dados primários de peso e altura para avaliação do estado nutricional e aplicado teste de acuidade de paladar; também foram coletados dados secundários sobre idade, tempo de internação, tipos de drogas utilizadas e idade de início de uso de drogas dos prontuários dos internos. Observou-se que 56,5% dos internos estavam em risco nutricional por excesso de peso. A acuidade de paladar diferiu para os gostos básicos testados (P = 0,014), sendo maior para o salgado (94,9%), seguida pelo doce (89,7%), ácido (79,5%) e amargo (38,5%), mas não esteve associada às variáveis de estudo. Conclui-se que a cessação do uso de drogas pode ter, sobre a acuidade do paladar do dependente, efeito similar ao da privação calórica, interferindo com o ganho ponderal excessivo. Contudo, sugere-se que a melhoria da percepção gustativa seja orientada no cenário terapêutico, propondo-se que, nessas condições, pode se constituir como fator de proteção para o dependente, fortalecendo-o na superação de sua condição de vulnerabilidade

The increase in appetite and, consequently, in body weight, evidenced in the majority of addicts under treatment, may be related to taste, since heavy drug use can lead to changes in taste buds. This study aimed to investigate the association between taste perception and nutritional status of drug addicts under treatment. The study was conducted in two therapeutic communities in the municipality of Chapecó, Santa Catarina state, with 39 male addicts over 18 years old. Primary data on weight and height were collected for assessment of nutritional status, and a taste acuity test was applied; also, secondary data were collected on age, length of stay, types of drugs used, and age of drug use onset, from the addicts' records. It was possible to observe that 56.5% of dependents were at nutritional risk for being overweight. Taste acuity significantly differed for the basic tastes evaluated (p= 0.014), being higher for salty (94.9%), followed by sweet (89.7%), acid (79.5%), and bitter (38, 5%) tastes, but it was not associated with the study variables. We conclude that the drug use cessation can have a similar effect to that of caloric deprivation on the taste acuity of dependents, interfering on excessive weight gain. However, it is suggested that the improvement of taste perception be oriented in the therapeutic setting, so that it becomes, in these conditions, a protection factor for dependents, strengthening them to overcome their condition of vulnerability

Disfuncao gustatoria e olfatoria em laringectomizados / Gustatory and olfactory dysfunction in laryngectomized patients

Após a cirurgia de laringectomia total, o fluxo aéreo nasal é transferido definitivamente para o traqueostoma, comprometendo a chegada de moléculas odoríferas até a cavidade nasal, podendo repercutir em alterações na percepção olfatória e gustatória nesses indivíduos. OBJETIVO: Avaliar as funções do olfato e do paladar em laringectomizados totais. Desenho do estudo: Estudo de série. MÉTODO: A amostra envolveu um grupo com 25 pacientes submetidos à laringectomia total e outro grupo de comparação com 25 pacientes não laringectomizados. A função gustatória foi avaliada por tiras gustativas de papel de filtro. Para avaliação da função olfatória, foi aplicado o teste Brief Smell Identification Test. RESULTADOS: No grupo de laringectomizados, houve maior frequência de hipogeusia (80%; p < 0,05), assim como de hiposmia (88%; p < 0,001), isoladas e concomitantes (72%; p < 0,001). Na discriminação dos sabores, o sabor amargo não diferiu entre os grupos, diferentemente dos demais sabores. No aspecto olfatório, os laringectomizados tiveram pior desempenho na detecção de odores de alerta e os relacionados à alimentação. Identificou-se que história de tabagismo e de alcoolismo foi significantemente mais frequente dentre laringectomizados. CONCLUSÃO: A diminuição das funções olfatória e gustatória em laringectomizados totais foi evidenciada nesse estudo. .

After total laryngectomy surgery, nasal airflow is moved permanently to the tracheostomy opening, compromising the contact of odorant molecules with the nasal cavity, which may reflect changes in the olfactory and gustatory perception in these individuals. OBJECTIVE: To evaluate the functions of smell and taste in total laryngectomized patients. Study design: a study of series. METHOD: The sample included a group of 25 patients submitted to total laryngectomy and another group of 25 patients who did not underwent the procedure. The taste function was evaluated by gustatory strips of filter paper. To assess the olfactory function we employed the Brief Smell Identification Test. RESULTS: Among the laryngectomized patients there was more hypogeusia (80%, p < 0.05), as well as hyposmia (88%, p < 0.001), alone and concomitant (72%, p < 0.001). Concerning flavor discrimination, the bitter taste did not differ between the groups - which was different from the other flavors. In the olfactory aspect, laryngectomized patients performed worse in detecting warning and food-related odors. We found that a history of smoking and alcohol consumption were significantly more frequent among laryngectomized patients. CONCLUSION: We found a decrease of gustatory and olfactory functions in total laryngectomized patients in this study. .

Reabilitação das funções do olfato e do paladar em laringectomizados totais: revisão sistemática / Rehabilitation of smell and taste functions in total laryngectomy: systematic review

TEMA: na laringectomia total ocorre a transferência do fluxo aéreo nasal definitivamente ao traqueostoma, podendo provocar diminuição na percepção do olfato e do paladar. Recentemente tem sido desenvolvidos métodos de intervenção a fim de melhorar a performance olfativa e gustativa em laringectomizados, embora sejam escassos os estudos que abordam esse tema. OBJETIVO: rever de forma sistemática as evidências de como as técnicas envolvidas na reabilitação das funções do olfato e do paladar tem efeito em indivíduos laringectomizados totais. CONCLUSÃO: nesta revisão todos os estudos selecionados demonstraram eficácia na utilização de técnicas de reabilitação para a função do olfato em laringectomizados totais. Para o paladar não houve propostas para intervir diretamente nesta função.

BACKGROUND: in total laryngectomy there occurs the transfer of the nasal airflow definitely to the tracheostoma, which could cause a decrease in the perception of smell and taste. There have been recently developed methods of intervention in order to improve performance in laryngectomized smell and taste, although few studies have investigated this issue. PURPOSE: this study aimed to systematically review the evidence of how the techniques involved in the rehabilitation of the functions of smell and taste have an effect on individuals with total laryngectomy. CONCLUSION: in this review all the selected studies demonstrated effective use of rehabilitation techniques for the role of olfaction in laryngectomized. As for taste, there were no proposals in order to intervene directly in this function.

The Relationship between Single Nucleotide Polymorphisms of the Carbonic Anhydrase 6 Gene andPhenylthiocarbamide Taste Sensitivity, Taste Disorder / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The phenylthiocarbamide (PTC) and 6-n-propylthiouracil (PROP) taste sensitivity varies among individuals. Recently, it is reported that PROP taste responsiveness is associated with carbonic anhydrase 6 (CA6) gene polymorphism. The CA6 gene, a zinc metalloprotein in human saliva, is affected in taste function and might be correlated with gustatory diversity. The aim of this study was to examine whether PTC taste sensitivity and taste disorder is associated with the CA6 gene polymorphism rs2274327 (C/T), rs2274328 (A/C), and rs2274333 (A/G). SUBJECTS AND METHOD: A total of 217 healthy normal subjects were recruited as controls, and 50 taste disorder patients were recruited as experimental group. The polymorphisms of CA6 gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis. All statistical analyses were calculated using the statistical package for the social science software. Haplotypes were estimated by Haploveiw and the PHASE programs. RESULTS: The CA6 gene polymorphisms showed association with taste disorder but not with PTC sensitivity (taster/nontaster). The number of control subjects carrying AA genotype of single nucleotide polymorphism rs2274328 (A/C) in the CA6 gene was higher than the number of the subjects with taste disorder (p=0.048). However, there was no association between controls and taste disorder subjects in the haplotype analysis. CONCLUSION: These data suggest that the CA6 gene polymorphism rs2274328 could affect taste function impairment in patients with taste disorder. This observation requires a further functional study of gustin protein to clarify the association of the CA6 gene polymorphisms with the taste disorder and sensitivity.

Anormalidades sensoriais: olfato e paladar / Sensorial abnormalities: smell and taste

INTRODUÇÃO: Anormalidades do paladar e do olfato comprovaram ser um tema bem mais complexo do que se reconhecia anteriormente. Diversas entidades nosológicas cursam com alterações olfatórias e gustatórias, podendo ser congênitas ou adquiridas. OBJETIVO: Analisar os principais aspectos das disfunções olfatórias e gustatórias. MÉTODO: Foram utilizadas as bases de dados informatizados para a coleta de dados, tendo como palavras-chave "alteração", "olfato" e "paladar". Realizou-se também busca não-sistemática em publicações científicas e livros médicos. REVISÃO DA LITERATURA: Disfunções olfatórias e gustatórias possuem etiologia variada, destacando-se as doenças nasais e sinusais obstrutivas, infecções do trato respiratório superior, traumatismo cranioencefálico, envelhecimento, exposição a tóxicos e algumas medicações, neoplasias nasais ou intracranianas, patologias psiquiátricas e neurológicas, iatrogenia, causas idiopáticas e congênitas. Anamnese detalhada, exame físico atencioso e exames complementares adequados são importantes para o diagnóstico dessas alterações. CONCLUSÃO: Disfunções olfatórias e gustatórias frequentemente ocorrem juntas. A detecção precoce de tais disfunções pode levar a um tratamento mais efetivo, retardando a progressão das doenças que as ocasionam e atenuando a severidade dos sintomas. Em muitos casos o tratamento dessas alterações não é fácil e é necessária uma cooperação interdisciplinar entre o otorrinolaringologista, endocrinologista, neurologista, psiquiatra entre outros.

INTRODUCTION: Taste and smell abnormalities have proven to be an extremely more complex subject than previously regarded. Wide-ranging nosologic entities arise along with smell and taste alterations, and they can be congenital or acquired. OBJECTIVE: Analyze the main features of smell and taste dysfunctions. METHOD: Automated databases were used to collect data, by searching keywords like 'alteration', 'smell', and 'taste'. A non-systematic search was also made in scientific printings and medical books. LITERATURE REVIEW: Smell and taste dysfunctions have a vast etiology, the most significant of which are obstructive nasal and sinusal disease, infections of the upper respiratory tract, cranioencephalic trauma, aging, exposure to toxics and some drugs, nasal or intracranial neoplasias, psychiatric and neurological pathologies, iatrogenic disease, idiopathic and congenital causes. A detailed anamnesis, a careful physical examination and supplementary evaluations are important for the diagnosis of these alterations. CONCLUSION: As a rule, smell and taste dysfunctions occur in a combined way. The early discovery of such dysfunctions can lead to a more efficient treatment, making the progress of diseases causing them retard and the symptoms less severe. In many cases, treating these alterations is not easy and there needs to be a multidisciplinary cooperation among the otorhinolaryngologist, endocrinologist, neurologist, psychiatrist, among others.