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Post-tonsillectomy dysgeusia with weight loss: possible involvement of soft palate

Published online by Cambridge University Press:  30 November 2007

A Scinska ,
A Jodkowska ,
A Korkosz ,
W Kukwa  and
H Sienkiewicz-Jarosz
A Scinska*
Affiliation:
Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Warsaw, Poland Mille Medica Outpatient Clinic Warsaw, Warsaw, Poland
A Jodkowska
Affiliation:
Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Warsaw, Poland
A Korkosz
Affiliation:
Departments of Pharmacology, Warsaw, Poland
W Kukwa
Affiliation:
Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Warsaw, Poland Mille Medica Outpatient Clinic Warsaw, Warsaw, Poland
H Sienkiewicz-Jarosz
Affiliation:
Neurology I, Institute of Psychiatry and Neurology, Warsaw, Poland
*
Address for correspondence: Dr Anna Scinska, Department of Otolaryngology, Czerniakowski Hospital, Warsaw Medical Academy, Stepinska 19/25 St, 00-739 Warsaw, Poland. Fax: +48 22 84 27 644 E-mail: scinska@ipin.edu.pl
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Abstract

Objective:

To demonstrate the importance of detailed, multidisciplinary examination of patients with post-tonsillectomy taste distortions, and to show that post-tonsillectomy dysgeusia may originate in the caudal part of the soft palate.

Case report:

We describe a 29-year-old man who suffered from severe post-tonsillectomy dysgeusia and phantogeusia with secondary weight loss and depression-like symptomatology. The patient had normal electrogustometric thresholds and sensitivity to touch on the posterior tongue. In contrast, elevated taste threshold and reduced sensitivity to touch was found on the caudal part of the soft palate (the palatoglossal arches). More marked elevation of electrogustometric threshold and insensitivity to touch on the right palatoglossal arch correlated with post-operative haemorrhage from the right tonsillar fossa. Psychiatric examination excluded major depression, eating disorders and drug abuse.

Conclusions:

Dysgeusia constitutes a rare but significant complication of tonsillectomy. Damage to the lingual branch of the glossopharyngeal nerve innervating the posterior tongue is thought to be a major cause of this complication. However, damage to the tonsillar branches of the glossopharyngeal nerve and the soft palate should also be considered as a cause of post-tonsillectomy dysgeusia. Further studies are needed to assess whether post-operative haemorrhage could indicate heightened risk of dysgeusia.

Keywords

TonsillectomyTasteComplicationsPalate
Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 2 , February 2008 , e5
Copyright
Copyright © JLO (1984) Limited 2007

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