Taste Disturbance After Tonsillectomy and microlaryngoscopy...?
A not-too-recent Japanese paper (Tomofuji et al; Auris Nasus Larynx 32 (2005) 381–386 )explored taste disturbance after tonsillectomy and laryngeal microsurgery and observed taste disturbance in as much as 25% of post tonsillectomy subject, and 2% of those who had laryngomicrosurgery. Reason adduced for the taste disturbance include injury to chorda tympani and / or glossopharyngeal nerve, and drug-induced (especially zinc-chelating analgesics). The author highlighted the likely of patients confusing the symptom of tongue numbness with taste disturbance.

Abstract: Objective: To investigate the incidence of taste disturbance after tonsillectomy and laryngomicrosurgery. Study design: A prospective study. Methods: Thirty-five consecutive patients underwent tonsillectomy with electric coagulator at Kanebo Memorial Hospital from September 2002 to May 2004. Another 35 consecutive patients underwent laryngomicrosurgery in a routine way during the same period. Both procedures were performed by two experienced doctors. The postoperative taste function was evaluated with questionnaire, electrogustometry (EGM), and serum levels of Zn, Cu and Fe. Results: After tonsillectomy, 3/35 patients (8.6%) complained of taste disturbance, due to the pressure on the tongue in two, and Zn deficiency after lack of intake in one. All three patients recovered taste within 1.5 months. None of our patients had taste disturbance due to surgical insult of the lingual branch of the glossopharyngeal nerve. After laryngomicrosurgery, only one patient (2.9%) complained of taste disturbance with elevation of the EGM threshold that resulted from the pressure on the tongue. In addition, abnormal sensation in the tongue occurred in 9 cases (25.7%) after tonsillectomy and in 2 cases (5.7%) after laryngomicrosurgery, and feeling of thirst occurred in 12 cases (34.3%) and in 8 cases (22.9%), respectively. Conclusion: Taste disturbance occurs in few cases when experienced surgeons perform tonsillectomy or laryngomicrosurgery. However, it is recommended to inform the patients of the potential postoperative complications such as taste disturbance and abnormal sensation of the tongue.

A follow-up publication from New York (Tessema B. et al; Ann Otol Rhinol Laryngol. 2006 Jan;115(1):18-22) also observed direct relationship between  tongue dysgeusia / paraesthesia and duration of microlaryngoscopy and attributed these to lingual nerve injury.

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Coming Events of Importance to Otolaryngologists in Africa...
 

1. 8th International Otology Course of the Jean Causse Ear Clinic
   June 22-24, 2006; Béziers, France
2. 110th American Academy of ORL,Head & Neck Surgery Annual Meeting & OTO EXPO
   September 17-20, 2006;
   Toronto, Canada.
3. 42nd South African ENT Congress joint meeting with the British Association of Otolaryngology - Head & Neck Surgery
   October 29-November 1, 2006;
   Cape Town, South Africa.

         For more Worldwide otolaryngological events and conferences....Click Here

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Another Stem Cell Research breakthrough for SNHL.....?       

An Australian study (Michael S. Hildebrad et al; JARO - Journal of the Association for Research in Otolaryngology , 2005 Volume 6, Number 4, Pages: 341 - 354 ) examined the issue of embryonic stem cells survival following introduction into the inner ear and reported that partially-differentiated ES cells could survive in the scala media of mammalian cochlea

Abstract  The low regenerative capacity of the hair cells of the mammalian inner ear is a major obstacle for functional recovery following sensorineural hearing loss. A potential treatment is to replace damaged tissue by transplantation of stem cells. To test this approach, undifferentiated and partially differentiated mouse embryonic stem (ES) cells were delivered into the scala media of the deafened guinea pig cochlea. Transplanted cells survived in the scala media for a postoperative period of at least nine weeks, evidenced by histochemical and direct fluorescent detection of enhanced green fluorescent protein (EGFP). Transplanted cells were discovered near the spiral ligament and stria vascularis in the endolymph fluid of the scala media. In some cases, cells were observed close to the damaged organ of Corti structure. There was no evidence of significant immunological rejection of the implanted ES cells despite the absence of immunosuppression. Our surgical approach allowed efficient delivery of ES cells to the scala media while preserving the delicate structures of the cochlea. This is the first report of the survival of partially differentiated ES cells in the scala media of the mammalian cochlea, and it provides support for the potential of cell-based therapies for sensorineural hearing impairment.

 

What is the diagnosis?

• Parting Shot...
  If you have an interesting case to discuss or share with other Otolaryngologists all over Africa, feel free to email Me or at best go to otolaryngology in Africa blogsite and post your case
• Also, if you are among those who requested for a copy of DODA at the last ORLSON Meeting @ Port Harcourt, please take time to view the DODA - FAQ page, you should have received your copy by now. If you have difficulty on using the program, please text +2348032472069.
• An online video demonstration of doda is available at http://www.otolaryngologyinafrica.net/doda_video.htm  This video takes about 30 - 45 minutes to fully load on a broad band network the first time, but once fully loaded could be viewed over and over again
• If you have anything you want to communicate with other Otolaryngologists - news, request, etc, feel free to email your communication to orl-mailer@ otolaryngologyinafrica.net. Your request will appear in member's page soon to be created.
• Reviewers wanted for otolaryngology news journals watch page. If you are an Otolaryngologist in Africa and will like to be our journal reviewer, please feel free to email orl-mailer@otolaryngologyinafrica.net

Till Next Week,

Biodun

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