Confocal microscopy of the peripheral gustatory system: comparison between healthy subjects and patients suffering from taste disorders during radiochemotherapy.
OBJECTIVE
Laser-scanning microscopy (LSM) was used to compare taste buds and epithelia of fungiform papillae of healthy subjects with those of patients suffering from taste disorders during/after radiochemotherapy (RCT). Aim of the study was to investigate effects responsible for taste loss at a microscopic level.


METHODS
Prospective study.


METHODS
Data from 12 healthy subjects (mean age 52.4, SD 9.5 years) were compared with those of 12 patients (mean age 54.7, SD 8.5 years) with head and neck cancer suffering from taste disorders during RCT. Four parameters from LSM were selected for analysis: 1) distance between the pore of the taste buds of fungiform papillae and the crest of the papillary vessels; 2) epithelial cells of each taste bud at 34 mum; 3), cell density, and 4) area of the taste pore at 4 mum. These data were correlated to measures of gustatory sensitivity obtained with both the validated "taste strips" test kit and electrogustometry.


RESULTS
Patients complaining from taste disorders during RCT exhibited a significant decrease of taste function assessed with both natural and electric stimuli. In these patients, we found thicker epithelia and smaller areas of the taste pores compared with healthy subjects. In 30% of those patients, no taste pores were detectable; in deeper sections, however, normal taste buds were present.


CONCLUSIONS
In conclusion, in RCT patients with taste disorders, LSM indicates changes of epithelia of fungiform papilla but no changes of the taste bud structure. Damage of the chorda tympani nerve by scattered rays, direct or indirect mucotoxic effects of chemotherapeutic agents, and covering of taste pores by epithelial cells are likely reasons for taste loss during RCT.
Just
Tino
T
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Rostock, Germany. tino.just@med.uni-rostock.de
Pau
Hans Wilhelm
HW
Bombor
Ingmar
I
Guthoff
Rudolf F
RF
Fietkau
Rainer
R
Hummel
Thomas
T
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002452:Cell Count; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D004848:Epithelium / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012720:Severity of Illness Index; D013649:Taste / Q000187:drug effects / Q000528:radiation effects; D013650:Taste Buds / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D013651:Taste Disorders / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D002945:Cisplatin; D005472:Fluorouracil