title: Confocal microscopy of the peripheral gustatory system: comparison between healthy subjects and patients suffering from taste disorders during radiochemotherapy.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Rostock, Germany. tino.just@med.uni-rostock.de
authors.forename: Tino
authors.initials: T
authors.lastname: Just
authors.forename: Hans Wilhelm
authors.initials: HW
authors.lastname: Pau
authors.forename: Ingmar
authors.initials: I
authors.lastname: Bombor
authors.forename: Rudolf F
authors.initials: RF
authors.lastname: Guthoff
authors.forename: Rainer
authors.initials: R
authors.lastname: Fietkau
authors.forename: Thomas
authors.initials: T
authors.lastname: Hummel
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D002945:Cisplatin; D005472:Fluorouracil