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20 March 2025

Smell and Taste Impairments in Head and Neck Cancer Patients—A Scoping Review

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Department of Otolaryngology, The Ohio State University, Columbus, OH 43210, USA
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Nutrients2025, 17(6), 1087;https://doi.org/10.3390/nu17061087
This article belongs to the Special Issue The Interaction Between Flavor and Diet
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Abstract

Head and neck cancer affects millions worldwide. The risk factors are numerous, including smoking, alcohol consumption, and human papillomavirus to name a few. While improved preventative, diagnostic, and treatment methods have decreased mortality rates, the treatments (chemotherapy, radiotherapy, or surgery) often result in smell and/or taste impairments. These can impact quality of life during and after cancer treatment. A scoping review was performed to understand current research and future directions regarding smell and taste impairments in head and neck cancer patients. PRISMA guidelines were followed and Rayyan.ai was used to search and compile journal articles. Three databases, EBSCOhost, Google Scholar, and PubMed, were also searched. Search terms included smell, taste, dysgeusia, ageusia, hypogeusia, parosmia, anosmia, hyposmia, dysosmia, and head and neck cancer. A total of 1580 articles were found through Rayyan.ai and 8022 were found through the three databases, which were manually screened. Articles assessing patients with a different malignancy, benign tumors, pediatric populations, animal studies, abstracts, and review articles were excluded. A total of 47 articles were found using this strategy. Of those we identified, 37 articles discussed taste impairments, 12 articles discussed smell impairments, and 3 articles discussed treatments for smell and/or taste impairments. All 37 articles concluded that there was some taste alteration in head and neck cancer patients due to their treatment. However, the specific taste qualities (sweet, sour, salty, or bitter) that were impaired, whether taste function returned to baseline, and which treatments led to impairments varied. For the 12 studies that assessed smell impairments, the results also varied. Some studies found significant objective impairments in smell while others found no significant impairment. Zinc sulfate was not found to be an effective treatment option for taste impairments; however, a liposomal spray showed some potential. Future studies should aim to understand which treatments and types of head and neck cancer lead to chemosensory impairments, whether chemosensory alterations negatively impact a patient’s nutritional status, and treatments or preventative measures for smell and taste changes.

1. Introduction

Nearly 1.5 million cases of head and neck cancer are diagnosed yearly [1]. Risk factors include smoking, alcohol consumption, human papillomavirus infection, Ebstein–Barr virus, betel nut consumption, and radiation exposure [2]. The initial symptoms patients experience depend on the location of the tumor; however, common symptoms include hoarseness, persistent sore throat, new neck mass, cranial nerve dysfunction, weight loss, chemosensory impairments (e.g., smell and taste), and difficulty chewing or swallowing [3,4]. The incidence of head and neck cancer has been increasing, yet improved preventative, diagnostic, and treatment methods have all decreased mortality rates worldwide [1]. Therefore, long-term outcomes and quality of life are of increasing importance in this population. Treatment options for these patients range from chemotherapy and radiotherapy to surgical removal of the tumor [5].
A common side effect of these treatments is sensory impairment, which can include losses in smell and/or taste [6,7,8,9,10,11]. These can negatively impact a patient’s quality of life and potentially lead to malnutrition during and after treatment [12,13,14]. Due to the SARS-CoV-2 pandemic, there has been an increase in research focused on smell and taste impairments. This has led to improvements in the diagnosis of chemosensory impairments as well as potential treatment options [15]. On one hand, recent studies have explored taste dysfunction in these patients; however, the results were inconsistent [8,10,11,16,17,18,19]. On the other hand, the impact of treatment on olfaction is less investigated. Furthermore, there is little information about how sensory impairments impact food consumption and nutritional status in patients. We performed a scoping review to understand the current research and future directions regarding smell and taste impairments in head and neck cancer patients.

2. Materials and Methods

PRISMA guidelines were followed for this scoping review [20]. Rayyan.ai was used for the search and compilation of journal articles [21,22,23]. Search terms included smell, taste, dysgeusia, ageusia, hypogeusia, parosmia, anosmia, hyposmia, dysosmia, and head and neck cancer to capture all available journal articles. Three additional databases (Google Scholar, EBSCOhost, and PubMed) were searched separately using the search terms listed above. A total of 1580 articles were found using Rayyan.ai, 7640 additional articles through Google Scholar, 372 articles through PubMed, and 10 through EBSCO-host.
An example of a PubMed search phrase is the following:
(“Smell”[tiab:~3] OR “anosmia”[tiab:~3] OR “hyposmia”[tiab:~3] OR “parosmia”[tiab:~3]) AND (“taste”[tiab:~3] OR “dysgeusia”[tiab:~3] OR “hypogeusia”[tiab:~3] OR “ageusia”[tiab:~3]) AND (“head and neck cancer”)
Relevant articles had to include measures to assess smell and/or taste impairment, or treatments for smell and/or taste impairment, or the nutritional impact of smell and/or taste impairment in head and neck cancer patients. Articles assessing patients with a different malignancy, benign tumors, pediatric populations, animal studies, abstracts, and review articles were excluded. Only studies assessing smell and taste objectively or subjectively in head and neck cancer patients were included.
Rayyan.ai allowed all six reviewers to independently assess titles and abstracts based on the inclusion and exclusion criteria. Reviewers were guided by the keywords listed above in order to identify relevant articles. Articles were rated as “included”, “excluded”, or “maybe” (i.e., insufficient information to decide eligibility) based on the title, then the abstract, and then the full-text reading. All articles listed as “included” and “maybe” were discussed as a group to decide eligibility. If there were discrepancies between reviewers, the article was discussed, and a final decision was made. Figure 1 is a PRISMA flow diagram that demonstrated the literature selection process. Papers included in this scoping review are organized in Table 1, which includes the following components: author, year published, patient population, sample size, measures used to assess chemosensory impairments, and results or findings.
Figure 1. A PRISMA flow diagram detailing the journal article selection process.
Table 1. Studies on taste and smell alterations in head and neck cancer patients.

3. Results

The search strategy aimed to gain a thorough understanding of smell and taste impairments in head and neck cancer patients. The journal articles included in this review spanned a variety of study designs and sample sizes, and used both objective and subjective assessment measures. Table 1 lists all the studies included in this scoping review.

3.1. Taste Impairments

A total of 37 articles assessed taste impairments in some degree; these included studies designed to assess the intensity of taste dysfunction, how changes in taste impacted quality of life, and the eating experience or nutritional impact of patients who experienced taste alterations. Patients received a range of treatments, including radiation therapy, chemotherapy, surgical removal of the tumor, or some combination of the three.
Studies used objective and/or subjective measures to assess changes in taste function. Some studies opted for objective measures using four taste qualities (sweet, sour, salty, and bitter). Seven studies focused specifically on assessing taste impairments at various dilutions, concentrations, or intensities of sweet, sour, salty, and bitter solutions. Other studies used subjective yet validated quality-of-life questionnaires such as the MD Anderson Symptom Inventory—Head and Neck Module, the European Organization for Research and Treatment of Cancer: Head and Neck Cancer Module-35, or the University of Washington Quality of Life version 4.
The median number of participants tested was 81 participants. Seven studies had a control group to compare the experimental group to. Patients were tested at multiple time points throughout treatment and after treatment.
All 37 studies found that there were significant changes in taste function among patients. In Riva et al., there were statistically significant, long-term taste impairments for the bitter and sour taste qualities between the control group and nasopharyngeal cancer (a subtype of head neck cancer) patient group [51]. There was also a statistically significant difference in the total taste scores between the control group and nasopharyngeal cancer patient group. Of the patients, 100% experienced bitter taste loss, 77.8% experienced salty taste loss, 70.4% experienced sour taste loss, and 40.7% experienced sweet taste loss. The sweet taste quality had the quickest recovery time while the bitter taste had the slowest recovery time. Nasopharyngeal cancer patients experienced maximum taste loss around the 4th week of chemoradiotherapy treatment [51]. Similarly, Mirza et al. found that patients had lower identification scores for bitter, salty, and sour tastes compared to the control group. They found that patients had a significant decrease in taste pore count from the first radiation treatment session to the second treatment session. Taste pore count in patients stabilized 6 months after radiation treatment was completed [44].
There are conflicting results on whether taste sensations return back to baseline after treatment. Stieb et al. reported that taste improved in the years after completing radiation, but plateaued after 5 years post-treatment [56]. Another study had similar results, stating that there is some improvement 1 year after intensity-modulated radiation therapy, but that taste did not return to baseline [49]. One study reported that while there were significant decreases in overall taste sensation during radiation treatment, all tastes returned to baseline after treatment [8]. All studies emphasized that taste alterations caused significant deteriorations in quality of life regardless of whether taste loss was partial or total.
Three studies focused on how treating head and neck cancer surgically impacted taste function [18,25,40]. Out of these three, one study compared transoral robotic surgery to definitive radiation treatment. Two of these studies utilized the University of Washington Quality of Life Questionnaire, while one study had patients complete posterolateral swab taste testing or whole-mouth taste testing 2 weeks after surgery [18,25,40]. In all these studies, patients reported their taste function was impacted post-operatively. One study showed that regional swab taste identification was decreased after surgery on the side of the tumor [18]. When comparing transoral robotic surgery to radiation, patients who underwent transoral robotic surgery scored significantly better in the saliva and taste domain than patients undergoing definitive radiation at all four time points. Among transoral robotic surgery patients, adjuvant chemotherapy was associated with worse quality-of-life scores in the taste domain at 6 and 12 months post-operatively [40].
One study evaluated the impact of radiation dose and salivary output on taste dysfunction [50]. Radiation dose to the taste bud bearing tongue mucosa was not significantly correlated with taste impairment [58]. However, there was a significant correlation between radiation dosage to the submandibular and parotid gland on the side of the tumor and moderate-to-severe taste impairment [55].
Four studies focused on how taste dysfunction impacted the nutritional status in patients. In Li et al., 67% of patients experienced significant weight loss [12]. Changes in taste functions were also associated with malnutrition, with malnutrition prevalence being significantly higher at the 3-month follow-up than the 6-month follow-up [13]. Finally, there was a statistically significant increase in patients who experienced taste loss in the food-restriction group [27]. Pingili et al. found that 40.2% of oral and oropharyngeal cancer patients experienced malnutrition [13]. They also found that malnutrition was significantly lower in patients who had taken nutritional supplements [13].
For patients who are unable to consume enough food, have difficulty swallowing, or struggle with severe nausea, a feeding tube is necessary to prevent malnutrition and continue treatment. One study focused on how taste alterations impacted quality of life in tube-fed vs. orally fed head and neck cancer patients receiving radiotherapy, chemotherapy, or a combination of the two [7]. All tube-fed patients had oral intake in the form of clear liquids and supplements. As the study progressed, the most distressing symptoms for tube-fed patients and orally fed patients were swallowing and saliva, respectively [7]. Taste was also considered an important symptom for both patient groups; however, it was not the most distressing symptom [7]. Tube-fed patients had significantly higher Taste Complaint Scores than orally fed patients [7]. At the 2.5-month follow-up, 49.3% of orally fed patients and 62.1% of tube-fed patients had significant taste impairments according to the UW-QoL assessment [7].

3.2. Smell Impairments

A total of 12 articles discussed smell impairments in head and neck cancer patients who received a range of treatments. These treatments include chemotherapy, radiotherapy, surgical removal of the tumor, or a combination of the three. The median number of study participants was 42, with three studies including a healthy control group. Studies used either objective methods or subjective methods to assess the association between head and neck cancer treatment and olfactory impairment. Objective measures included Sniffin’ sticks to assess odor threshold, discrimination, and identification, the NIH Toolbox Odor Identification Test, or the University of Pennsylvania Smell Identification Test. Subjective measures included the quality-of-life questionnaires previously listed above.
The findings of the 12 studies were limited and conflicting. Barbosa Da Silva et al. found that head and neck cancer patients had significantly worse identification performance for 33 out of the 40 odorants compared to the control group prior to treatment [24]. The chance of a patient having olfactory losses was 10 times higher than in the control group [24]. However, this study focused on symptoms before beginning treatment rather than during or after treatment [24]. Another study reported that smell function significantly worsened in the long term according to the Health-Related Quality of Life Questionnaire [48]. Other studies found significant subjective differences between the patient and control groups in regard to olfactory impairment [29,51,53]. In these studies, up to 92% of patients reported some degree of smell alteration and 51.1% of patients reported severe alterations in smell [38]. Yet these were subjective findings the patients reported rather than objective findings through validated olfactory assessments. Veyseller et al. reported that there was a significant difference between olfactory scores between nasopharyngeal cancer patients and the control group. Olfactory bulb volumes of the healthy control group were significantly higher than in the nasopharyngeal cancer patient group [57].
Unlike taste, there is limited information on how smell impairment impacts nutrition and quality of life in head and neck cancer patients. Only one study indicated that smell alterations were significantly correlated with anxiety and quality-of-life survival scores [38].

3.3. Treatments for Sensory Impairments

Treatments for head and neck patients experiencing smell and/or taste impairments are limited. One preventative option is to limit radiation to the taste bud bearing tongue mucosa and the olfactory bulb [57]. Another potential option is to decrease the treatment dose to protect the taste bud bearing tongue mucosa and the olfactory bulb. Both of these preventative options are difficult, since radiation doses reach large quantities and it is difficult to localize treatments for all head and neck cancers, especially if they have metastasized.
Three articles were found that discussed two potential treatments for smell and taste impairments in head and neck cancer patients: zinc sulfate and a liposomal spray. The number of participants in these three studies was 35, 98, and 169, respectively. Two of the studies were randomized control trials while the third was a pre–post study [31,33,45]. Zinc sulfate was only assessed as a potential treatment for taste impairment while the liposomal spray was tested as a potential treatment for both taste and smell.
Zinc sulfate was assigned three times a day throughout radiation and 1-month post-treatment for experimental group patients. Control group patients were given a placebo. All patients had taste impairments during the first two months of treatment. In this particular study, zinc sulfate did not favorably affect taste recovery [31]. In another study, zinc sulfate was given to prevent the effects of taste alteration in the experimental group. In patients who received zinc, taste perception threshold did not change at the end of radiation except for the sour taste. In the placebo group, taste perception threshold significantly increased for all tastes. In the zinc group, there was only a slight increase in the perception threshold for the salty taste post-treatment [45].
The liposomal spray was used for the nose and mouth for 2 months. All participants suffered from a smell and taste disorder after finishing head and neck cancer treatment. Patients with primary radiation had a decreased sense of smell; however, this was not statistically significant. Patients underwent a variety of treatments and were split into three separate groups: only surgery, surgery and adjuvant radiochemotherapy, and primarily radiochemotherapy. Patients were requested to take the liposomal spray for 2 months, three times a day, with five sprays in each nostril and the mouth [33]. After liposomal application, sense of smell increased significantly for all three groups. The same results were seen for taste, with significant increases being seen in all three groups. Of the patients, 13.3% showed no improvement for smell, with their results showing no greater than a 2-point increase in their TDI scores. Meanwhile, 10.2% of patients showed no improvement in taste, with their results showing no greater than a 1-point increase in their taste strip score [33]. These results indicate a potential treatment option for patients who experience smell and taste impairments.

4. Discussion

This scoping review identified and reported on 47 articles and publications discussing smell and taste alterations in head and neck cancer patients. All 37 articles about taste impairments reported significant changes in taste function. There was conflicting information about which taste qualities were the most impacted by head and neck cancer treatment and if taste function returned to baseline after treatment was completed. Since the information on smell alterations was limited, conclusive results could not be determined. Three studies found significant impairments in olfactory function for head and neck cancer patients. Only 9 out of 47 studies had a control group. Not all studies used objective measures to assess smell and taste losses in patients. Some studies used quality-of-life questionnaires that inquired about smell and taste dysfunction.
This scoping review also reported on how surgical interventions for head and neck cancer impacted taste function. Three studies focused on the impact of surgical interventions on chemosensory function. These studies found that taste function was impacted post-operatively. Transoral robotic surgery patients had better outcomes for the saliva and taste domain than patients undergoing definitive radiation, but had worse quality-of-life scores in the taste domain if they received adjuvant chemotherapy [40]. Another study reported that taste identification was decreased on the side of the tumor post-operatively [18]. This indicates that surgical interventions could have a negative effect on chemosensory function.
New surgical interventions could be a possible treatment to alleviate smell and taste impairments. Menzel et al. studied various endoscopic approaches to electrically stimulate the olfactory bulb in human cadavers. This study suggests that this surgical approach is low-to-medium risk for the patient and allows the electrode to be near the olfactory bulb [59]. Similarly, electrical stimulation could improve the function of certain taste receptors. Katsuki et al. studied how electrical taste stimulation impacted salt taste perception in stroke patients [60]. Their findings suggested that salt taste perception was significantly enhanced in stroke patients without significantly altering the salt concentration. Funamizu et al. conducted a similar study to understand how transcutaneous electrical stimulation near the mouth impacted taste perception [61]. Similarly to Katsuki et al., the intensity of the salty taste was enhanced along with the overall taste of six different foods [61]. While further research is necessary in the head and neck cancer population, these preliminary studies showed promising results to enhance taste perception using a non-invasive method.
The current scoping review captured research on how head and neck cancer impacts smell and taste. Recent advances have allowed for personalized and localized treatment options for patients. These could lead to new chemosensory side effects that have not previously been studied. Moreover, since treatment options vary depending on the type of head and neck cancer, chemosensory alterations could differ based on the treatment a patient receives.
Future research should aim to understand what specifically is causing chemosensory impairments in head and neck cancer patients receiving treatment. They should also inquire about which types of head and neck cancer treatments are more likely to cause smell and/or taste impairments. The nutritional status of head and neck cancer patients, specifically how they navigate consuming food, is an important aspect of treatment that should also be followed. Finally, potential treatments should be investigated. Right now, only three studies have assessed potential treatments: zinc sulfate and a liposomal spray. It would be beneficial to continue evaluating potential treatments for smell and taste alterations due to head and neck cancer treatments, so patients have multiple methods to choose from.

Author Contributions

N.J. wrote the manuscript and selected articles for review; J.S. selected articles for review; L.G. selected articles for review; S.P. selected articles for review; W.L. selected articles for review; E.P. selected articles for review; A.R. advised and helped edit the review; K.Z. advised and helped edit the review. All authors have read and agreed to the published version of the manuscript.

Funding

NIH-NIDCD, R01 DC020737 and R01DC020302 to K.Z.

Data Availability Statement

All data, code, and materials used in the analysis are available to any researcher for purposes of reproducing or extending the analysis via institutional materials transfer agreements (MTAs).

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Zhou, T.; Huang, W.; Wang, X.; Zhang, J.; Zhou, E.; Tu, Y.; Zou, J.; Su, K.; Yi, H.; Yin, S. Global burden of head and neck cancers from 1990 to 2019. iScience 2024, 27, 109282. [Google Scholar] [CrossRef] [PubMed]
  2. Dhull, A.K.; Atri, R.; Dhankhar, R.; Chauhan, A.K.; Kaushal, V. Major Risk Factors in Head and Neck Cancer: A Retrospective Analysis of 12-Year Experiences. World J. Oncol. 2018, 9, 80–84. [Google Scholar] [CrossRef] [PubMed]
  3. Bradley, P.T.; Lee, Y.K.; Albutt, A.; Hardman, J.; Kellar, I.; Odo, C.; Randell, R.; Rousseau, N.; Tikka, T.; Patterson, J.M.; et al. Nomenclature of the symptoms of head and neck cancer: A systematic scoping review. Front. Oncol. 2024, 14, 1404860. [Google Scholar] [CrossRef]
  4. Murphy, B.A.; Wulff-Burchfield, E.; Ghiam, M.; Bond, S.M.; Deng, J. Chronic Systemic Symptoms in Head and Neck Cancer Patients. JNCI Monogr. 2019, 2019, lgz004. [Google Scholar] [CrossRef]
  5. Lee, A.M.; Weaver, A.N.; Acosta, P.; Harris, L.; Bowles, D.W. Review of Current and Future Medical Treatments in Head and Neck Squamous Cell Carcinoma. Cancers 2024, 16, 3488. [Google Scholar] [CrossRef] [PubMed]
  6. Alfaro, R.; Crowder, S.; Sarma, K.P.; Arthur, A.E.; Pepino, M.Y. Taste and Smell Function in Head and Neck Cancer Survivors. Chem. Senses 2021, 46, bjab026. [Google Scholar] [CrossRef] [PubMed]
  7. Alvarez-Camacho, M.; Gonella, S.; Ghosh, S.; Kubrak, C.; Scrimger, R.A.; Chu, K.P.; Wismer, W.V. The impact of taste and smell alterations on quality of life in head and neck cancer patients. Qual. Life Res. 2016, 25, 1495–1504. [Google Scholar] [CrossRef]
  8. Asif, M.; Moore, A.; Yarom, N.; Popovtzer, A. The effect of radiotherapy on taste sensation in head and neck cancer patients—A prospective study. Radiat. Oncol. 2020, 15, 144. [Google Scholar] [CrossRef]
  9. Chen, W.C.; Hsu, C.M.; Tsai, Y.T.; Lin, M.H.; Tsai, M.S.; Chang, G.H.; Lai, C.H.; Fang, F.; Chen, M.F. Prospective Evaluation of Taste Function in Patients With Head and Neck Cancer Receiving Intensity-Modulated Radiotherapy. JAMA Otolaryngol.–Head. Neck Surg. 2022, 148, 604–611. [Google Scholar] [CrossRef]
  10. Chen, W.C.; Tsai, M.S.; Tsai, Y.T.; Lai, C.H.; Lee, C.P.; Chen, M.F. Long-Term Taste Impairment after Intensity-Modulated Radiotherapy to Treat Head-and-Neck Cancer: Correlations with Glossectomy and the Mean Radiation Dose to the Oral Cavity. Chem. Senses 2019, 44, 319–326. [Google Scholar] [CrossRef]
  11. Mathlin, J.; Courtier, N.; Hopkinson, J. Taste changes during radiotherapy for head and neck cancer. Radiography 2023, 29, 746–751. [Google Scholar] [CrossRef] [PubMed]
  12. Li, M.; Nutting, C.; Zhang, T.; Gou, Q.; Liu, T. Nutrition impact symptoms in head and neck cancer during radiotherapy: A longitudinal study. Acta Oto-Laryngol. 2023, 143, 499–506. [Google Scholar] [CrossRef] [PubMed]
  13. Pingili, S.; Ahmed, J.; Sujir, N.; Shenoy, N.; Ongole, R. Evaluation of Malnutrition and Quality of Life in Patients Treated for Oral and Oropharyngeal Cancer. Sci. World J. 2021, 2021, 9936715. [Google Scholar] [CrossRef]
  14. Mulasi, U.; Vock, D.M.; Jager-Wittenaar, H.; Teigen, L.; Kuchnia, A.J.; Jha, G.; Fujioka, N.; Rudrapatna, V.; Patel, M.R.; Earthman, C.P. Nutrition Status and Health-Related Quality of Life Among Outpatients With Advanced Head and Neck Cancer. Nutr. Clin. Pract. 2020, 35, 1129–1137. [Google Scholar] [CrossRef]
  15. Cattaneo, C.; Pagliarini, E.; Mambrini, S.P.; Tortorici, E.; Mené, R.; Torlasco, C.; Perger, E.; Parati, G.; Bertoli, S. Changes in smell and taste perception related to COVID-19 infection: A case–control study. Sci. Rep. 2022, 12, 8192. [Google Scholar] [CrossRef] [PubMed]
  16. Baharvand, M.; ShoalehSaadi, N.; Barakian, R.; Jalali Moghaddam, E. Taste alteration and impact on quality of life after head and neck radiotherapy. J. Oral Pathol. Med. 2013, 42, 106–112. [Google Scholar] [CrossRef]
  17. McLaughlin, L. Taste Dysfunction in Head and Neck Cancer Survivors. Oncol. Nurs. Forum 2013, 40, E4–E13. [Google Scholar] [CrossRef]
  18. Tharakan, T.; Piccirillo, J.F.; Miller, B.; Reed, D.R.; Kallogjeri, D.; Paniello, R.; Puram, S.V.; Jackson, R.S. Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery. Laryngoscope 2023, 133, 3520–3528. [Google Scholar] [CrossRef]
  19. Yamashita, H.; Nakagawa, K.; Hosoi, Y.; Kurokawa, A.; Fukuda, Y.; Matsumoto, I.; Misaka, T.; Abe, K. Umami taste dysfunction in patients receiving radiotherapy for head and neck cancer. Oral Oncol. 2009, 45, e19–e23. [Google Scholar] [CrossRef]
  20. Tricco, A.C.; Lillie, E.; Zarin, W.; O’Brien, K.K.; Colquhoun, H.; Levac, D.; Moher, D.; Peters, M.D.J.; Horsley, T.; Weeks, L.; et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann. Intern. Med. 2018, 169, 467–473. [Google Scholar] [CrossRef]
  21. Hedley, P.L.; Hagen, C.M.; Wilstrup, C.; Christiansen, M. The use of artificial intelligence and machine learning methods in first trimester pre-eclampsia screening: A systematic review protocol. medRxiv 2022. [Google Scholar] [CrossRef]
  22. Valizadeh, A.; Moassefi, M.; Nakhostin-Ansari, A.; Asl, S.H.H.; Torbati, M.S.; Aghajani, R.; Ghorbani, Z.M.; Faghani, S. Abstract screening using the automated tool Rayyan: Results of effectiveness in three diagnostic test accuracy systematic reviews. BMC Med. Res. Methodol. 2022, 22, 160. [Google Scholar] [CrossRef]
  23. Yu, F.; Liu, C.; Sharmin, S. Performance, Usability, and User Experience of Rayyan for Systematic Reviews. Proc. Assoc. Inf. Sci. Technol. 2022, 59, 843–844. [Google Scholar] [CrossRef]
  24. da Silva, J.L.B.; Anzolin, L.K.; Nicacio, S.P.; Doty, R.L.; Pinna, F.d.R.; Voegels, R.L.; Fornazieri, M.A. High prevalence of olfactory dysfunction detected in treatment-naive patients with head and neck cancer. Acta Oto-Laryngol. 2023, 143, 201–204. [Google Scholar] [CrossRef] [PubMed]
  25. Biazevic, M.G.H.; Antunes, J.L.F.; Togni, J.; De Andrade, F.P.; De Carvalho, M.B.; Wünsch-Filho, V. Immediate Impact of Primary Surgery on Health-Related Quality of Life of Hospitalized Patients With Oral and Oropharyngeal Cancer. J. Oral. Maxillofac. Surg. 2008, 66, 1343–1350. [Google Scholar] [CrossRef]
  26. Brown, T.; Banks, M.; Hughes, B.G.M.; Lin, C.; Kenny, L.; Bauer, J. Tube feeding during treatment for head and neck cancer—Adherence and patient reported barriers. Oral Oncol. 2017, 72, 140–149. [Google Scholar] [CrossRef]
  27. Cruz, É.d.P.d.; Toporcov, T.N.; Rotundo, L.D.B.; Biazevic, M.G.H.; Brasileiro, R.S.; de Carvalho, M.B.; Kowalski, L.P.; Antunes, J.L.F. Food restrictions of patients who are undergoing treatment for oral and oropharyngeal cancer. Eur. J. Oncol. Nurs. 2012, 16, 253–257. [Google Scholar] [CrossRef]
  28. Dalton, J.; Rothpletz-Puglia, P.; Epstein, J.B.; Rawal, S.; Ganzer, H.; Brody, R.; Byham-Gray, L.; Touger-Decker, R. Transitioning the eating experience in survivors of head and neck cancer. Support. Care Cancer 2022, 30, 1451–1461. [Google Scholar] [CrossRef] [PubMed]
  29. Epstein, J.B.; Villines, D.; Epstein, G.L.; Smutzer, G. Oral examination findings, taste and smell testing during and following head and neck cancer therapy. Support. Care Cancer 2020, 28, 4305–4311. [Google Scholar] [CrossRef]
  30. Gurushekar, P.R.; Isiah, R.; John, S.; Sebastian, T.; Varghese, L. Effects of radiotherapy on olfaction and nasal function in head and neck cancer patients. Am. J. Otolaryngol. 2020, 41, 102537. [Google Scholar] [CrossRef]
  31. Halyard, M.Y.; Jatoi, A.; Sloan, J.A.; Bearden, J.D.; Vora, S.A.; Atherton, P.J.; Perez, E.A.; Soori, G.; Zalduendo, A.C.; Zhu, A.; et al. Does Zinc Sulfate Prevent Therapy-Induced Taste Alterations in Head and Neck Cancer Patients? Results of Phase III Double-Blind, Placebo-Controlled Trial from the North Central Cancer Treatment Group (N01C4). Int. J. Radiat. Oncol.*Biol.*Phys. 2007, 67, 1318–1322. [Google Scholar] [CrossRef] [PubMed]
  32. Haxel, B.R.; Berg, S.; Boessert, P.; Mann, W.J.; Fruth, K. Olfaction in chemotherapy for head and neck malignancies. Auris Nasus Larynx 2016, 43, 74–78. [Google Scholar] [CrossRef] [PubMed]
  33. Heiser, C.; Hofauer, B.; Scherer, E.; Schukraft, J.; Knopf, A. Liposomal treatment of xerostomia, odor, and taste abnormalities in patients with head and neck cancer. Head Neck 2016, 38, E1232–E1237. [Google Scholar] [CrossRef]
  34. Jalali, M.M.; Gerami, H.; Rahimi, A.; Jafari, M. Assessment of Olfactory Threshold in Patients Undergoing Radiotherapy for Head and Neck Malignancies. Iran. J. Otorhinolaryngol. 2014, 26, 211–217. [Google Scholar] [PubMed]
  35. Jin, S.; Lu, Q.; Jin, S.; Zhang, L.; Cui, H.; Li, H. Relationship between subjective taste alteration and weight loss in head and neck cancer patients treated with radiotherapy: A longitudinal study. Eur. J. Oncol. Nurs. 2018, 37, 43–50. [Google Scholar] [CrossRef]
  36. Jun, H.W.; Song, C.M.; Park, H.J.; Ji, Y.B.; Tae, K. Serial Changes in Parotid Gland Volume and Symptoms After Radiation Therapy in Oropharyngeal Cancer. Ear Nose Throat J. 2023, 01455613231185086. [Google Scholar] [CrossRef]
  37. Kamstra, J.I.; Jager-Wittenaar, H.; Dijkstra, P.U.; Huisman, P.M.; van Oort, R.P.; van der Laan, B.F.A.M.; Roodenburg, J.L.N. Oral symptoms and functional outcome related to oral and oropharyngeal cancer. Support. Care Cancer 2011, 19, 1327–1333. [Google Scholar] [CrossRef]
  38. Liang, H.; Yang, H.; Yin, L.; Wang, L.; Jiu, E.; Li, B.; Pang, H. Correlation between taste and smell alterations and quality of survival in patients treated with radiotherapy for nasopharyngeal carcinoma: A cross-sectional study in China. Preprints 2024. [Google Scholar] [CrossRef]
  39. Lilja, M.; Markkanen-Leppänen, M.; Viitasalo, S.; Saarilahti, K.; Lindford, A.; Lassus, P.; Mäkitie, A. Olfactory and gustatory functions after free flap reconstruction and radiotherapy for oral and pharyngeal cancer: A prospective follow-up study. Eur. Arch. Otorhinolaryngol. 2018, 275, 959–966. [Google Scholar] [CrossRef]
  40. Ling, D.C.; Chapman, B.V.; Kim, J.; Choby, G.W.; Kabolizadeh, P.; Clump, D.A.; Ferris, R.L.; Kim, S.; Beriwal, S.; Heron, D.E.; et al. Oncologic outcomes and patient-reported quality of life in patients with oropharyngeal squamous cell carcinoma treated with definitive transoral robotic surgery versus definitive chemoradiation. Oral Oncol. 2016, 61, 41–46. [Google Scholar] [CrossRef]
  41. Manojan, S.; Saldanha, M.; Ail, S.; Bhat, V.; Aroor, R. Effects of Radiation on Olfactory Function in Head and Neck Malignancy. Ann. Otol. Rhinol. Laryngol. 2024, 133, 735–740. [Google Scholar] [CrossRef] [PubMed]
  42. Manzar, G.S.; Lester, S.C.; Routman, D.M.; Harmsen, W.S.; Petersen, M.M.; Sloan, J.A.; Mundy, D.W.; Hunzeker, A.E.; Amundson, A.C.; Anderson, J.L.; et al. Comparative analysis of acute toxicities and patient reported outcomes between intensity-modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) for the treatment of oropharyngeal cancer. Radiother. Oncol. 2020, 147, 64–74. [Google Scholar] [CrossRef]
  43. Mau-Sun Hua, S.T.C. Olfactory function in patients with nasopharygeal carcinoma following radiotherapy. Brain Inj. 1999, 13, 905–915. [Google Scholar] [CrossRef]
  44. Mirza, N.; Machtay, M.; Devine, P.A.; Troxel, A.; Abboud, S.K.; Doty, R.L. Gustatory Impairment in Patients Undergoing Head and Neck Irradiation. Laryngoscope 2008, 118, 24–31. [Google Scholar] [CrossRef]
  45. Najafizade, N.; Hemati, S.; Gookizade, A.; Berjis, N.; Hashemi, M.; Vejdani, S.; Ghannadi, A.; Shahsanaee, A.; Arbab, N. Preventive effects of zinc sulfate on taste alterations in patients under irradiation for head and neck cancers: A randomized placebo-controlled trial. J. Res. Med. Sci. 2013, 18, 123–126. [Google Scholar] [PubMed]
  46. Negi, P.; Kingsley, P.A.; Thomas, M.; Sachdeva, J.; Srivastava, H.; Kalra, B. Pattern of Gustatory Impairment and its Recovery after Head and Neck Irradiation. Iran. J. Otorhinolaryngol. 2017, 29, 319–327. [Google Scholar] [PubMed]
  47. Ogama, N.; Suzuki, S.; Yasui, Y.; Azenishi, K.; Shimizu, Y. Analysis of causal models of diet for patients with head and neck cancer receiving radiation therapy. Eur. J. Oncol. Nurs. 2010, 14, 291–298. [Google Scholar] [CrossRef]
  48. Oskam, I.M.; Leeuw, I.M.V.-D.; Aaronson, N.K.; Witte, B.I.; de Bree, R.; Doornaert, P.; Langendijk, J.A.; Leemans, C.R. Prospective evaluation of health-related quality of life in long-term oral and oropharyngeal cancer survivors and the perceived need for supportive care. Oral. Oncol. 2013, 49, 443–448. [Google Scholar] [CrossRef]
  49. Pearlstein, K.A.; Wang, K.; Amdur, R.J.; Shen, C.J.; Dagan, R.; Weiss, J.; Grilley-Olson, J.E.; Zanation, A.; Hackman, T.G.; Thorp, B.D.; et al. Quality of Life for Patients With Favorable-Risk HPV-Associated Oropharyngeal Cancer After De-intensified Chemoradiotherapy. Int. J. Radiat. Oncol.*Biol.*Phys. 2019, 103, 646–653. [Google Scholar] [CrossRef]
  50. Riantiningtyas, R.R.; Valenti, A.; Dougkas, A.; Bredie, W.L.; Kwiecien, C.; Bruyas, A.; Giboreau, A.; Carrouel, F. Oral somatosensory alterations and salivary dysfunction in head and neck cancer patients. Support. Care Cancer 2023, 31, 627. [Google Scholar] [CrossRef]
  51. Riva, G.; Raimondo, L.; Ravera, M.; Moretto, F.; Boita, M.; Potenza, I.; Rampino, M.; Ricardi, U.; Garzaro, M. Late Sensorial Alterations in Different Radiotherapy Techniques for Nasopharyngeal Cancer. Chem. Senses 2015, 40, 285–292. [Google Scholar] [CrossRef] [PubMed]
  52. Rogers, S.N.; Johnson, I.A.; Lowe, D. Xerostomia After Treatment for Oral and Oropharyngeal Cancer Using the University of Washington Saliva Domain and a Xerostomia-Related Quality-of-Life Scale. Int. J. Radiat. Oncol.*Biol.*Phys. 2010, 77, 16–23. [Google Scholar] [CrossRef]
  53. Sandow, P.L.; Hejrat-Yazdi, M.; Heft, M.W. Taste Loss and Recovery Following Radiation Therapy. J. Dent. Res. 2006, 85, 608–611. [Google Scholar] [CrossRef] [PubMed]
  54. Sapir, E.; Tao, Y.; Feng, F.; Samuels, S.; El Naqa, I.; Murdoch-Kinch, C.A.; Feng, M.; Schipper, M.; Eisbruch, A. Predictors of Dysgeusia in Patients With Oropharyngeal Cancer Treated With Chemotherapy and Intensity Modulated Radiation Therapy. Int. J. Radiat. Oncol.*Biol.*Phys. 2016, 96, 354–361. [Google Scholar] [CrossRef]
  55. Stieb, S.; Engeseth, G.M.; Mohamed, A.S.R.; He, R.; Perez-Martinez, I.; Rock, S.; Deshpande, T.S.; Garden, A.S.; Rosenthal, D.I.; Frank, S.J.; et al. The influence of radiation dose on taste impairment in a prospective observational study cohort of oropharyngeal cancer patients. Acta Oncol. 2022, 61, 146–152. [Google Scholar] [CrossRef]
  56. Stieb, S.; Mohamed, A.S.; Deshpande, T.S.; Harp, J.; Greiner, B.; Garden, A.S.; Goepfert, R.P.; Cardoso, R.; Ferrarotto, R.; Phan, J.; et al. Prospective observational evaluation of radiation-induced late taste impairment kinetics in oropharyngeal cancer patients: Potential for improvement over time? Clin. Transl. Radiat. Oncol. 2020, 22, 98–105. [Google Scholar] [CrossRef] [PubMed]
  57. Veyseller, B.; Ozucer, B.; Degirmenci, N.; Gurbuz, D.; Tambas, M.; Altun, M.; Aksoy, F.; Ozturan, O. Olfactory bulb volume and olfactory function after radiotherapy in patients with nasopharyngeal cancer. Auris Nasus Larynx 2014, 41, 436–440. [Google Scholar] [CrossRef]
  58. Stieb, S.; Mohamed, A.S.; He, R.; Zhu, L.L.; McDonald, B.A.; Wahid, K.; van Dijk, L.V.; Ventura, J.; Ahmed, S.; McCoy, L.; et al. Development and validation of a contouring guideline for the taste bud bearing tongue mucosa. Radiother. Oncol. 2021, 157, 63–69. [Google Scholar] [CrossRef]
  59. Menzel, S.; Konstantinidis, I.; Valentini, M.; Battaglia, P.; Turri-Zanoni, M.; Sileo, G.; Monti, G.; Castelnuovo, P.G.M.; Hummel, T.; Macchi, A. Surgical Approaches for Possible Positions of an Olfactory Implant to Stimulate the Olfactory Bulb. ORL J. Otorhinolaryngol. Relat. Spec. 2023, 85, 253–263. [Google Scholar] [CrossRef]
  60. Katsuki, M.; Fukushima, T.; Wada, N.; Goto, T.; Imai, A.; Hanaoka, Y.; Yasude, T.; Kaneko, K.; Horiuchi, T. Enhancing Salty Taste Perception in Stroke Patients via Anodal Electrical Stimulation to the Chin. Foods 2024, 13, 4087. [Google Scholar] [CrossRef]
  61. Funamizu, T.; Matsumoto, R.; Suzuki, A.; Watabe, K.; Nakamura, H.; Kasamatsu, C. Sensory studies on the taste and flavor perception of food products by anodal transcutaneous electrical stimulation. Hypertens. Res. 2025, 48, 763–771. [Google Scholar] [CrossRef] [PubMed]
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