Oral Somatosensory Alterations in Head and Neck Cancer Patients—An Overview of the Evidence and Causes
Abstract
:Simple Summary
Abstract
1. Introduction
2. Evidence of Oral Somatosensory Alterations in Head and Neck Cancer Patients
2.1. Subjective Perception of Oral Somatosensory Alterations in Head and Neck Cancer Patients
2.2. Alteration of Tactile Functions in Head and Neck Cancer Patients
2.3. Alterations of Thermal Sensitivity in Head and Neck Cancer Patients
3. Aetiology of Oral Somatosensory Alterations in Head and Neck Cancer
3.1. Impact of Tumour and Cancer Inflammation on Oral Somatosensation in Head and Neck Cancer Patients
3.2. Impact of Cancer Treatments on Oral Somatosensation in Head and Neck Cancer Patients
3.2.1. Impact of Surgery on Oral Somatosensation in Head and Neck Cancer Patients
3.2.2. Impact of Radiotherapy on Oral Somatosensation in Head and Neck Cancer Patients
3.2.3. Impact of Chemotherapy on Oral Somatosensation in Head and Neck Cancer Patients
3.3. Secondary Effects and Consequences of Treatment That Impact Oral Somatosensation in Head and Neck Cancer Patients
3.3.1. Impact of Xerostomia on Oral Somatosensation in Head and Neck Cancer Patients
3.3.2. Impact of Dysphagia on Oral Somatosensation in Head and Neck Cancer Patients
3.3.3. Impact of Mucositis on Oral Somatosensation in Head and Neck Cancer Patients
3.3.4. Impact of Chemosensory Alterations and Other Oral Complications on Oral Somatosensation in Head and Neck Cancer Patients
4. Conclusions and Future Perspectives
Author Contributions
Funding
Conflicts of Interest
References
- Sroussi, H.Y.; Epstein, J.B.; Bensadoun, R.J.; Saunders, D.P.; Lalla, R.V.; Migliorati, C.A.; Heaivilin, N.; Zumsteg, Z.S. Common Oral Complications of Head and Neck Cancer Radiation Therapy: Mucositis, Infections, Saliva Change, Fibrosis, Sensory Dysfunctions, Dental Caries, Periodontal Disease, and Osteoradionecrosis. Cancer Med. 2017, 6, 2918–2931. [Google Scholar] [CrossRef]
- Epstein, J.B.; Thariat, J.; Bensadoun, R.-J.; Barasch, A.; Murphy, B.A.; Kolnick, L.; Popplewell, L.; Maghami, E. Oral Complications of Cancer and Cancer Therapy. CA. Cancer J. Clin. 2012, 62, 400–422. [Google Scholar] [CrossRef] [PubMed]
- Talwar, B. Head and Neck Cancer. In Nutrition and Cancer; Shaw, C., Ed.; John Wiley & Sons: New York, NY, USA, 2010; pp. 188–220. [Google Scholar]
- 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]
- Hutton, J.L.; Baracos, V.E.; Wismer, W.V. Chemosensory Dysfunction Is a Primary Factor in the Evolution of Declining Nutritional Status and Quality of Life in Patients With Advanced Cancer. J. Pain Symptom Manag. 2007, 33, 156–165. [Google Scholar] [CrossRef]
- Messing, B.P.; Ward, E.C.; Lazarus, C.; Ryniak, K.; Maloney, J.; Thompson, C.B.; Kramer, E. Longitudinal Comparisons of a Whole-Mouth Taste Test to Clinician-Rated and Patient-Reported Outcomes of Dysgeusia Postradiotherapy in Patients with Head and Neck Cancer and Associations with Oral Intake. Head Neck 2021, 43, 2159–2177. [Google Scholar] [CrossRef] [PubMed]
- Burges Watson, D.L.; Lewis, S.; Bryant, V.; Patterson, J.; Kelly, C.; Edwards-Stuart, R.; Murtagh, M.J.; Deary, V. Altered Eating: A Definition and Framework for Assessment and Intervention. BMC Nutr. 2018, 4, 14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ganzer, H.; Touger-Decker, R.; Byham-Gray, L.; Murphy, B.A.; Epstein, J.B. The Eating Experience after Treatment for Head and Neck Cancer: A Review of the Literature. Oral Oncol. 2015, 51, 634–642. [Google Scholar] [CrossRef]
- Boltong, A.; Keast, R.; Aranda, S. Experiences and Consequences of Altered Taste, Flavour and Food Hedonics during Chemotherapy Treatment. Support. Care Cancer 2012, 20, 2765–2774. [Google Scholar] [CrossRef]
- Brisbois, T.D.; De Kock, I.H.; Watanabe, S.M.; Baracos, V.E.; Wismer, W.V. Characterization of Chemosensory Alterations in Advanced Cancer Reveals Specific Chemosensory Phenotypes Impacting Dietary Intake and Quality of Life. J. Pain Symptom Manag. 2011, 41, 673–683. [Google Scholar] [CrossRef]
- Snchez-Lara, K.; Sosa-Snchez, R.; Green-Renner, D.; Rodríguez, C.; Laviano, A.; Motola-Kuba, D.; Arrieta, O. Influence of Taste Disorders on Dietary Behaviors in Cancer Patients under Chemotherapy. Nutr. J. 2010, 9, 15. [Google Scholar] [CrossRef] [Green Version]
- Coa, K.I.; Epstein, J.B.; Ettinger, D.; Jatoi, A.; McManus, K.; Platek, M.E.; Price, W.; Stewart, M.; Teknos, T.N.; Moskowitz, B. The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment. Nutr. Cancer 2015, 67, 339–353. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- 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] [PubMed]
- Irune, E.; Dwivedi, R.C.; Nutting, C.M.; Harrington, K.J. Treatment-Related Dysgeusia in Head and Neck Cancer Patients. Cancer Treat. Rev. 2014, 40, 1106–1117. [Google Scholar] [CrossRef] [PubMed]
- de Vries, Y.C.; Boesveldt, S.; Kelfkens, C.S.; Posthuma, E.E.; van den Berg, M.M.G.A.; de Kruif, J.T.C.M.; Haringhuizen, A.; Sommeijer, D.W.; Buist, N.; Grosfeld, S.; et al. Taste and Smell Perception and Quality of Life during and after Systemic Therapy for Breast Cancer. Breast Cancer Res. Treat. 2018, 170, 27–34. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gunn, L.; Gilbert, J.; Nenclares, P.; Soliman, H.; Newbold, K.; Bhide, S.; Wong, K.H.; Harrington, K.; Nutting, C. Taste Dysfunction Following Radiotherapy to the Head and Neck: A Systematic Review. Radiother. Oncol. 2021, 157, 130–140. [Google Scholar] [CrossRef]
- Boltong, A.; Campbell, K. “Taste” Changes: A Problem for Patients and Their Dietitians. Nutr. Diet. 2013, 70, 262–269. [Google Scholar] [CrossRef]
- Álvarez-Camacho, M.; Gonella, S.; Campbell, S.; Scrimger, R.A.; Wismer, W. V A Systematic Review of Smell Alterations after Radiotherapy for Head and Neck Cancer. Cancer Treat. Rev. 2017, 54, 110–121. [Google Scholar] [CrossRef]
- Spence, C. Multisensory Flavour Perception. In Flavour: From Food to Perception; John Wiley & Sons: New York, NY, USA, 2016; pp. 373–394. ISBN 9781118929414. [Google Scholar]
- Simon, S.A.; De Araujo, I.E.; Stapleton, J.R.; Nicolelis, M.A.L. Multisensory Processing of Gustatory Stimuli. Chemosens. Percept. 2008, 1, 95–102. [Google Scholar] [CrossRef] [Green Version]
- Engelen, L. Oral Receptors. In Food Oral Processing: Fundamentals of Eating and Sensory Perception; John Wiley & Sons: New York, NY, USA, 2012; pp. 15–43. ISBN 9781444360943. [Google Scholar]
- Small, D.M. Flavor Is in the Brain. Physiol. Behav. 2012, 107, 540–552. [Google Scholar] [CrossRef]
- McLaughlin, L.; Mahon, S.M. Taste Dysfunction and Eating Behaviors in Survivors of Head and Neck Cancer Treatment. MedSurg Nurs. 2014, 23, 165. [Google Scholar]
- Crowder, S.L.; Najam, N.; Sarma, K.P.; Fiese, B.H.; Arthur, A.E. Head and Neck Cancer Survivors’ Experiences with Chronic Nutrition Impact Symptom Burden after Radiation: A Qualitative Study. J. Acad. Nutr. Diet. 2020, 120, 1643–1653. [Google Scholar] [CrossRef]
- Gabbiani, F.; Cox, S.J. Relating Neuronal Responses and Psychophysics. In Mathematics for Neuroscientists; Academic Press: Cambridge, MA, USA, 2017; pp. 463–473. ISBN 9780128018958. [Google Scholar]
- Aviv, J.E.; Hecht, C.; Weinberg, H.; Dalton, J.F.; Urken, M.L. Surface Sensibility of the Floor of the Mouth and Tongue in Healthy Controls and in Radiated Patients. Otolaryngol. Neck Surg. 1992, 107, 418–423. [Google Scholar] [CrossRef]
- Elfring, T.T.; Boliek, C.A.; Seikaly, H.; Harris, J.; Rieger, J.M. Sensory Outcomes of the Anterior Tongue after Lingual Nerve Repair in Oropharyngeal Cancer. J. Oral Rehabil. 2012, 39, 170–181. [Google Scholar] [CrossRef]
- Bearelly, S.; Wang, S.J.; Cheung, S.W. Oral Sensory Dysfunction Following Radiotherapy. Laryngoscope 2017, 127, 2282–2286. [Google Scholar] [CrossRef]
- Kimata, Y.; Uchiyama, K.; Ebihara, S.; Kishimoto, S.; Asai, M.; Saikawa, M.; Ohyama, W.; Haneda, T.; Hayashi, R.; Onitsuka, T.; et al. Comparison of Innervated and Noninnervated Free Flaps in Oral Reconstruction. Plast. Reconstr. Surg. 1999, 104, 1307–1313. [Google Scholar] [CrossRef]
- Loewen, I.J.; Boliek, C.A.; Harris, J.; Seikaly, H.; Rieger, J.M. Oral Sensation and Function: A Comparison of Patients with Innervated Radial Forearm Free Flap Reconstruction to Healthy Matched Controls. Head Neck 2010, 32, 85–95. [Google Scholar] [CrossRef]
- Bodin, I.; Jäghagen, E.L.; Isberg, A. Intraoral Sensation before and after Radiotherapy and Surgery for Oral and Pharyngeal Cancer. Head Neck 2004, 26, 923–929. [Google Scholar] [CrossRef]
- Bodin, I.; Lind, M.G.; Henningsson, G.; Isberg, A. Deterioration of Intraoral Hole Size Identification after Treatment of Oral and Pharyngeal Cancer. Acta Otolaryngol. 1999, 119, 609–616. [Google Scholar] [CrossRef]
- Bodin, I.; Magnus, L.; Gunilla, H.; Isberg, A. Deterioration of Intraoral Recognition of Shapes after Treatment of Oral and Pharyngeal Cancer. Otolaryngol. Head Neck Surg. 2000, 122, 584–589. [Google Scholar] [CrossRef]
- Chen, J. Food Oral Processing: Some Important Underpinning Principles of Eating and Sensory Perception. Food Struct. 2014, 1, 91–105. [Google Scholar] [CrossRef]
- Togni, L.; Mascitti, M.; Vignigni, A.; Alia, S.; Sartini, D.; Barlattani, A.; Emanuelli, M.; Santarelli, A. Treatment-related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review. Nutrients 2021, 13, 3325. [Google Scholar] [CrossRef]
- Wang, H.; Zhou, M.; Brand, J.; Huang, L. Inflammation and Taste Disorders: Mechanisms in Taste Buds. In Annals of the New York Academy of Sciences; Blackwell Publishing Inc.: Hoboken, NJ, USA, 2009; Volume 1170, pp. 596–603. [Google Scholar]
- Grayson, M.; Furr, A.; Ruparel, S. Depiction of Oral Tumor-Induced Trigeminal Afferent Responses Using Single-Fiber Electrophysiology. Sci. Rep. 2019, 9, 4574. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Scheff, N.N.; Wall, I.M.; Nicholson, S.; Williams, H.; Chen, E.; Tu, N.H.; Dolan, J.C.; Liu, C.Z.; Janal, M.N.; Bunnett, N.W.; et al. Oral Cancer Induced TRPV1 Sensitization Is Mediated by PAR2 Signaling in Primary Afferent Neurons Innervating the Cancer Microenvironment. Sci. Rep. 2022, 12, 4121. [Google Scholar] [CrossRef] [PubMed]
- Lam, D.K.; Schmidt, B.L. Orofacial Pain Onset Predicts Transition to Head and Neck Cancer. Pain 2011, 152, 1206–1209. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Baral, P.; Udit, S.; Chiu, I.M. Pain and Immunity: Implications for Host Defence. Nat. Rev. Immunol. 2019, 19, 433–447. [Google Scholar] [CrossRef] [PubMed]
- Sessle, B.J. Mechanisms of Oral Somatosensory and Motor Functions and Their Clinical Correlates. J. Oral Rehabil. 2006, 33, 243–261. [Google Scholar] [CrossRef] [PubMed]
- Bartoshuk, L.M.; Catalanotto, F.; Hoffman, H.; Logan, H.; Snyder, D.J. Taste Damage (Otitis Media, Tonsillectomy and Head and Neck Cancer), Oral Sensations and BMI. Physiol. Behav. 2012, 107, 516–526. [Google Scholar] [CrossRef]
- 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]
- Yamashita, H.; Nakagawa, K.; Tago, M.; Nakamura, N.; Shiraishi, K.; Eda, M.; Nakata, H.; Nagamatsu, N.; Yokoyama, R.; Onimura, M.; et al. Taste Dysfunction in Patients Receiving Radiotherapy. Head Neck 2006, 28, 508–516. [Google Scholar] [CrossRef]
- Just, T.; Pau, H.W.; Bombor, I.; Guthoff, R.F.; Fietkau, R.; Hummel, T. Confocal Microscopy of the Peripheral Gustatory System: Comparison between Healthy Subjects and Patients Suffering from Taste Disorders during Radiochemotherapy. Laryngoscope 2005, 115, 2178–2182. [Google Scholar] [CrossRef]
- Mistretta, C.M.; Bradley, R.M. The Fungiform Papilla Is a Complex, Multimodal, Oral Sensory Organ. Curr. Opin. Physiol. 2021, 20, 165–173. [Google Scholar] [CrossRef]
- Boltong, A.; Keast, R. The Influence of Chemotherapy on Taste Perception and Food Hedonics: A Systematic Review. Cancer Treat. Rev. 2012, 38, 152–163. [Google Scholar] [CrossRef]
- Zabernigg, A.; Gamper, E.; Giesinger, J.M.; Rumpold, G.; Kemmler, G.; Gattringer, K.; Sperner-Unterweger, B.; Holzner, B. Taste Alterations in Cancer Patients Receiving Chemotherapy: A Neglected Side Effect? Oncologist 2010, 15, 913–920. [Google Scholar] [CrossRef] [Green Version]
- Reith, A.J.M.; Spence, C. The Mystery of “Metal Mouth” in Chemotherapy. Chem. Senses 2020, 45, 73–84. [Google Scholar] [CrossRef]
- Murtaza, B.; Hichami, A.; Khan, A.S.; Ghiringhelli, F.; Khan, N.A. Alteration in Taste Perception in Cancer: Causes and Strategies of Treatment. Front. Physiol. 2017, 8, 134. [Google Scholar] [CrossRef] [Green Version]
- Mistretta, C.M.; Kumari, A. Tongue and Taste Organ Biology and Function: Homeostasis Maintained by Hedgehog Signaling. Annu. Rev. Physiol. 2017, 79, 335–356. [Google Scholar] [CrossRef] [Green Version]
- Mistretta, C.M.; Kumari, A. Hedgehog Signaling Regulates Taste Organs and Oral Sensation: Distinctive Roles in the Epithelium, Stroma, and Innervation. Int. J. Mol. Sci. 2019, 20, 1341. [Google Scholar] [CrossRef] [Green Version]
- Do Nascimento, M.L.; de Farias, A.B.S.; Carvalho, A.T.; de Albuquerque, R.F.; Ribeiro, L.N.; Leão, J.C.; Silva, I.H.M. Impact of Xerostomia on the Quality of Life of Patients Submitted to Head and Neck Radiotherapy. Med. Oral Patol. Oral Cirugia Bucal 2019, 24, e770–e775. [Google Scholar] [CrossRef] [PubMed]
- Logemann, J.A.; Pauloski, B.R.; Rademaker, A.W.; Lazarus, C.L.; Mittal, B.; Gaziano, J.; Stachowiak, L.; MacCracken, E.; Newman, L.A. Xerostomia: 12-Month Changes in Saliva Production and Its Relationship to Perception and Performance of Swallow Function, Oral Intake, and Diet after Chemoradiation. Head Neck 2003, 25, 432–437. [Google Scholar] [CrossRef]
- Wang, Y.; Lu, Q.; Zhang, L.; Zhuang, B.; Zhang, T.; Jin, S.; Sun, Y.; Xiao, S.; Zheng, B.; Fang, Y.; et al. Nutrition Impact Symptom Clusters in Patients With Head and Neck Cancer Receiving Concurrent Chemoradiotherapy. J. Pain Symptom Manag. 2021, 62, 277–285. [Google Scholar] [CrossRef]
- Dirix, P.; Nuyts, S.; Van den Bogaert, W. Radiation-Induced Xerostomia in Patients with Head and Neck Cancer. Cancer 2006, 107, 2525–2534. [Google Scholar] [CrossRef]
- Langius, J.A.E.; Doornaert, P.; Spreeuwenberg, M.D.; Langendijk, J.A.; Leemans, C.R.; Schueren, M.A.E.V.B.D. Van Der Radiotherapy on the Neck Nodes Predicts Severe Weight Loss in Patients with Early Stage Laryngeal Cancer. Radiother. Oncol. 2010, 97, 80–85. [Google Scholar] [CrossRef] [PubMed]
- Engelen, L.; de Wijk, R.A. Oral Processing and Texture Perception. In Food Oral Processing: Fundamentals of Eating and Sensory Perception; John Wiley & Sons: New York, NY, USA, 2012; pp. 159–176. ISBN 3-540-25541-9. [Google Scholar]
- García-Peris, P.; Parón, L.; Velasco, C.; de la Cuerda, C.; Camblor, M.; Bretón, I.; Herencia, H.; Verdaguer, J.; Navarro, C.; Clave, P. Long-Term Prevalence of Oropharyngeal Dysphagia in Head and Neck Cancer Patients: Impact on Quality of Life. Clin. Nutr. 2007, 26, 710–717. [Google Scholar] [CrossRef]
- Denaro, N.; Merlano, M.C.; Russi, E.G. Dysphagia in Head and Neck Cancer Patients: Pretreatment Evaluation, Predictive Factors, and Assessment during Radio-Chemotherapy, Recommendations. Clin. Exp. Otorhinolaryngol. 2013, 6, 117–126. [Google Scholar] [CrossRef]
- Shankar, A.; Roy, S.; Bhandari, M.; Rath, G.K.; Biswas, A.S.; Kanodia, R.; Adhikari, N.; Sachan, R. Current Trends in Management of Oral Mucositis in Cancer Treatment. Asian Pac. J. Cancer Prev. 2017, 18, 2019–2026. [Google Scholar] [CrossRef] [PubMed]
- Sonis, S.T.; Costa, J.W. Oral Complications of Radiotherapy. In Holland-Frei Cancer Medicine, 6th ed.; Kufe, D.W., Pollock, R.E., Weichselbaum, R.R., Eds.; PMPH-USA: Cary, NC, USA, 2003. [Google Scholar]
- Bogdanov, V.; Reinhard, J.; McGlone, F.; Haehner, A.; Simons, C.T.; Hummel, T. Oral Somatosensory Sensitivity in Patients With Taste Disturbance. Laryngoscope 2021, 131, 2572–2577. [Google Scholar] [CrossRef] [PubMed]
- Aarup-Kristensen, S.; Hansen, C.R.; Forner, L.; Brink, C.; Eriksen, J.G.; Johansen, J. Osteoradionecrosis of the Mandible after Radiotherapy for Head and Neck Cancer: Risk Factors and Dose-Volume Correlations. Acta Oncol. 2019, 58, 1373–1377. [Google Scholar] [CrossRef] [PubMed]
- Pauli, N.; Mejersjö, C.; Fagerberg-Mohlin, B.; Finizia, C. Temporomandibular Disorder in Head and Neck Cancer Patients Undergoing Radiotherapy: Clinical Findings and Patient-Reported Symptoms. Head Neck 2019, 41, 3570–3576. [Google Scholar] [CrossRef]
- Loh, S.Y.; Mcleod, R.W.J.; Elhassan, H.A. Trismus Following Different Treatment Modalities for Head and Neck Cancer: A Systematic Review of Subjective Measures. Eur. Arch. Otorhinolaryngol. 2017, 274, 2695–2707. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Agarwal, P.; Shiva Kumar, H.R.; Rai, K.K. Trismus in Oral Cancer Patients Undergoing Surgery and Radiotherapy. J. Oral Biol. Craniofacial Res. 2016, 6, S9–S13. [Google Scholar] [CrossRef] [Green Version]
- Ray-Chaudhuri, A.; Shah, K.; Porter, R.J. The Oral Management of Patients Who Have Received Radiotherapy to the Head and Neck Region. Br. Dent. J. 2013, 214, 387–393. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jones, M.R.; Urits, I.; Ehrhardt, K.P.; Cefalu, J.N.; Kendrick, J.B.; Park, D.J.; Cornett, E.M.; Kaye, A.D.; Viswanath, O. A Comprehensive Review of Trigeminal Neuralgia. Curr. Pain Headache Rep. 2019, 23, 74. [Google Scholar] [CrossRef]
- Madariaga, V.I.; Tanaka, H.; Ernberg, M. Psychophysical Characterisation of Burning Mouth Syndrome—A Systematic Review and Meta-Analysis. J. Oral Rehabil. 2020, 47, 1590–1605. [Google Scholar] [CrossRef] [PubMed]
- Villafuerte, K.R.V.; Martinez, C.d.J.H.; Dantas, F.T.; Carrara, H.H.A.; dos Reis, F.J.C.; Palioto, D.B. The Impact of Chemotherapeutic Treatment on the Oral Microbiota of Patients with Cancer: A Systematic Review. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2018, 125, 552–566. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Reference | Population | Tumour Subsite, Treatment | Sensory Tests | Findings |
---|---|---|---|---|
Aviv et al. 1992 [26] | HNC patients 12–36 mo after RT (n = 20), control (n = 90). Cross-sectional | Tonsil or nasopharynx, RT | - Two-point discrimination (tongue and floor of mouth) | Radiated HNC patients were less sensitive in oral tactile acuity test than the control group |
Elfring et al. 2012 [27] | HNC patients (n = 30), control (n = 30). Cross-sectional | Tongue, surgery with or without RT or CT | - Point pressure - Two-point discrimination - Hot/cold discrimination with dental mirrors 55 and 3 °C - Texture discrimination of resin - Stereognosis | All patients with lingual nerve disruption exhibited significantly poorer outcomes in the point pressure test, 2-point discrimination test, and hot/cold discrimination test. No difference in texture discrimination, less conclusive for oral stereognosis |
Bearelly et al. 2017 [28] | HNC patients (n = 34), control (n = 23). Cross-sectional | Oral cavity and oropharynx, RT | - Point pressure (tongue, buccal mucosa, soft palate) | Elevated sensory threshold in patients compared to the control group |
Kimata et al. 1999 [29] | HNC patients who received innervated (n = 15) and noninnervated (n = 13) free flaps reconstruction surgery. Cross-sectional | Tongue, hemiglossectomy | - Point-pressure - Two-point discrimination - Hot/cold discrimination with cotton swabs | Sensory recovery was significantly better with innervated thigh flaps than non-innervated ones for all sensory modalities and better with innervated abdominis flaps than non-innervated ones for all modalities except thermal sensitivity. |
Loewen et al. 2010 [30] | HNC patients with innervated free flap reconstruction surgery (n = 8), control (n = 8). Cross-sectional | Tongue, hemiglossectomy | - Point-pressure test - Two-point discrimination - Hot/cold discrimination with dental mirrors - Texture discrimination with acrylic resin | Sensation of intact tongue tissue after reconstruction of the hemitongue did not differ from controls. Although some sensory ability was restored to patients’ reconstructed tongue, differences existed between the patient group and controls. However, the texture discrimination ability was comparable with controls. |
Bodin et al. 2004 [31] | HNC patients (n = 27), control (n = 20). Longitudinal (diagnosis, post-RT, 6 mo post-surgery, 12 mo post-surgery) | Oral or pharyngeal, RT and surgery | - Point pressure test - Hot/cold discrimination with metal rolls 44 and 28 °C | Deterioration of tactile and thermal sensitivity at 6 mo after surgery |
Bodin et al. 1999 [32] | HNC patients (n = 31), control (n = 20). Longitudinal (before RT, after RT, 6 mo after surgery following RT, 12 mo after surgery following RT) | Pharyngeal and oral cavity, surgery following RT | Stereognosis: hole size identification | The oral group did not show a decline in the hole-size identification ability after radiotherapy, but did 6 mo after the surgery following RT. Deterioration was persistent for 1 year after. The pharyngeal group did not change performance in hole-size identification at any time point. |
Bodin et al. 2000 [33] | HNC patients (n = 30), control (n = 20). Longitudinal (before RT, after RT, 6 mo after surgery following RT, 12 mo after surgery following RT) | Pharyngeal and oral cavity, surgery following RT | Stereognosis: shape identification | The mere existence of a tumour did not affect shape-recognition abilities. RT caused some impairment of shape recognition, while the combined effect of surgery following RT caused significant deterioration. No effect of tumour location was observed. |
Mechanisms | Peripheral Level | Nerve Level |
---|---|---|
Cancerous Cells | Disruption of regeneration of sensory receptor cells Over-expression and sensitization of ion channels (e.g., TRPV1) | - |
Tumour | Disruption of mucosal receptors on sites of tumour growth | Compression of sensory nerve on sites of tumour growth |
Surgery | - | Impairment on sensory nerve |
Radiotherapy | Damage to papillae and mucosal sensory receptors | - |
Chemotherapy | Disruption of regeneration of sensory receptors | - |
Oral Manifestation | Description | Influence on Oral Perception |
---|---|---|
Osteoradionecrosis [1,64] | Condition of bone and mucosal breakdown after RT. Incidence rate is 4–37% in HNC patients. Mandible surgery and tooth extraction before RT, tobacco use, and treatment dose were associated with the development of ORN | Chronic oral pain and irritation |
Temporomandibular disorder [65] | A collective term to describe masticatory pain and dysfunction. A study showed that 68, 94, and 81% of HNC patients had TMD before, 6 mo after treatments, and 12 mo after treatments, respectively | Difficulty with certain textures, oral pain, and discomfort |
Trismus [66,67,68] | Restricted mouth opening caused by radiation damage on the temporomandibular joint, resulting in scarring and fibrosis of pterygoid muscles and ligaments. Prevalence among HNC patients ranges from 5–86% depending on tumour location, treatment, and stage of treatment | Oral discomfort, difficulty chewing and swallowing certain food textures |
Trigeminal Neuralgia [69] | A chronic syndrome is signified by recurrent facial pain in the dermatome of the trigeminal nerve (fifth cranial nerve). It is associated with nerve injury or lesion. | Heightened sensitivity to temperature and trigeminal sensation |
Burning mouth syndrome [70] | Constant burning sensation or discomfort. Multifactor, unclear aetiology may be caused by a damaged chorda tympani, nerve-stimulation phantoms | Intensified trigeminal sensations, sensitivity to hot temperature |
Opportunistic infection (e.g., oral candidiasis) [1,71] | Infection caused by fungi, bacterial, or viral due to disrupted homeostasis (RT, mucositis, hyposalivation) leading to dental caries (>25% of patients receiving RT) | Mucosal pain, dysphagia, taste change, trigeminal sensitivity, sensation of coating in the mouth |
Periodontal disease [1] | Loss of tooth-supporting tissue and alveolar bones. Oral manifestation of RT through mucositis and changes in oral microbiome | Pain and infection in jaw bones, tooth loss, reduced sensitivity to particles (texture), chewing difficulty |
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Riantiningtyas, R.R.; Carrouel, F.; Bruyas, A.; Bredie, W.L.P.; Kwiecien, C.; Giboreau, A.; Dougkas, A. Oral Somatosensory Alterations in Head and Neck Cancer Patients—An Overview of the Evidence and Causes. Cancers 2023, 15, 718. https://doi.org/10.3390/cancers15030718
Riantiningtyas RR, Carrouel F, Bruyas A, Bredie WLP, Kwiecien C, Giboreau A, Dougkas A. Oral Somatosensory Alterations in Head and Neck Cancer Patients—An Overview of the Evidence and Causes. Cancers. 2023; 15(3):718. https://doi.org/10.3390/cancers15030718
Chicago/Turabian StyleRiantiningtyas, Reisya R., Florence Carrouel, Amandine Bruyas, Wender L.P. Bredie, Camille Kwiecien, Agnès Giboreau, and Anestis Dougkas. 2023. "Oral Somatosensory Alterations in Head and Neck Cancer Patients—An Overview of the Evidence and Causes" Cancers 15, no. 3: 718. https://doi.org/10.3390/cancers15030718