Taste Disorders: DR - Abdullah Alhayani, MBBS

Taste disorders
Dr.Abdullah alhayani,MBBS.
Case scenario 1
30 Years old male came to
your clinic 2 weeks after

tympanoplasty c/o change in
taste .
Case scenario 2
25 yrs old female has history of
allergic rhinitis and nasal

obstruction came to your clinic c/o
loss of smell and taste sensation .
Objectives
Anatomy .
Physiology
Histology
Pathology
Clinical application
Anatomy of the Taste System

Taste buds are located through out the oral
cavity , ,pharynx,epiglottis .
Total number about 4600 / tongue .
Taste buds are contained within papillae .
Lingual papillae have the following 4

forms :
1. Fungiform papillae : visible small red
structures ; tip/edges; 0-15 taste pores on

papillae .( 7th CN )
2. Foliate papillae . on edges of tongue
base; located between adjacent folds;
deeper red ( 9th CN )
3. Circumvallate papillae largest in
middle; 3-4 on either side forming
inverted V; between ant 2/3 and post 1/3.
( 9th CN )
4. Filiform (most numerous; no role in
TASTE TRANSDUCTION
Stimuli entering the mouth first interact
with sites on the microvilli within the taste

pore.
Salts and sour acidic stimuli use ion
channels while sweet and bitter substances
use with protein compounds.
Taste receptors trigger transduction
cascades, which then activate synapses
and cause the excitation of nerve fibers.
Once the stimulant enters the cell there is
a change in the internal electrical state of

the cell, which leads to the secretion of a
neurotransmitter and activation of a nerve
fiber.
A signal is produced, which is then carried
to the brain, relaying information on the
identity and intensity of the gustatory
stimulus.
Tongue
Tongue map
map
No
No map;
map; all
all four
four taste
taste perceivable
perceivable in
in any
any area
area
Nerves
CN IX ( glosssopharyngeal nerve )
Taste innervation to circumvallate and foliate
papillae
General sensory to base of tongue
Stylopharyngeus is only muscle innervated by it
Travels to inferior petrosal ganglion .
Enters the medulla; nucleus solitarius
CN VII chorda tympani (branch of facial
nerve )
Taste from fungiform papillae on ant 2/3 .
Runs with lingual, which provides general sensory
Gives preganglionic PSN fibers to submand ganglion
Enters infratemporal fossa .
Passes middle ear through (Huguier canal)
Enters fallopian canal
Afferents and visceral efferents leaving geniculate
ganglion known as nervus intermedius; stays separate

from motor branch within IAC, and traverses CPA between
VII and VIII
Terminate in nucleus solitarius
CN VII GSPN ( branch of facial
nerve )
Taste to palate; buds on margin
between hard and soft
Course with palatine n. (V2); lesser
palatine foramen
Pterygopalatine ganglion; join deep
petrosal nerve
Joins ant margin of geniculte
ganglion ; run with nervus
intermedius
Central connections
All three form solitary fasciculus;
terminates on second-order gustatory

neurons in rostral half of nucleus
solitarius (medulla)
Ipsilaterally ascend to thalamus via
central tegmental tract
Insula is the taste cortex (between
temporal and frontal lobes)
Terminology
Ageusia - Inability to taste
Hypogeusia - Decreased ability to taste
Dysgeusia Distorted ability to taste
Cacogeusia -- sensation of bad taste not
related to the ingestion of specific

substances .
disorders of taste and smell have
been difficult to diagnose and treat.

An alteration in taste or smell may
be a secondary process in various
disease states, or it may be the
primary symptom .
approximately 80% of taste
disorders are truly smell
disorders .
Etiology
Lesions at any site from the mucosa, taste
buds, unmyelinated nerves, or cranial nerves

to the brain stem may impair gustation.
Oral cavity and mucosal disorders including
oral infections, inflammation, and radiationinduced mucositis can impair taste sensation.
Poor oral hygiene is a leading cause of
hypogeusia and cacogeusia. Viral, bacterial,
fungal, and parasitic infections may lead to
taste disturbances because of secondary
taste bud involvement.
Normal aging produces taste loss due to
changes in taste cell membranes involving

altered function of ion channels and
receptors rather than taste bud loss.
Malignancies of the head and neck, as well
as of other sites, are associated with
decreased appetite and inability to
appreciate flavors.
Use of dentures or other palatal prostheses
may impair sour and bitter perception, and
tongue brushing has been shown to
decrease taste acuity.
Surgical manipulation may alter taste
permanently or temporarily.
Resection of the tongue and/or portions of
the oral cavity, most commonly for reasons
of malignancy, decreases the number of
taste buds.
Radiation and chemotherapy damage taste
receptors and decrease salivary flow,
altering taste perception.
In ear surgery, stretching or transection of
the chorda tympani nerve may result in

temporary dysgeusia.
Nutritional deficiencies are involved in taste
alterations. Decreased zinc, copper, and

nickel levels can correlate with taste
alterations. Nutritional deficiencies may be
caused by anorexia, malabsorption, and/or
increased urinary losses.
Endocrine disorders also are involved in
taste and olfactory disorders.

Diabetes mellitus, hypogonadism,
Sjogrens and pseudohypoparathyroidism
may decrease taste sensation, while
hypothyroidism and adrenal cortical
insufficiency may increase taste sensitivity.
Hormonal fluctuations in menstruation and
pregnancy also influence taste.

Phantoms from Damage to Peripheral Structures
Chorda tympani
Metallic taste sensation; occasionally a bitter
or salty taste
Nervus intermedius
Salty phantoms; last 6/12 then fade
CN IX
Some report bitter phantom
EFFECTS OF TASTE LOSS

What most individuals complain of is a loss
of flavor and enjoyment of foods, which is

most often related to the well known loss of
olfaction combined with some taste loss .
loss of appetite which puts the individual at
higher risk for depression, anorexia. and
weight loss.
Poor taste perception combined with
olfactory loss puts the individual at risk for
food poisoning from the ingestion of spoiled
foods.
Conclusion
Taste is affected by many diseases such as
diabetes, chronic renal failure, Parkinson,

and Alzheimer.
Some common medications affect taste,
such as antihypertensives and
chemotherapy drugs.
Taste may be affected by interruption of the
sensory neural pathways such as chorda
tympani and lingual nerve.
No specific treatment exists for taste
dysfunction.
Case scenario 1
30 Years old male came to
your clinic 2 weeks after

tympanoplasty c/o change in
taste .
Case scenario 2
25 yrs old female has history of
allergic rhinitis and nasal

obstruction came to your clinic c/o
loss of smell and taste sensation .

Taste Disorders: DR - Abdullah Alhayani, MBBS

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What are the main anatomical structures involved in taste?

What are the main anatomical structures involved in taste?

How does the taste transduction process work?

How does the taste transduction process work?

Taste disorders

your clinic 2 weeks after

allergic rhinitis and nasal

Anatomy of the Taste System

Lingual papillae have the following 4

structures ; tip/edges; 0-15 taste pores on

with sites on the microvilli within the taste

Once the stimulant enters the cell there is

a change in the internal electrical state of

CN VII chorda tympani (branch of facial

ganglion known as nervus intermedius; stays separate

CN VII GSPN ( branch of facial

All three form solitary fasciculus;

terminates on second-order gustatory

related to the ingestion of specific

disorders of taste and smell have

been difficult to diagnose and treat.

buds, unmyelinated nerves, or cranial nerves

Normal aging produces taste loss due to

changes in taste cell membranes involving

Surgical manipulation may alter taste

In ear surgery, stretching or transection of

the chorda tympani nerve may result in

Nutritional deficiencies are involved in taste

alterations. Decreased zinc, copper, and

Endocrine disorders also are involved in

taste and olfactory disorders.

EFFECTS OF TASTE LOSS

of flavor and enjoyment of foods, which is

diabetes, chronic renal failure, Parkinson,

your clinic 2 weeks after

allergic rhinitis and nasal

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