미각 장애 환자의 임상적 고찰

임근혜,신승헌,예미경 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.5

Background and Objectives:Taste disorders have not received sufficient attention by otolaryngologists and only a few studies have documented the clinical characteristics of taste disorders. We therefore analyzed the characteristics of patients with taste disorders who visited our Taste and Smell Clinic over a 3-year period. Subjects and Method:Sixty patients with taste disorders were investigated. The efficacy of treatment was evaluated according to the age, sex, duration of symptom, cause, and severity of taste disorder. Results:Sixty percent of patients visited the clinic within 6 months of the onset of decrease in taste sensation. Multiple etiology was more common than single etiology. Taste disorder due to olfactory disorder was the most frequent etiology, followed by drug induced taste disorder and taste disorder due to zinc deficiency. Sixty percent of the patients experienced improvement of the taste abnormality. The efficacy of treatment decreased with increasing severity of taste disorder at the initial visit. Conclusion:Careful history taking and physical examination are needed for determination of the cause of any taste abnormality. The site and severity of dysgeusia should be determined through the chemical and electrical taste threshold test. Treatment should direct toward the causative abnormality, if possible.

Carbonic Anhydrase 6 유전자의 단일염기다형성과 Phenylthiocarbamide 민감도 및 미각 장애와의 관계

배재웅,김언경,오세경,류미라,신승헌,예미경 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.3

Background and Objectives The phenylthiocarbamide (PTC) and 6-n-propylthiouracil (PROP) taste sensitivity varies among individuals. Recently, it is reported that PROP taste responsiveness is associated with carbonic anhydrase 6 (CA6) gene polymorphism. The CA6 gene, a zinc metalloprotein in human saliva, is affected in taste function and might be correlated with gustatory diversity. The aim of this study was to examine whether PTC taste sensitivity and taste disorder is associated with the CA6 gene polymorphism rs2274327 (C/T), rs2274328 (A/C), and rs2274333 (A/G). Subjects and Method A total of 217 healthy normal subjects were recruited as controls, and 50 taste disorder patients were recruited as experimental group. The polymorphisms of CA6 gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis. All statistical analyses were calculated using the statistical package for the social science software. Haplotypes were estimated by Haploveiw and the PHASE programs. Results The CA6 gene polymorphisms showed association with taste disorder but not with PTC sensitivity (taster/nontaster). The number of control subjects carrying AA genotype of single nucleotide polymorphism rs2274328 (A/C) in the CA6 gene was higher than the number of the subjects with taste disorder (p=0.048). However, there was no association between controls and taste disorder subjects in the haplotype analysis. Conclusion These data suggest that the CA6 gene polymorphism rs2274328 could affect taste function impairment in patients with taste disorder. This observation requires a further functional study of gustin protein to clarify the association of the CA6 gene polymorphisms with the taste disorder and sensitivity.

비타민 B12 결핍으로 인한 미각 장애

강병준,신승헌,예미경 대한이비인후과학회 부산,울산,경남 지부회 2020 임상이비인후과 Vol.31 No.1

Background and Objectives: The etiologies of taste disorder are multiple. It is rarely considered vitamin deficiency can impact taste function. Vitamin B12 deficiency can be caused by total gastrectomy or malnutrition. The aim of this study was to investigate the characteristics of patients with taste disorders caused by vitamin B12 deficiency. Materials and Methods: We treated fourteen patients with vitamin B12 deficiency induced taste disorders. The symptoms of patients were decreased taste sensitivity, tongue pain, and abnormal tongue sensation. The patients’ tongues were red, smooth, and no papillae. The laboratory test showed that decreased serum concentration of vitamin B12. Taste function test showed increased taste thresholds. Ten patients had total gastrectomyhistory and four patients were poor nutritional status. All patients were treated by administration of vitamin B12 intramuscularly. Results: The patients’symptoms were improved after treatment. The appearance of the tongue and the results of taste testing were also improved. Conclusions: The patients with taste disorder and tongue pain should be asked about operation history including gastrectomy, and vitamin B12 deficiency induced taste disorder should be considered in the differential diagnosis.

미각장애 환자에서 TAS2R38 쓴맛수용체 유전자 단일염기다형성의 역할

강병준,박진우,금상연,김언경,신승헌,예미경 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.11

Background and Objectives Several studies have shown that three single nucleotide polymorphisms(SNPs) in the TAS2R38 gene demonstrate a strong association with the ability tosense the bitter taste of phenylthiocarbamide (PTC) in. We have previously reported aboutTAS2R38 genotypes in normal volunteers. The aim of this study was to investigate the roleTAS2R38 gene plays in taste disorder by examining SNPs in the TAS2R38 gene in taste disorderpatients. Subjects and Method Ninety-four patients with taste dysfunction from multiple etiologieswere enrolled. The genotypes were defined by identifying SNPs on the TAS2R38 gene. Theproportion of different TAS2R38 genotypes in the group was compared with that in the normalvolunteers of our previous study. The whole mouth taste threshold tests were performedand the thresholds were compared among the three different genotypic groups. Results The proportion of each diplotype in taste disorder patients were as follows: PAV/PAV 36.2% (34/94), PAV/AVI 34.0% (32/94), and AVI/AVI 29.8% (28/94). The proportion ofAVI/AVI type was higher in the group than in the normal volunteers (p=0.031). The detectionand recognition thresholds of all four basic tastes were increased in the order of PAV/PAV,PAV/AVI, and AVI/AVI genotypes. Conclusion The proportion of AVI/AVI homozygous was significantly higher in taste disorderpatients than in the normal volunteers. Our findings suggest that the genotypes of TAS2R38may represent one of the risk factors responsible for the development of taste disorders.

미각장애와 TAS1R3 및 GNAT3 유전자의 다형성과의 연관성

Jae-Woong Bae(배재웅),Un-Kyung Kim(김언경),Tae-Jun Kwon(권태준),Su-Jin Choi(최수진),Mi-Kyung Ye(예미경) 한국생명과학회 2011 생명과학회지 Vol.21 No.3

단맛은 우리 몸에 열량을 공급하는 역할을 담당하는 중요함 감각으로 인지도가 개인마다 조금씩 다르다고 알려져 있으나, 이에 대한 분자수준의 연구는 아직 부족한 실정이다. 본 연구에서는 미각 장애에 미치는 유전적 요인에 대해 알아보고자 50명의 미각 환자 및 100명의 정상인을 대상으로 단맛 민감도 차이와 연관이 있는 TAS1R3 및 GNAT3유전자의 다형성 간의 관련성을 알아보았다. TAS1R3 유전자 rs307355 및 rs35744813의 유전자형과 대립유전자의 빈도는 미각 장애 환자군과 대조군 간에 통계적으로 유의한 차이가 있었으며, 두 다형성에 대한 일배체형을 분석한 결과, C-C 및 T-T의 두 종류만이 검출되었으며 환자군과 대조군 간의 일배체형 빈도 간에도 통계적으로 유의한 차이를 보였다. GNAT3유전자에서는 rs7792845의 유전자형 빈도가 환자군과 대조군간에 유의적인 차이를 나타냈었으나, 대립유전자빈도에서는 차이가 없었다. 이러한 연구결과는 단맛의 민감도 차이에 영향을 미치는 것으로 보고된 TAS1R3 및 GNAT3 유전자의 다형성에 대한 한국인 집단에서의 유전자형 빈도를 조사함으로써 집단유전학적 연구를 위한 기초자료를 제공하고 미각장애환자군과의 비교분석을 통해 TAS1R3 및 GNAT3유전자의 다형성이 연관성이 있을 가능성이 있음을 제시해 줌으로써 향후 미각장애를 진단하기 위한 검사시 지표로 활용될 수 있으리라 생각된다. 위에 제시한 연구결과는 향후 추가적인 샘플링을 통해 보다 많은 환자군과 대조군에 대한 추가적인 연구가 수행되어야 할 것이다. Taste sensation plays a crucial role in selecting and ingesting foods with different qualities which convey information about their nutrient content and/or safety. Sweetness is one of the five modalities in humans and serves as an energy resource for metabolism. There are reports on allelic polymorphisms which influence perception of sweetness in mice and humans. Since the influence of genetic factors on taste disorder has not been studied, we investigated the association of genetic polymorphisms in TAS1R3 and guanine nucleotide binding protein, alpha transducing 3 (GNAT3) genes and taste disorder. A total of 150 individuals composed of 50 patients with taste disorder and 100 healthy controls were recruited for the study and PCR-mediated directing sequencing method was used to genotype for two different single nucleotide polymorphisms (SNPs) - rs307355 (T>C) and rs35744813 (T>C) in the TAS1R3gene, and rs7792845 (T>C) and rs1524600 (C>T) in the the GNAT3gene. The allele and genotype frequencies of rs307355 and rs35744813 in the TAS1R3gene showed a significant association between patients with taste disorder (p=0.022 and p=0.013 in both of SNPs, respectively). In addition, the frequency of T-T haplotype in the TAS1R3gene was higher in taste disorder cases than in the controls (OR, 1.93: 95%. CI, 1.09?3.39, p=0.022). In the GNAT3, the genotype frequency of rs7792845 in the patients was also different from the controls (p=0.048), but allele frequency was not significantly associated in either group. Our result provides the frequencies of SNPs and haplotypes of the TAS1R3 and GNAT3genes for the fundamental information of nutrigenetics in perception of the taste of sweetness in the Korean population. Also, the study suggests that the allelic polymorphisms of TAS1R3 and GNAT3genes may be useful as a molecular marker for evaluating patients with taste disorder. Further studies with large samples are required to clarify our observation.

Traumatic Brain Injury-Induced Mixed Chemosensory Disorder: a Case Study on Taste and Smell Dysfunction

임영관,김슬기,성충만,김재형 대한안면통증∙구강내과학회 2023 Journal of Oral Medicine and Pain Vol.48 No.4

We present a case report of a 52-year-old male patient who suffered head trauma in a car accident and subsequently experienced taste and smell disorders. Following the accident, the patient reported difficulty detecting salty and sour tastes and diminished olfactory perception. Neurosurgical evaluation revealed subarachnoid and subdural hemorrhages, while otolaryngology investigations revealed hyposmia—a decreased sense of smell. Upon referral to the Department of Oral Medicine, a comprehensive assessment revealed a general bilateral reduction in taste sensation, particularly ageusia for salty taste. Electric taste-detection thresholds significantly exceeded the normal ranges. Integrating our findings from neurosurgery, otolaryngology, and oral medicine resulted in a diagnosis of mixed chemosensory disorder attributed to head trauma. This case highlights the intricate interplay of alterations in taste and smell following head injury, emphasizing the significance of multidisciplinary evaluations in diagnosing mixed chemosensory disorders resulting from traumatic brain injury.

미각 장애 환자 5례를 대상으로 한 대한 한방 치료의 효과

백승환,김진성,장승원,손지영,최제인,한성준,이엄지,류봉하,Baek, Seung-Hwan,Kim, Jin-Sung,Jang, Seung-Won,Son, Ji-Yeong,Choi, Jane,Han, Seong-Jun,Lee, Eom-Jee,Ryu, Bong-Ha 대한한방내과학회 2014 大韓韓方內科學會誌 Vol.35 No.3

Objectives: The purpose of this study was to report the effect of traditional Korean medical therapy such as acupuncture, electroacupuncture and herbal medicine in taste disorder patients. Methods: We surveyed 5 taste disorder patients visiting the Oral Diseases Clinic in the Kyung Hee University Oriental Medicine Hospital from January, 2014 to June, 2014. Before starting traditional Korean medical therapy such as acupuncture, electroacupuncture and herbal medicine, the subjects were evaluated on severity of discomfort using visual analogue scale (VAS), salivary flow rate (SFR), quality of life about oral health (based on the 14-item Oral Health Impact Profile-14) and qi-stagnation condition (based on the 23-item qi-stagnation Questionnaire). Visual analogue scale was re-evaluated during the treatment period. Results: There was no relationship between diminished SFR and severity of discomfort. Also change or loss of taste did not influence the quality of life about oral health. However, stress which refers to qi-stagnation could be one of the reasons taste disorder occurs. After receiving traditional Korean medical therapy, all 5 patients' visual analogue scale score decreased. Conclusions: Traditional Korean medical therapy may potentially be an option for taste disorder. Further evaluations including pre-post comparison with larger number of cases will be needed in the future.

의인성 미각 장애

예미경 대한비과학회 2010 Journal of rhinology Vol.17 No.2

Taste is a critical component of a person’s overall sense of well-being and quality of life. Loss of taste interferes with pleasure derived from food and food-related activities. Clinically, taste disorders are less common than smell disorders and therefore the work-up and understanding of taste disorders are limited. Taste is typically ignored by otolaryngologists, even though some otolaryngologic operative procedures compromise the functioning of this sense. Long-lasting postoperative dysgeusia is less frequent but has significant consequences on patients’ quality of life, with some cases leading to medicolegal issues. Many drugs can affect the patient’s sense of taste and contribute significantly to the morbidity of the associated illness. This report provides a brief overview of iatrogenic taste disorders and emphasizes the need for increased awareness among clinicians regarding these problems.

Clinical Characteristics and Gustatory Profiles in Patients with Subjective Taste Complaints

Kim, Seo-Yeong,Byun, Jin-Seok,Jung, Jae-Kwang,Choi, Jae-Kap Korean Academy of Orofacial Pain and Oral Medicine 2019 Journal of Oral Medicine and Pain Vol.44 No.3

Purpose: Patients with taste complaints presenting with various abnormal perceptions and alterations in gustatory function are often encountered in dental clinics. Since taste perception is thought to be influenced by numerous factors including neurological and psychological factors, the gustatory profiles of patients complaining of taste abnormalities should be very different. However, the gustatory profiles based on the clinical subtypes of taste complaints have not been fully studied. This study aimed to better understand the gustatory profiles depending on the clinical subtypes of taste complaints. Methods: Clinical data from 169 patients with complaints of altered taste were retrospectively collected to analyse their clinical and gustatory profiles. These complaints were subdivided into hypergeusia, hypogeusia, and dysgeusia for each taste quality according to the clinical types of these complaints. The gustatory profiles were then established by analysing the detection and recognition thresholds for each taste quality depending on the clinical subtypes of taste complaints. Results: Clinical analysis revealed that patients with taste complaints had widely diverse clinical profiles. There were significant differences between males and females with taste complaints in the prevalence rates of symptoms like dry mouth, tongue coating, and burning sensation. While hypogeusia (76.3%) was the most frequent type of taste complaint, it was revealed that the taste thresholds were not always consistent with the patient's description of gustatory symptoms. Conclusions: Patients with taste complaints exhibited diverse clinical profiles with sex differences. Considering the diversity of the taste complaints, the quantitative gustatory testing methods can be valuable to differentially evaluate the presence and intensity of altered taste in patients with these complaints.

Clinical Characteristics and Gustatory Profiles in Patients with Subjective Taste Clinical Characteristics and Gustatory Profiles in Patients with Subjective Taste Complaints

김서영,변진석,정재광,최재갑 대한안면통증∙구강내과학회 2019 Journal of Oral Medicine and Pain Vol.44 No.3

Purpose: Patients with taste complaints presenting with various abnormal perceptions andalterations in gustatory function are often encountered in dental clinics. Since taste perceptionis thought to be influenced by numerous factors including neurological and psychologicalfactors, the gustatory profiles of patients complaining of taste abnormalities shouldbe very different. However, the gustatory profiles based on the clinical subtypes of tastecomplaints have not been fully studied. This study aimed to better understand the gustatoryprofiles depending on the clinical subtypes of taste complaints. Methods: Clinical data from 169 patients with complaints of altered taste were retrospectivelycollected to analyse their clinical and gustatory profiles. These complaints were subdividedinto hypergeusia, hypogeusia, and dysgeusia for each taste quality according to theclinical types of these complaints. The gustatory profiles were then established by analysingthe detection and recognition thresholds for each taste quality depending on the clinicalsubtypes of taste complaints. Results: Clinical analysis revealed that patients with taste complaints had widely diverseclinical profiles. There were significant differences between males and females with tastecomplaints in the prevalence rates of symptoms like dry mouth, tongue coating, and burningsensation. While hypogeusia (76.3%) was the most frequent type of taste complaint, itwas revealed that the taste thresholds were not always consistent with the patient’s descriptionof gustatory symptoms. Conclusions: Patients with taste complaints exhibited diverse clinical profiles with sex differences. Considering the diversity of the taste complaints, the quantitative gustatory testingmethods can be valuable to differentially evaluate the presence and intensity of alteredtaste in patients with these complaints.