[in Japanese]

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[in Japanese]

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We clarified the clinical features of “flavor dysfunction,” defined as olfactory dysfunction with self-reported hypogeusia but normal taste function in gustatory tests compared to those of “smell and taste dysfunction” hyposmia and hypogeusia in olfactory and gustatory tests.
Patients with flavor dysfunction reported significantly milder taste loss than those with other smell and taste dysfunction. The major smell and taste loss etiology was upper respiratory tract infection (URI) in the flavor dysfunction group and the URI rate was significantly higher in the flavor dysfunction group than in the smell and taste dysfunction group. Smell identification thresholds in T & T olfactometry were not different between groups. Flavor dysfunction, hyposmia was treated medically but not with conventional hypogeusia medication. Medication including zinc was administered for other smell and taste dysfunction. Both groups significantly recovered from taste dysfunction.
Our results indicate that treating olfactory dysfunction effectively improves flavor dysfunction but hypogeusia need not necessarily be treated. Hyposmia and hypogeusia must be treated together for other smell and taste dysfunction, making it vital that we conduct appropriate gustatory testing to correctly differentiate between flavor and other smell and taste dysfunctions.

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Our treatment of choice in voice reconstruction for recurrent laryngeal nerve (RLN) resection is concurrent nerve reconstruction. If this is not possible, we secondarily inject fat. We studied postoperative voice function and the feasibility of this voice reconstruction treatment strategy. Subjects were 39 patients with advanced thyroid cancer having the primary lesion resected together with RLN between 2001 and 2007. Of these 39, 9 underwent concurrent reconstruction by directly anastomosing the ansa cervicalis to the peripheral RLN. Fat was secondarily injected in 25 and 5 did not undergo any reconstruction.
We found that:
1) Postoperative maximum phonation time (MPT), mean flow rate (MFR) and pitch perturbation quotient (PPQ) in the direct anastomosis group were significantly better than in the nonreconstruction group (p<0.05).
2) Postoperative MPT, MFR, and PPQ in the fat injection group were significantly better than in the nonreconstruction group (p<0.05).
3) MPT in the fat injection group was significantly better than in the direct anastomosis group one month postoperatively (p=0.007), although this finding was reversed six months postoperatively (p=0.08).
4) MFR in the fat injection group tended to be better than the direct anastomosis group one month postoperatively (p=0.1), although this finding was reversed six months postoperatively (p=0.1).
We thus recommend concurrent voice reconstruction by direct anastomosis in conjuction with nerve resection.

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