Iatrogenic smell and taste loss after surgery and anaesthesia.

INTRODUCTION

Loss of taste and smell is a debilitating yet overlooked complication of certain medical procedures. This study aimed to characterise patients with permanent iatrogenic olfactory or gustatory dysfunction referred to a flavour clinic.

METHODS

This retrospective cohort study included patients assessed at the Flavour Clinic, Regional Hospital West Jutland, between May 2017 and November 2024. Patients were included if they experienced olfactory or gustatory dysfunction lasting more than one year, with a clear temporal relationship to a medical intervention. Standardised sensory testing, otorhinolaryngological examination, and relevant imaging and laboratory assessments were performed.

RESULTS

Out of more than 3,000 patients assessed, 55 met the inclusion criteria. Sinonasal surgery using local anaesthesia was the predominant cause of olfactory dysfunction (n = 11), despite procedures being remote from the olfactory cleft. Gustatory dysfunction was primarily associated with tonsillectomy (n = 18), frequently involving glossopharyngeal or facial nerve damage. A smaller number of cases were linked to general anaesthesia or systemic therapy. Recommendations to reduce the risks are presented.

CONCLUSIONS

Permanent iatrogenic olfactory or gustatory dysfunction is rare but clinically significant. Tonsillectomy, sinonasal surgery and anaesthesia - both local and general - are key contributors. Greater awareness, meticulous surgical technique and comprehensive informed consent are essential to minimise incidence and medicolegal consequences.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.