Optical coherence tomography assessment of tongue papillary atrophy and patient-reported impact on taste following head and neck cancer therapy
File(s)
Published version
Author(s)
Hamdoon, Zaid
Jerjes, Waseem
Rashed, Dara
Hopper, Colin
Type
Journal Article
Abstract
Background: Taste disturbances are common after head and neck cancer treatment and can impair nutrition and quality of life. Aim: The aim of this study was to characterise tongue papilla morphology using optical coherence tomography (OCT), apply an ordinal atrophy grading system, and evaluate associations between structural changes and patient-reported taste outcomes. Materials and Methods: A case–control study was conducted including 53 participants: 33 head and neck cancer survivors (radiotherapy, chemotherapy, or combined treatment) and 20 healthy controls. OCT was used to assess papilla height, width, and signal intensity, and a five-point ordinal atrophy scale was applied to fungiform and filiform papillae. Taste outcomes were assessed using the UW-QOL (v4). Interobserver reliability was evaluated using Cohen’s kappa. Results: Cancer patients exhibited significantly reduced papilla height and width compared with controls (fungiform mean difference −350 µm; filiform −250 µm; all p < 0.001). Radiotherapy and combined therapy were associated with more severe atrophy than chemotherapy alone. Severe fungiform atrophy was strongly associated with patient-reported taste impact (UW-QOL taste domain; Spearman ρ = 0.80), with up to 90% reporting impairment at the highest atrophy grades. After controlling for age, the association attenuated but remained statistically significant (partial Spearman ρ = 0.39, p = 0.04; regression β = 0.14, 95% CI 0.03–0.25, p = 0.01), and it was further attenuated after additional adjustment for xerostomia (UW-QOL saliva domain; β = 0.09, 95% CI −0.02–0.20, p = 0.11). Interobserver agreement was substantial. Conclusions: OCT enables non-invasive, high-resolution assessment of tongue papillary atrophy and its cross-sectional association with patient-reported taste impact after head and neck cancer therapy. Findings should be interpreted as associative; age-matched and longitudinal studies incorporating objective taste testing are warranted.
Date Issued
2026-02-17
Date Acceptance
2026-02-10
Citation
Journal of Clinical Medicine, 2026, 15 (4)
ISSN
2077-0383
Publisher
MDPI AG
Journal / Book Title
Journal of Clinical Medicine
Volume
15
Issue
4
Copyright Statement
© 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41753264
PII: jcm15041577
Subjects
chemotherapy
optical coherence tomography
radiotherapy
taste disorders
tongue
xerostomia
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
1577
Date Publish Online
2026-02-17