"Evolución de la función gustativa tras la cirugía endoscópica de los senos paranasales: una revisión sistemática".

Abstract

Taste alterations are frequently reported by patients with chronic rhinosinusitis (CRS), yet they remain underrecognized and poorly characterized in clinical practice. These symptoms are often attributed to impaired retronasal olfaction rather than true gustatory dysfunction, and current assessment tools frequently fail to distinguish between taste and flavor perception. Consequently, this study sought to evaluate postoperative changes  in gustatory function in adult patients with chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery (ESS/FESS) using validated objective assessment tools. 

Methods:
A systematic review of databases such as CENTRAL, Embase, LILACS, MEDLINE, and Scopus,  was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251079569). Studies including adult patients (>18 years) with CRS undergoing ESS/FESS and reporting gustatory outcomes were included.

Results:
Four studies comprising 169 patients were included. Baseline gustatory dysfunction was variably reported, with some studies demonstrating reduced taste function compared to controls, while others found no significant differences across CRS phenotypes. Following surgery, no consistent improvement in global gustatory function was observed, as measured by whole-mouth taste testing (WMTT) and taste quad testing (TQT) scores (p > 0.05). Selective changes in individual tastants were identified, including decreased sweet and bitter perception in CRS with nasal polyps (CRSwNP), and decreased salty perception with increased sweet scores in CRS without nasal polyps (CRSsNP). These changes were inconsistent across studies and did not translate into clinically meaningful global improvements. Temporal analyses suggested transient postoperative alterations with subsequent recovery.

Conclusion:
Gustatory function in patients with CRS appears to remain largely unchanged following ESS/FESS. Observed postoperative changes are inconsistent, and likely transient. These findings highlight a dissociation between olfactory and gustatory outcomes and underscore the need for standardized, validated tools to assess gustatory and flavor perception in CRS