Validation of the Tamil Version of the Taste and Smell Questionnaire for Assessing Sensory Dysfunction in Head and Neck Cancer Patients Undergoing Chemoradiotherapy

Chemoradiation-induced sensory dysfunction, including altered taste and smell, is a common yet underreported consequence of chemoradiotherapy (CRT) in patients with Head and Neck Cancer (HNC). A culturally and linguistically adapted tool in Tamil is crucial for the symptom assessment and supportive care among Tamil-speaking populations. The Taste and Smell Questionnaire (TSQ) is a self-reported measure that facilitates the evaluation of taste and smell difficulties in patients with HNC. This study aimed to translate and validate the Tamil version of the TSQ (TSQ-T), and to evaluate self-perceived taste and smell disturbances in healthy adults and HNC patients after CRT.

This cross-sectional study was conducted in two phases: (i) forward-backward translation of the TSQ, expert panel review, pilot testing, and cognitive debriefing; and (ii) administration of the finalized Tamil TSQ to 264 HNC patients and 75 healthy controls. Internal consistency, known-group comparisons, and symptom correlations with clinical aspects were analyzed.

The Tamil TSQ demonstrated excellent internal consistency (Cronbach's α = .98). Patients with HNC reported significantly higher taste (M = 3.38) and smell (M = 1.19) scores compared with healthy controls (M = 0.40 and M = 0.03, respectively; p < 0.001). Symptom severity was greatest within the first three months following CRT and declined gradually with longer post-CRT duration. When compared across cancer sites, patients with tongue cancer reported the highest TSQ scores. The treatment modality (surgery vs. CRT) did not yield significant differences in scores. Patients who reported greater swallowing difficulties also reported higher taste and smell symptom scores, supporting the association between dysphagia and chemosensory changes.

The Tamil version of the TSQ is a reliable and valid instrument for assessing taste and smell dysfunction in HNC patients.