[Pathogenesis of disorders of smell and taste].
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The present study introduces a novel measure of adenosine receptor sensitivity that is based on the action of specific receptor blockers (e.g., caffeine) to potentiate the ability to detect threshold quinine concentrations. The test is used to compare gustatory adenosinergic responses to caffeine challenges in normal controls and patients with panic disorder or posttraumatic stress disorder (PTSD). Panic disorder patients had an exaggerated response to the caffeine challenge that was not found in controls or PTSD patients, although the latter had higher anxiety scores on psychometric tests. The results are related to a model in which A1-adenosine receptors up-regulate in an attempt to modulate hyperactive excitatory neuronal systems.
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Olfactory and gustatory function can be reiably studied in patients with craniofacial anomalies over the age of 7 years. In our unoperated patients with orbital hypertelorism or craniofacial dysostosis, preoperative evaluation of the olfactory and gustatory functions showed normal values. The same techniques were employed to study any changes in these modalities following reconstructive craniofacial surgery, and the results are presented.
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The olfactory, auditory, and gustatory functions of 20 women with gonadal dysgenesis were studied. Various abnormalities of these functions were found, and they occurred principally in patients with mosaicism of the sex chromosomes. This is further evidence of the increased likelihood of various somatic abnormalities among women with gonadal dysgenesis, and particularly among those who carry more than one line of sex chromosomes.
In spite of the normal clinical appearance of the oral mucosa, BMS subjects do have demonstrated changes in sensory perception and salivary factors in addition to alterations in psychologic features. Although some of these changes may be suggestive of a peripheral or central dysfunction of small afferent nerve fibres, the extent of this alteration and its cause both remain unclear. The existence of changes other than psychologic, however, do weaken the proposition that BMS has a primarily psychogenic origin and suggests instead that future research should address the question of other organic changes in BMS.
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Disorders of taste are prevalent in patients undergoing chemotherapy and often have a negative impact on quality of life and nutrition. We now present a review of the physiology of taste and smell and a discussion of the multiple causes of disturbances in these senses in patients undergoing standard- and high-dose chemotherapy. A better understanding of the complex and often multifactorial etiology of taste dysfunction should enable the clinician to institute measures to minimize the impact of these disturbing changes.