What can I do to improve my declining sense of taste?
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Renewed attention to chemosensory dysfunction has revealed that a substantial portion of the population are affected during their lives, many simply as a result of aging. The authors discuss terminology, assessment, etiology, and prognosis and compare current understanding with that presented by Mackenzie in 1884.
Disorders of taste and smell are common occurrences that can lead to modifications of dietary habits that may in turn exacerbate disease states or nutritional deficiencies. In addition, they are often nagging problems that diminish the quality of life. Such disorders can result from a range of disease states, pharmacologic and surgical intervention, aging, radiation, and environmental exposure. A search for the pathogenetic mechanism should include the determination of possible (1) local injury from physical or chemical causes, (2) damage to neural projections, (3) disturbance of the cycle of regeneration of chemoreceptors resulting from general malnutrition, disease agents, metabolic disturbances, drugs, or radiation, and (4) alteration in the saliva or fluids bathing the olfactory mucosa by drugs or metabolic agents. Viral infections, normal aging, head injuries, and nasal obstructions are the most common causes of smell disorders. Drugs are common offenders in taste dysfunction. Chemosensory disorders frequently remit when concomitant medical conditions are treated or offending drugs removed, although full recovery may take several months. Considerable research is now under way in this area, and it is to be hoped that we will soon have a better understanding of how to diagnose and treat these common disorders.
Compared to disorders of the ears and eyes, diseases of smell and taste seem to be far less outstanding: however, the unimpaired perception of odours and flavours comprises an important part of our well-being, as can be seen in the perfume industry or in drinking and eating habits. The ENT-specialist covers organic causes of these senses, as he has the tools to explore and treat in the depth of the nasal and oral cavities. The "Arbeitsgemeinchaft Olfaktologie/Gustologie der Deutschen Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie" therefore is in process of establishing a new set for a standardised smell and taste test, which is based in part on the sniffin'sticks, which were developed by Prof. Kobal, Erlangen. The examination procedure of nasal and oral chemosensory performance requires a high test-retest reliability and an efficiency comparable to internationally established measurements in order to render valid results in diagnostic and therapeutic procedures. The new test kit with the sniffin'sticks is presented in this paper, followed by an overview on some disorders of smell and taste perception and proposals for actual therapeutic procedures.
As with almost any aspect of medical practice, a thorough history and physical examination coupled with a good understanding of the anatomy and physiology of an organ system are the key factors in reaching a diagnosis. The information in this article is provided to assist the internist with the diagnosis of chemosensory disorders and the differentiation of malingering or other disease process as well as providing insight into the workup, prognosis, and treatment of patients with taste and smell disorders.
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This article discusses halitosis, and disorders of taste, orofacial movement or sensation.
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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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OBJECTIVE: To characterize clinically acute insular strokes from four patients with a first ever acute stroke restricted to the insula on MRI. METHODS: The authors studied the clinical presentation of four patients with a first ever acute stroke restricted to the insula on MRI. RESULTS: The authors found five main groups of clinical presentations: 1) somatosensory deficits in three patients with posterior insular stroke (two with a transient pseudothalamic sensory syndrome, one with partial distribution); 2) gustatory disorder in a patient with left posterior insular infarct; 3) vestibular-like syndrome, with dizziness, gait instability, and tendency to fall, but no nystagmus, in three patients with posterior insular strokes; 4) cardiovascular disturbances, consisting of hypertensive episodes in a patient with a right posterior insular infarct; and 5) neuropsychological disorders, including aphasia (left posterior insula), dysarthria, and transient somatoparaphrenia (right posterior insula). CONCLUSION: Strokes restricted to the posterior insula may present with pseudothalamic sensory and vestibular-like syndromes as prominent clinical manifestations, but also dysarthria and aphasia (in left lesions), somatoparaphrenia (right lesions) and gustatory dysfunction and blood pressure with hypertensive episodes in right lesions; we did not find acute dysphagia reported in anterior, insular strokes.
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.