[Value of otoneurologic examinations in the certification of late results of craniocerebral injuries].
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The authors illustrate the technical characteristics of a low cost, pocket electrogustometer, which works on batteries and offers complete safety both for the patient and for the examiner; this model is able to carry out, both in normal and selected patients, the same functions as can be carried out with more sophisticated and costly equipment, currently available.
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This study completes a previous one in which the authors tested the electrogustometric threshold in 300 normal subjects used as controls. The collected datas has been computerized on a programable calculator according to a lognormal model. Comparison between the electrogustometric threshold in diabetic patients, ethylic ones and controls demonstrate that they are statistically different. More than a half of the diabetics and ethylics have abnormaly high electrogustometric thresholds. The responses have been studied as a function of the evolution of the disease, of the clinical form and of gravity. Diabete and chronic ethylism do not disturb the gustatic function at the same speed and with the same intensity: one year evolution is at least necessary for diabetics, and ten years for ethylics in order to detect abnormal electrogustometric thresholds. But if the action of ethylic intoxication is slower, it determines the most important gustometric deteriorations.
For the first time in clinical routine testings impulse-gustometry was used in comparison to normal chemical or electrogustometric methods. Loss of taste caused by tympanoplasty, radiation of tumors in head and neck and accompanying facial nerve palsies was tested. The exactly defined location of the stimulus is known advantage in electrogustometry. Impulse-gustometry, however, is able to stimulate different taste sensations like the chemical methods. The sensible sensation, therefore, is eliminated. The stimulating pulses ranged between 0,5 and 2,0 ms at frequencies of 10 to 300 cps. Like with Krarup's method in impulsegustometry there is not always a taste sensation.
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The relation between age and taste threshold in populations living both in Istanbul and Resadiye, a town located in eastern part of Turkey, was investigated. In Turkey the nontaster/taster ratio has been found lower than in the other countries of Europe and Asia (3 ,4 ,8 ,9). With aging the taste sensitivity of tasters does diminish. However, the differences in the taste threshold levels of nontasters, in different age groups, have been found as being statistically not significant.
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Chemosensory dysfunction is most often secondary to one of only a few causes: nasal/sinus disease, viral infection, toxic chemical exposure, head trauma, as well as medication-related and idiopathic conditions. Medication-related disorders are corrected by discontinuance of the causative medicine. Our experiences have also shown that only dysfunctions of smell caused by disorders of the nose and/or sinuses are amendable to therapy.
Specific neurologic causes of chemosensory deficits are uncommon. A careful history and neurologic examination and the use of appropriate neurodiagnostic studies will identify the underlying cause in many cases and allow for appropriate management. The neurologic evaluation of the patient with abnormalities of smell, taste, or both is reviewed with specific reference to the disorders of the central and peripheral nervous system that may be causative.
Chemosensory disorders have been receiving increasing clinical attention but remain a difficult diagnostic problem. With the development of several well-standardized testing methods, taste or smell loss can now be verified, and this has added to knowledge concerning the common causes of dysfunction. Diagnosis typically rests upon the history and physical examination, but, except in the case of obstructive nasal and sinus pathologic conditions, therapy usually remains elusive.