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Tuesday, 22 February 2011

Diagnosing Smell and Taste Disorders

Posted on 14:35 by Unknown
This article is reprinted with kind permission from Dr. Robert Henkin of the Smell and Taste Clinic located in Washington DC.

Answers to the Four Questions Required to Determine Cause of Smell and Taste Disorders: 

Question 1. DETECTION THRESHOLD – Can you detect the least concentrated stimulus from among three presented stimuli – two of which are either water (tastants) or neutral (odorants) and one of which is different?

This answer tells us of the presence and character of functioning taste and/or smell receptors. If this threshold number is higher (less sensitive) than normal then the patient requires more tastant or odorant than normal to stimulate taste and/or smell receptors. If the number is higher than normal then the patient has lost sensory receptor function due to some pathology.

Question 2. RECOGNITION THRESHOLD – Can you recognize correctly the different stimulus you just detected?

This answer tells us of the interaction between taste and/or smell receptors and the brain which processes this information. If the threshold number is higher (less sensitive) than normal then the patient requires more tastant or odorant than normal both to stimulate receptors and for the brain to process the sensory information correctly. This means that the patient has either lost sensory receptor sensitivity and/or has brain impairment which inhibits processing of the sensory stimulus due to some pathology.

Question 3. MAGNITUDE ESTIMATION – Can you judge the intensity of the correct recognition you just made using a scale from 0-100?

This answer tells us of the number of functioning taste and/or smell receptors. Taste and smell receptor activation involves a “field effect”; the larger the field, the more functioning receptors, the higher the magnitude estimation number. Thus, if the magnitude estimation number is lower than normal then the receptor number (taste and/or smell) is diminished and indicates pathology of the sensory system related to decreased receptor number.

Question 4. HEDONIC ESTIMATION – Can you judge the unpleasantness on a scale of -100 – 0, or pleasantness on a scale from 0 – +100, of the stimulus you just correctly recognized?

This answer tells us of the interaction between sensory receptor and the brain with respect to intensity of distortions of the sensory stimulus. This test uses a scale from 0 - −100 to indicate unpleasantness and a scale from 0 - +100 to indicate pleasantness. If a sweet tastant stimulus is considered unpleasant (e.g., -50% at a moderate concentration of sucrose, 300mM) then this response indicates a sensory distortion and thereby pathology of the taste system. Similarly, if the fruity odorant stimulus of amyl acetate is considered unpleasant (e.g., -50% at a moderate concentration of 10-1M) then the response indicates a sensory distortion and thereby pathology of the smell system.


By use of answers to these four questions it is possible to determine the nature and character of the pathology affecting taste and smell dysfunction. Answers to each of these questions are essential to determine this pathology.

These tests are used at The Taste and Smell Clinic in Washington, DC to determine the nature and character of sensory abnormalities of patients with taste and smell dysfunction. Only by use of this entire test battery can the nature and character of sensory dysfunction be determined. Simpler tests cannot fulfill this requirement.

Dr. Robert Henken
The Taste and Smell Clinic
Phone: (202) 364-4180

Reference:
An open label controlled trial of theophylline for treatment of patients with hyposmia. American Journal of the Medical Sciences. Vol. 337, pp. 396-406, 2009.
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  • prescribing
  • prescription
  • prescriptions
  • pressure
  • prick
  • prilosec
  • primer
  • problem
  • problems
  • procedure
  • process
  • professional
  • propel
  • protein kinase
  • provider
  • public
  • publication
  • puck
  • pulsatile
  • pumpkin
  • punishment
  • purchase
  • purulent
  • pus
  • puzzle
  • pylori
  • quickly
  • quickmark
  • r. kelly
  • radiation
  • radio
  • radioactive
  • radioactivity
  • radiological
  • radiology
  • raft
  • ragweed
  • random
  • rapid
  • raspy
  • RAST
  • reaction
  • reader
  • real-time
  • rebound
  • reckitt
  • record
  • recording
  • records
  • recurrent
  • red eyes
  • reduction
  • referral
  • reflux
  • regurgitation
  • rehm
  • removal
  • renovation
  • renovations
  • repair
  • repellant
  • replacement
  • reporter
  • research
  • residency
  • resident
  • resistance
  • response
  • resurface
  • resurfacing
  • review
  • rhinitis
  • rhinoplasty
  • richmond
  • right
  • ringing
  • rinse
  • risk
  • robert
  • robot
  • robotic
  • rock
  • roger
  • roof
  • room
  • rotating
  • routine
  • rubber
  • runny nose
  • rupture
  • ryan
  • safe
  • sale
  • saline
  • saliva
  • salivary stone
  • saltwater
  • santa claus
  • scan
  • scans
  • scar
  • scheduling
  • science
  • scientist
  • SCIT
  • scopolamine
  • scramble
  • scratch
  • screening
  • SD
  • seafood
  • search
  • seasonal
  • seaweed
  • secondhand
  • secure
  • security
  • sedated
  • sedation
  • self-pay
  • sensory
  • sepsis
  • septal
  • septo
  • septoplasty
  • septum
  • sermo
  • service
  • set
  • severe
  • sex
  • shampoo
  • shape
  • shark
  • shenandoah university
  • shop
  • shortness of breath
  • shot
  • shots
  • show
  • shrimp
  • sialadenitis
  • sialendoscopy
  • sialoadenitis
  • sickness
  • side
  • side effect
  • silent
  • silver nitrate
  • singer
  • singing
  • singing cat
  • singulair
  • singultus
  • sinuneb
  • sinuplasty
  • sinus
  • sinus fracture
  • sinus infection
  • sinus lift
  • sinus surgery
  • sinusitis
  • skating
  • skin
  • skin cancer
  • skull
  • sleep
  • sleep disorder
  • SLIT
  • sluder
  • small
  • smartphone
  • smell
  • smoke
  • smoking
  • sms
  • sneeze
  • sneezing
  • snore
  • snoring
  • snot
  • snotty nose
  • social
  • social media
  • social networking
  • soda
  • sodium
  • soft
  • song
  • sore
  • sore throat
  • sour
  • spa
  • spam
  • spanish
  • spasmodic
  • spasmodic dypshonia
  • spasmodic dysphonia
  • spasms
  • special
  • specialist
  • speech
  • speech therapy
  • spinal
  • spinning
  • spit
  • splints
  • split tube
  • spray
  • spur
  • ssnhl
  • staph
  • starvation
  • stat
  • station
  • stem
  • stereoisomer
  • sterile
  • steroid
  • steroids
  • sticky
  • stink
  • stone
  • stones
  • stops
  • storybooks
  • strange
  • strep
  • strep throat
  • stridor
  • strobe
  • stroboscopy
  • stroke
  • stuck
  • stud
  • student
  • study
  • stuffed animals
  • stuttering
  • sublingual
  • submandibular
  • submaxillary
  • sudden
  • sudden hearing loss
  • sun
  • sunblock
  • sunscreen
  • sunshine
  • superbill
  • superbowl
  • superbug
  • support
  • surgeon
  • surgery
  • surgical
  • survey
  • suture
  • swallow
  • swallowing
  • swelling
  • sword
  • symbicort
  • symphony
  • symptom
  • symptoms
  • syndrome
  • T-tube
  • tablet
  • talk
  • talking
  • tall
  • target
  • taste
  • tea
  • teacher
  • technology
  • teen
  • teenager
  • teeth
  • television
  • temperature
  • terrorism
  • terrorist
  • test
  • testing
  • tests
  • text messaging
  • the doctors
  • the onion
  • theory
  • therapy
  • thick
  • throat
  • throat cancer
  • throat clearing
  • throat-clearing
  • thrombosis
  • thrombus
  • throwing
  • thyroid
  • thyroidectomy
  • tia
  • tic
  • tic cough
  • tick
  • tilt
  • time
  • times
  • tinnitus
  • tiny
  • Tionne
  • TLC
  • TMJ
  • tobacco
  • TOCPM
  • today
  • tongue
  • tonsil
  • tonsil stones
  • tonsillectomy
  • tonsilliits
  • tonsillitis
  • tonsilloliths
  • tonsillotomy
  • tonsilolith
  • tonsiloliths
  • tony
  • tooth
  • tooth pain
  • top
  • topical
  • TORD
  • torres
  • tors
  • torticollis
  • tour
  • toxin
  • toyota
  • trach
  • tracheostomy
  • training
  • trans
  • translation
  • transmedics
  • transmission
  • transplant
  • transplantation
  • transportation
  • trauma
  • treating
  • treatment
  • tremor
  • trend
  • triangle
  • trombone
  • trouble
  • tube
  • tubes
  • tucci
  • tumor
  • turbinate coblation
  • turbinate hypertrophy
  • turbinate reduction
  • turning
  • tutorial
  • TV
  • tween
  • tweet
  • twitching
  • twitter
  • two
  • tylenol
  • tympanic
  • type
  • ulcer
  • ulpa
  • ulrich
  • ultrasound
  • unable
  • unclog
  • under
  • uninsured
  • united kingdom
  • university
  • Update
  • upper
  • upper respiratory infection
  • uppp
  • urgent
  • URI
  • urine
  • urticaria
  • usa
  • USA today
  • uva
  • uvula
  • uvulectomy
  • uvulopalatopharyngoplasty
  • vaccination
  • vaccine
  • vagal neuropathy
  • vascular
  • vasomotor
  • vasomotor rhinnitis
  • vcd
  • ventilation
  • versus
  • vertigo
  • ves
  • vessel
  • viagra
  • vibration
  • video
  • viral
  • virginia
  • virus
  • viruses
  • vit d
  • vitamin
  • vitamin A
  • vitamin d
  • vivosonic
  • vlog
  • vocal
  • vocal cord
  • vocal cord dysfunction
  • vocal cord paralysis
  • vocal cord paresis
  • vocal cords
  • vocal process
  • voice
  • voice therapy
  • voicebox
  • voicelift
  • volume
  • vomit
  • vs
  • wait
  • waiting
  • wall
  • wall street journal
  • warm
  • warrenton
  • washes
  • washington
  • washington dc
  • washington post
  • water
  • watkins
  • wax
  • wearable
  • web
  • web 2.0
  • webapp
  • Website
  • Website Update
  • wedge
  • weight gain
  • whale
  • what to do
  • wheezing
  • where
  • whisperer
  • whispering
  • white
  • who
  • whooping
  • wierd
  • wifi
  • will.i.am
  • wind
  • windows 7
  • winter
  • wire
  • wireless
  • withdrawal
  • without
  • woman
  • word
  • world
  • world voice day
  • world's
  • worlds
  • wound center
  • wp
  • wrestling
  • wrong
  • wsj
  • x-ray
  • xeomin
  • xray
  • xylitol
  • xyzal
  • youtube
  • zenker's
  • zenkers
  • zeta
  • zicam
  • zinc
  • zyrtec

Blog Archive

  • ▼  2011 (190)
    • ►  September (26)
    • ►  August (22)
    • ►  July (20)
    • ►  June (15)
    • ►  May (10)
    • ►  April (18)
    • ►  March (12)
    • ▼  February (33)
      • Septal Stapler for Septoplasty Surgery
      • The Doctors TV Show Does the Mouth
      • Baby Shampoo Used to Treat Chronic Sinusitis
      • Miscarriage During Pregnancy Is Murder Committed b...
      • Do Cell Phones Pose a Health Hazard? Do Cell Phone...
      • Diagnosing Smell and Taste Disorders
      • New Video of Phlegmy Throat
      • Oral Sex Causes More Oral Cancer Than Smoking!
      • The King's Speech and Those With Spasmodic Dysphonia
      • How a Grizzly Bear Can Help Patients
      • Boy With Missing Cerebellum & Pons Learning to Walk!
      • How is Love Like Dizziness? Medically Speaking...
      • Stabbing Headaches??? Maybe It's A Knife in the He...
      • U.S. Marshals Seize Auralgan Otic Solution (Unappr...
      • Ear Pain Due to Tooth... In the Ear Canal!
      • New Anti-Snoring Device... aveoTSD
      • 1 Out of 5 Kids With Viral URI Develop Ear Infections
      • Not All Facial Fractures Require Repair... Ask Ana...
      • Fauquier Hearing Aid and Hearing Testing Services ...
      • New Video Produced on Non-Sedated ABR/OAE Testing
      • How to Unclog a Clogged Ear
      • Dr. Chang to Guest Lecture at Shenandoah University
      • Is Whispering Bad for Your Vocal Cords???
      • Video of Monkey Behaving Like a ENT Doctor
      • “The Who" Roger Daltrey Underwent Vocal Cord Surgery
      • Homeless Man With the Golden Voice
      • Miley Cyrus "I Cut My Uvula"! ...NOT!
      • New Video on Uvula Excision for Snoring (and Other...
      • Xyzal and Clarinex Generics Now Available
      • Non-Sedated ABR & OAE Now Offered at Fauquier ENT
      • Tonsillectomy Causes Obesity?
      • The Doctors TV Show Does Surgery for Obstructive S...
      • New Video on UPPP Surgery to Treat Sleep Apnea (Uv...
    • ►  January (34)
  • ►  2010 (267)
    • ►  December (23)
    • ►  November (18)
    • ►  October (32)
    • ►  September (30)
    • ►  August (35)
    • ►  July (16)
    • ►  June (27)
    • ►  May (22)
    • ►  April (27)
    • ►  March (11)
    • ►  February (13)
    • ►  January (13)
  • ►  2009 (43)
    • ►  December (11)
    • ►  November (13)
    • ►  October (19)
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