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Disorders of taste and smell.

Symptoms of disorders in taste and smell range from loss of the sensations to an increased sensitivity. Causes include infections, metabolic disorders, and central nervous system disturbances. In many instances, the diagnosis for these disorders is obvious, such as an upper respiratory tract infection. In some cases, the diagnosis eludes the clinician and no pathologic condition is found. For the idiopathic taste disorders, zinc therapy is available; however, no therapy exists for idiopathic smell disorders.

Adolescent

[Evaluating function and disorders of taste].

In a first anatomical section the peripheral gustatory pathways, their central connections, nuclei and cortical projections are discussed. It is evident, that the gustatory fibres from the posterior part of the tongue run in the IX nerve and those from the soft palate reach the medulla oblongata via the petrosal and facial nerve. For the anterior part of the tongue there obviously exists only one gustatory pathway via the chorda tympani-facial nerve. About the further central pathways of taste fibres is much less known. In a second part the methods of taste testing with different taste solutions and the electrogustometry are described. Their practical use and the pitfalls of testing are considered. The disorders of the taste sense compose a third part. Genetic and endocrine abnormalities as well as the side effects of drugs and radiotherapy and the destruction of taste nerves may lead to gustatory deviations. The possibility of central gustatory disorders, especially the combined loss of taste and smell as a result of trauma are mentioned. A chapter dealing with the therapy of taste disorders and a short outlook on the genetic aspects of this oral sense complete this review.

Afferent Pathways

[Gustatory disturbances as sideeffect of medical treatment (author's transl)].

A review of the pharmacological induced taste disorders is given. Many patients complain only of a spontaneous metallic, bitter or salty sensation in their mouths. More serious is the development of a dissociated hypogeusia or even an ageusia. 7 cases with gustatory disturbances caused by orally given medicine are presented. The phenylbutazone, oxyphedrine, carbamazepine, Muskel-Trancopal comp. (Chlormezanon, Paracetamol) and Lioresal (baclofen) were accused to have caused a partial or complete loss of taste. After the treatment had been discontinued it took weeks or even months for a complete recovery.

Acetaminophen

Posthypophysectomy taste abnormalities: their relationship to remote effects of cancer.

Abnormalities in taste sensation have been studied in 15 patients consisting of five normal controls, five patients with diffuse neoplasm and five patients post hypophysectomy. Threshold recognition for salt and HC1 in the three groups studied was the same. Sucrose and urea recognition was higher in patients with neoplasm as compared to normal controls. Patients post hypophysectomy had a lower threshold recognition for sucrose than both normal individuals and patients with neoplasm. The threshold recognition has markedly shifted for both sucrose (decreased) and urea (increased) post hypophysectomy. These observations are in support of previous findings and suggest that the pituitary plays at least a necessary permissible factor in the development of abnormalities in taste as observed in patients with disseminated cancer.

Breast Neoplasms