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Approach to the Patient: Disorders of the Sense of Taste Patients who complain of loss of taste should be evaluated for both gustatory and olfactory function. Clinical assessment of taste is not as well developed or standardized as that of smell. The first step is to perform suprathreshold whole-mouth taste testing for quality, intensity, and pleasantness perception of four taste qualities: sweet, salty, sour, and bitter. Most commonly used reagents for taste testing are sucrose, citric acid or hydrochloric acid, caffeine or quinine (sulfate or hydrochloride), and sodium chloride. The taste stimuli should be freshly prepared and have similar. | Chapter 030. Disorders of Smell Taste and Hearing Part 6 Approach to the Patient Disorders of the Sense of Taste Patients who complain of loss of taste should be evaluated for both gustatory and olfactory function. Clinical assessment of taste is not as well developed or standardized as that of smell. The first step is to perform suprathreshold whole-mouth taste testing for quality intensity and pleasantness perception of four taste qualities sweet salty sour and bitter. Most commonly used reagents for taste testing are sucrose citric acid or hydrochloric acid caffeine or quinine sulfate or hydrochloride and sodium chloride. The taste stimuli should be freshly prepared and have similar viscosity. For quantification detection thresholds are obtained by applying graduated dilutions to the tongue quadrants or by whole-mouth sips. Electric taste testing electrogustometry is used clinically to identify taste deficits in specific quadrants of the tongue. Regional gustatory testing may also be performed to assess for the possibility of loss localized to one or several receptor fields as a result of a peripheral or central lesion. The history of the disease and localization studies provide important clues to the causes of the taste disturbance. For example absence of taste on the anterior two-thirds of the tongue associated with a facial paralysis indicates that the lesion is proximal to the juncture of the chorda tympani branch with the facial nerve in the mastoid. Disorders of the Sense of Taste Treatment Treatment of gustatory disorders is limited. No effective therapies exist for the sensorineural disorders of taste. Altered taste due to surgical stretch injury of the chorda tympani nerve usually improves within 3-4 months while dysfunction is usually permanent with transection of the nerve. Taste dysfunction following trauma may resolve spontaneously without intervention and is more likely to do so than posttraumatic smell dysfunction. Idiopathic alterations of taste
