How are taste and smell disorders diagnosed?

Updated: Dec 11, 2018
  • Author: Eric H Holbrook, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

The first step in diagnosing any deficit of taste and smell is obtaining a thorough history and physical examination. Give attention to any antecedent URI, nasal or sinus pathology, history of trauma, other medical problems, and medications taken.

Order sinus CT scans if the history and examination are not consistent with a common pattern (eg gradually progressing olfactory loss in a 38-year-old male). Generally, olfactory loss in the absence of CNS symptoms or an abnormal neurologic examination is highly unlikely to be associated with an intracranial mass such as a meningioma. However, an MRI of the brain is often recommended when the history is not straightforward or a secondary neurologic symptom or sign is obtained (eg, 50-year-old woman with a taste phantom that does not resolve after 6 months). Although a standard laboratory panel is not recommended, tests to evaluate for allergy, diabetes mellitus, thyroid functions, renal and liver function, endocrine function, and nutritional deficiencies may be obtained based on history and the physical examination. Olfactory epithelium biopsy is used primarily as a research technique.


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