Psychophysical testing of smell and taste function

The senses of smell and taste are largely underappreciated by laypersons and medical professionals alike. Unlike vision, hearing, balance, and touch, they are rarely evaluated quantitatively in the clinic, even though hundreds of thousands of persons seek medical help annually for disorders of these senses. Chemosensory disorders impact quality of life, including the flavor of foods and beverages, and compromise the ability to detect such environmental hazards as fires, leaking natural gas, and spoiled foodstuffs. Moreover, olfactory dysfunction can be a harbinger for Alzheimer's and other neurodegenerative diseases, and is known to triple the likelihood of mortality in older persons over the course of 4 or 5 years. Without accurate testing, one cannot establish the veracity of a patient's complaint, the probability of malingering, the impact of treatments, and whether the degree of dysfunction is normal relative to a patient's age and sex. This chapter provides basic information as to how to measure both the senses of smell and taste, as well as normative data for several clinical smell and taste tests.