Taste and smell problems: validation of questions for the clinical history

Complaints of taste and smell dysfunction unaccompanied by symptoms of neurological or nasal problems are not uncommon. However, "I can't taste" is not necessarily an accurate symptom description. Complaints tend to reflect the common confusion between taste sensations (that is, salt, sour, sweet, bitter) and flavor sensations (including taste, smell, temperature, and texture). A number of questions have been identified that help classify symptoms according to the type of dysfunction (taste, smell, or both): whether the problem is quantitative (reduced or absent sensation) or qualitative (distorted sensations); and what might have caused the dysfunction. Directed questioning can yield a clinical history that predicts chemosensory function and identifies the most likely cause of the problem. Questions were assessed by comparing the self-reports of taste and smell symptoms to the clinical evaluation of chemosensory function for 101 new patients seen in the Taste and Smell Center at the University of Connecticut Health Center in 1983.