A Prospective Cohort Study Investigating the Role of a Screening Smell and Taste Test in Patients Following Head...

Head trauma is a major cause of chemosensory deficit, with olfactory loss occurring in approximately 22% of cases. Following head injury, olfactory and gustatory loss are often unassessed; patients are often unaware of the problem, thus presenting late to specialist clinics.

To determine the role of screening olfactory and gustatory testing in patients following head trauma.

This prospective cohort study, conducted at three secondary hospitals, included patients with head injury aged ≥ 18 years, with capacity to consent within 30 days of injury. Patients with previous head injury requiring admission or with pre-existing olfactory/gustatory loss were excluded. Participants underwent screening chemosensory assessment using Burghart Sniffin' Sticks and Taste Strips. If significant loss was identified, patients were referred to Smell & Taste clinic to be seen within 3 months of injury for extended testing.

A total of 121 participants took part in the study (65 male, 56 female); 71% experienced olfactory dysfunction and 62% gustatory dysfunction post head injury. There was no statistically significant association between gender and olfactory/gustatory dysfunction (p > 0.05). Older participants experienced a higher prevalence of olfactory and gustatory dysfunction. Seven participants progressed to a follow-up consultation in the Smell & Taste Clinic, all of whom had persistent olfactory dysfunction.

Our study highlights that a significant proportion of mild head injuries result in olfactory/gustatory dysfunction, thus reinforcing the use of psychophysical testing in this patient cohort. Improvements should be made to ensure they receive suitable follow-up in a Smell & Taste clinic.