Specific aspects of medical expert opinions of smell and taste disorders.

Background: The number of medical expert opinions dealing with smell and ta ste disorders has continuously increased in recent years. However, an overv iew of the specific problems and results of those expert opinions has not b een published until now. Individuals and Methods: Olfaction was assessed by multiple subjective tests in 145 individuals with chemosensory dysfunction caused by trauma or occupational and environmental exposures. Additionally , a gustatory test, nasal endoscopy, anterior rhinomanometry, and radiograp hy of the paranasal sinuses were performed, Malignering was diagnosed on a trial of multiple symptoms. Retronasal olfaction was tested using the Gutti ch gustatory olfaction test. Results: Most of the medical expert opinions h ave been ordered by professional associations (42%) and insurance companies (28%). Compensation for olfactory dysfunction was claimed after trauma (64 %), occupational exposure (23%) rhinosurgical procedures (8%), and laryngec tomy (5%). Anosmia or hyposmia was claimed by 66% and 24% of all individual s, respectively, According to the results of the chemosensory tests, 41% of patients suffered from anosmia and 40% had hyposmia, Malignering was regis tered in 14%. Conclusions: The study shows that the "characteristic case" i s a male in the late fourties, complaining of anosmia initially noticed aft er an occipital or frontobasal head trauma. The assessment of olfactory def icits related to toxic or chemical occupational exposure is difficult when a latency between the occupational exposure and the onset of chemosensory d ysfunction is present. Moreover, interactions between the occupational expo sure and nicotine or alcohol abuse must be taken into consideration. Claims for medical liability arose in 3% of the study group after septoplasty and sinus surgery.