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

BACKGROUND: 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. PRIMARY AIM: To determine the role of screening olfactory and gustatory testing in patients following head trauma. METHODS: 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. RESULTS: 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. CONCLUSION: 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.