Canale M, Canale F, Pallestrini E, Castello E
Istituto di Medicina Legale e delle Assicurazioni dell'Università di Genova.
Acta Otorhinolaryngol Ital. 1994;14 Suppl 42:1-17.
Taste disorders can a rise from lesions of peripheral receptors, taste control pathways or cortical area involvement. Among peripheral lesions, trauma of the tongue and oropharynx are the most common. Iatrogenic lesions of facial and glossopharingeal nerves are very important in Forensic Medicine, while there are different opinions about taste alterations due to head injuries; hypogeusia associated to smell disorders are found in 0.4-0.5% of patient after head trauma with good prognosis (90% healing) while qualitative disorders are more common (30%). The Authors describe clinical methodologies for taste evaluation and their application in Forensic Medicine. Forensic estimation of taste disorders con be classified by two main groups: study of cause relation between the occurrence and damage and quantitative valuation of the damage in three different juridical ambits: Penal, Civil, Insurance and foresight. In Penal Right taste damages could be classified among personal lesion crimes and can be classified as serious (permanent injury of taste) ore very serious (complete lost of taste function). Italian Legislation equipare the 5 sense organs. In Civil Right evaluation the so-called "biologic damage" and working ability are considered; this means very different evaluations. In the most recent baremes, generic damage is estimated by different Authors from 0 to 10% while with regard to specific working capacity, common evaluation criteria does not exist. In Insurance taste disorders evaluation is based only on working ability and not on biologic damage. In the previdenzial ambit, taste disorders are not even included in the most recent tables of permanent invalidity estimation. The Authors propose new and more efficacious valutation criteria for taste disorders in all ambits, hoping for more interest in the Forensic aspects of taste, a too often forgotten sensory function.
味觉障碍可能源于外周感受器病变、味觉控制通路损伤或皮质区域受累。在外周病变中，舌部和口咽部创伤最为常见。面神 经和舌咽神经的医源性损伤在法医学中非常重要，而关于头部损伤导致的味觉改变存在不同观点；头部创伤后，0.4 - 0.5% 的患者会出现与嗅觉障碍相关的味觉减退，预后良好（90%可恢复），而定性味觉障碍则更为常见（30%）。作者描述了味觉评估的临床方法及其在法医学中的应用。法医学中味觉障碍的评估可分为两大类：研究事件发生与损害之间的因果关系，以及在刑事、民事、保险和前瞻性这三个不同司法领域对损害进行定量评估。在刑法领域，味觉损害可归类为个人伤害犯罪，可分为严重（味觉永久性损伤）或非常严重（味觉功能完全丧失）。意大利立法对五种感官器官一视同仁。在民事权利评估中，会考虑所谓的“生物损害”和工作能力；这意味着评估差异很大。在最新的赔偿表中，不同作者对一般损害的估计从0到10%不等，而对于特定的工作能力，不存在通用的评估标准。在保险领域，味觉障碍评估仅基于工作能力，而非生物损害。在前瞻性领域，味觉障碍甚至未被纳入最新的永久性残疾评估表中。作者针对所有领域提出了新的、更有效的味觉障碍评估标准，希望人们对味觉这一常常被遗忘的感官功能的法医学方面给予更多关注。
