RU2806234C1 - Method for rehabilitation of patients with olfactory disorders - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: used to restore the sense of smell. Conduct olfactory training with essential oils in combination with psychological training to restore olfactory memory. For olfactory training, the patient is provided with test tubes with sets of essential oils, which the patient inhales 6 times a day of each aroma for 10 breaths with a break of 30 seconds for 14 days. The patient also uses Ringo's aroma ring 20 minutes before bedtime for 14 days. Psychological trainings are carried out in the form of solving psychological problems related to the sense of smell, in the form of a question and answer once every 3 days, for 14 days. In this case, olfactory training precedes psychological training.

EFFECT: effective restoration of impaired sense of smell in a short time through a combination of olfactory training with essential oils and psychological training to restore olfactory memory.

3 cl, 8 dwg, 2 ex

Description

The invention relates to medicine, namely to otorhinolaryngology, and can be used for rehabilitation (restoration) of the sense of smell, in particular, after suffering a new coronavirus infection COVID-19.

For smell impairment associated with various reasons, including post-COVID-19, olfactory training is recommended for patients with loss of smell as one of the means of smell rehabilitation.

Research by Hummel et al. has shown that "olfactory training" - the practice of repeatedly and repeatedly ingesting different odors in patients with smell loss - helps restore the sense of smell. (Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehner A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology. Supplement. 2017;54(26):1-30. https://www.rhinologyjournal.com /Documents/Supplements/supplement_26.pdf)

There are known methods for conducting olfactory training based on inhaling aromatic odorous substances through the nose (for example, international application WO2020060167A1, published on 03/26/2020, RF patent No. 2713786C1, published on 02/07/2020).

International application WO2020060167A1 describes a method for conducting olfactory training, during which the patient is asked, in accordance with a protocol developed by a doctor, to inhale various aromatic substances, while the concentration of odorous substances in the air, the time during which the patient inhales a certain aroma, is set by the doctor via a computer, depending from the achieved treatment results.

From the patent document of the Russian Federation No. 2713786, a method of treating olfactory dysfunction in patients with atrophic rhinitis is known, including rinsing the nasal cavity with a physiological solution of NaCl 0.9%, olfactory training using rose, eucalyptus, lemon and clove oils, which are brought to the vestibule of the nose for 10 seconds for each, with a break of 10 seconds for from 84 to 252 days, drug therapy with Neuromidin.

The disadvantage of the described methods is the lack of impact on the brain structures responsible for olfactory memory, which reduces the effectiveness of rehabilitation.

There is a known method for the rehabilitation of the sense of smell based on a brain-computer interface (RF patent No. 2768172C1, published 03/23/2022). To implement the known method, it is proposed to use a system that includes a device for displaying the training task and/or its implementation, a device for recording brain activity, an olfactory display for influencing the trained function, and a computer for recognizing and isolating recorded signals of brain activity with the ability to isolate evoked potential signals and olfactory signals. zones of the cerebral cortex and interpretation of the selected recorded signal using a database. The computer is configured to transmit commands generated based on the interpretation of the recorded brain activity signals to the olfactory display and/or to the display device according to the transmit-receive principle. At the same time, the display device provides a training task aimed at restoring the affected function of smell and taste. Brain activity signals are recorded using a brain activity recording device. The recorded signals are transmitted to the computer. The signals of brain activity necessary for interpretation are isolated using a computer, including evoked potential signals and signals from the olfactory zone of the cerebral cortex. Interpret the selected signals by comparing them with the database. Commands generated based on the interpretation of the recorded brain activity signals are transmitted to the olfactory display and/or display device. The olfactory display influences the trained function. Transmits signals to the display device. The display device represents the progress and degree of completion of the task.

The disadvantages of this method include the complexity of implementation, which makes the method difficult to use at home, as well as the lack of impact on the brain structures responsible for olfactory memory, which reduces the effectiveness of rehabilitation.

The technical problem to be solved by the invention is to create a method that allows one to effectively restore a person’s olfactory function in a short time and without the use of drugs at home.

The technical result achieved by the proposed invention is to increase the efficiency of rehabilitation of patients with olfactory disorders (reducing the rehabilitation period and restoring the sense of smell and olfactory memory to the state that was observed in the patient before the disease) due to the combination of effects on the olfactory epithelium of the nasal cavity and the structure of the brain, responsible for olfactory memory.

This technical result is achieved due to the fact that in the method of rehabilitation of patients with olfactory disorders, including olfactory training with odorous substances, in combination with olfactory training, psychological training is carried out to restore olfactory memory, and psychological training is carried out after olfactory training.

Olfactory training is carried out with purified essential oils, while providing the patient with test tubes with sets of essential oils, and the patient inhales each aroma 6 times a day for 10 breaths with a break of 30 seconds for 14 days. The following types of essential oils are used:

• mint

• spruce

• niauli

• fir

• tea tree

• eucalyptus

• anise

• spiderwort

• tangerine

• ylang-ylang

• lavender

• basil

• clove

• lime

• lemongrass

• coriander

Additionally, the patient puts an aroma ring soaked in essential oils on the nasal septum for 20 minutes before bedtime for 14 days.

Psychological training for the restoration of olfactory memory is carried out in the form of a question and answer 1 time every 3 days for 14 days, while the patient is shown 5 different pictures and given 5 numbered aromas, the patient is asked to compare the aromas that best match the images, and remember the resulting pairs, through For 10 minutes, the patient is shown the same images and given the aromas in a different sequence, asked to remember previously made pairs and correlate the image with the aroma from memory.

When conducting psychological training to restore olfactory memory, the patient is given a blank sheet of paper and 5 numbered scents, the patient is asked to smell each scent and draw it as a symbol on paper, after 10 minutes the patient is shown the drawn symbols and the scents are given in a different sequence, the patient is asked to remember the earlier pairs and match the image with the scent from memory.

When conducting psychological training to restore olfactory memory, the patient is given 5 boards with different pasted textures and 5 numbered aromas, the patient is asked to compare the aromas that best match the texture and remember the pairs of aromas with texture, after 10 minutes the patient is given the same boards and aromas in another sequences, ask the patient to remember earlier pairs and correlate the texture with the aroma from memory.

The alternation of olfactory and psychological training provides irritation of both peripheral and central olfactory structures, which makes it possible to reduce rehabilitation time and restore the sense of smell and olfactory memory to the state that was observed in the patient before the illness. Moreover, the sequence of exposure is important, first irritation of the olfactory epithelium (peripheral zone), and then work to restore olfactory memory (central zone), as this makes it possible to restart the neuroreflexogenic channels of the olfactory tract and restore the sense of smell.

The implementation of the proposed method is possible using simple devices, such as a set of aromatic substances (essential oils), an aroma ring, a set of cards for psychological training, which allows the patient to carry out smell rehabilitation at home.

The results of the impact of the proposed method on the sense of smell are illustrated with diagrams.

In fig. Figure 1 presents the aroma criteria of patient K., 25 years old, before treatment.

In fig. Figure 2 shows the number of errors when performing psychological tests of patient K., 25 years old, before treatment.

In fig. Figure 3 presents the aroma criteria of patient K., 25 years old, after treatment.

In fig. Figure 4 shows the number of errors when performing psychological tests of patient K., 25 years old, after treatment.

In fig. Figure 5 shows the aroma criteria of patient O., 37 years old, before treatment.

In fig. Figure 6 shows the number of errors when performing psychological tests of patient O., 37 years old, before treatment.

In fig. Figure 7 presents the aroma criteria of patient O., 37 years old, after treatment.

In fig. Figure 8 shows the number of errors when performing psychological tests of patient O., 37 years old, after treatment.

The method is carried out as follows.

The following describes one of the possible options for implementing the claimed method.

For 14 days, olfactory training is carried out daily and psychological training is carried out once every 3 days. At the same time, psychological trainings are carried out from the first days of rehabilitation after olfactory training. During psychological training, the psychological tests described below are carried out in any order. In this case, it is possible to conduct only one or two of the described psychological trainings.

Olfactory training is carried out with purified essential oils (for example, produced by Violet MSK LLC, Russia). To do this, the patient is provided with test tubes with sets of odorous substances (essential oils), which are asked to inhale 6 times a day of each aroma for 10 breaths with a break of 30 seconds for 14 days.

Types of essential oils:

• mint

• spruce

• niauli

• fir

• tea tree

• eucalyptus

• anise

• patchouli

• tangerine

• ylang-ylang

• lavender

• basil

• clove

• lime

• lemongrass

• coriander

Also, to perform olfactory training, the patient is given a special Ringo aroma ring (manufactured by Ringo Rus LLC Russia), soaked in essential oils, which should be worn on the nasal septum for 20 minutes before bedtime for 14 days.

The ring is made of organic hypoallergenic cellulose impregnated with natural essential oils:

• lavender

• oregano

Psychological trainings are proposed to be carried out in the form of solving psychological problems related to the sense of smell, in the form of a question and answer once every 3 days, for 14 days, while first they propose to perform olfactory training, and then psychological training. They suggest performing the following tests (psychological tasks).

Test No. 1

Shows 5 different pictures and gives out 5 numbered scents. The patient is asked to compare the scents that most closely match the images. They offer to memorize pairs of aromas with images. After 10 minutes, the same images are shown again and aromas are given out, but in a different sequence. They ask you to remember previously made pairs and match the image with the aroma from memory.

Test No. 2

They give you a blank sheet of paper and 5 numbered scents. They suggest smelling each scent and trying to sketch it as a symbol on paper. After 10 minutes, I again show the drawn symbols and give out aromas, but in a different sequence. They suggest remembering previously made pairs and matching the image with the aroma from memory.

Test No. 3

They give out 5 boards with different glued textures and 5 numbered scents. Types of texture: foil, bubble wrap, sandpaper, hard sponge, soft sponge. They suggest comparing the flavors that best match the texture. The patient is asked to remember the combined pairs of aromas with texture. After 10 minutes, the same boards are handed out again and the aromas are given out, but in a different sequence. They ask you to remember previously made pairs and match the image with the aroma from memory.

Clinical examples.

Patient K., 25 years old, suffered a mild new coronavirus infection in November 2021. During the illness, hyposmia appeared, which bothered me for a long time. I applied to the Department of Otorhinolaryngology of the Russian State Social University, where I underwent olfactory rehabilitation.

An endoscopic examination of the nasal cavity revealed no nasal pathology. The nasal mucosa is pink, there is no swelling or discharge. Nasal septum in the midline.

A questionnaire was conducted and a subjective assessment of the sense of smell was carried out using essential oils and a visual analogue scale (VAS), which was a segment of 10 cm, where 0 means that there was no criterion, 10 is the maximum value.

The results of the survey are presented in Fig. 1.

The patient conducted olfactory training with essential oils 6 times a day, 10 breaths with breaks of 30 seconds of each aroma for 14 days and used a Ringo aroma ring soaked in essential oils, which was worn on the nasal septum for 20 minutes before bedtime for 14 days.

The patient also performed psychological training in the form of solving psychological problems related to the sense of smell, 1 time every 3 days for 14 days.

During the first psychological test, the number of errors in repeating the task was recorded (Fig. 2).

After rehabilitation courses, the subjective assessment of smell became significantly better (Fig. 3).

As can be seen from Fig. 3, the criteria of smell - strength, variety and persistence of aroma - increased, and the perversity of odors fell markedly.

After olfactory and psychological training, olfactory memory also improved significantly, which indicated a decrease in errors when performing tests (Fig. 4).

Patient O., 37 years old, suffered a mild new coronavirus infection in March 2021. During the illness, hyposmia appeared, which persists to this day. She applied to the Department of Otorhinolaryngology of the Russian State Social University, where she underwent olfactory rehabilitation.

An endoscopic examination of the nasal cavity revealed no nasal pathology. The nasal mucosa is pink, there is no swelling or discharge. Nasal septum along the midline. The nasal turbinates are not enlarged.

A questionnaire was conducted and a subjective assessment of the sense of smell was carried out using essential oils and a visual analogue scale (VAS), which was a segment of 10 cm, where 0 means that there was no criterion, 10 is the maximum value.

As a result, the results presented in Fig. 1 were obtained. 5.

The patient conducted olfactory training with essential oils 6 times a day, 10 breaths with breaks of 30 seconds of each aroma for 14 days and used a Ringo aroma ring soaked in essential oils, which was worn on the nasal septum for 20 minutes before bed for 14 days.

The patient also performed psychological training in the form of solving psychological problems related to the sense of smell, once every 3 days for 14 days.

During the first psychological test, the number of errors in repeating the task was recorded (Fig. 6).

After rehabilitation courses, the subjective assessment of smell also became significantly better (Fig. 7).

As can be seen from the table presented in Fig. 7, the olfactory criteria of strength, variety and persistence of aroma have increased significantly.

After olfactory and psychological training, olfactory memory also improved significantly, which indicated a decrease in errors when performing tests (Fig. 8).

Thus, the proposed method for the rehabilitation of patients with olfactory disorders after the new coronavirus infection COVID-19 allows to improve the sense of smell and restore olfactory memory.

Claims (22)

1. A method of rehabilitation of patients with olfactory disorders, including olfactory training with essential oils, characterized in that, in combination with olfactory training, psychological training is carried out to restore olfactory memory; for olfactory training, the patient is provided with test tubes with sets of essential oils, which the patient inhales 6 times per a day of each aroma, 10 inhalations with a break of 30 seconds for 14 days, the patient is also given a Ringo aroma ring soaked in essential oils of lavender and oregano, which the patient puts on the nasal septum for 20 minutes before bedtime for 14 days; psychological trainings are carried out in the form of solving psychological problems related to the sense of smell, in the form of a question and answer once every 3 days, for 14 days, while olfactory training precedes psychological training. 2. The method according to claim 1, characterized in that the following types of essential oils are used: • mint, • spruce, • niauli, • fir, • tea tree, • eucalyptus, • anise, • patchouli, • tangerine, • ylang-ylang, • lavender, • basil, • clove, • lime, • lemongrass, • coriander. 3. The method according to claim 1, characterized in that when conducting psychological training to restore olfactory memory, the patient performs the following psychological tasks: show 5 different pictures and give out 5 numbered aromas, ask the patient to compare the aromas that best match the images and remember the resulting pairs, after 10 minutes they show the patient the same images and give out the aromas in a different sequence, offer to remember the previously made pairs and match the image from memory with aroma; give a blank sheet of paper and 5 numbered aromas, ask the patient to smell each aroma and draw it in the form of a symbol on paper, after 10 minutes the patient is shown the drawn symbols and given the aromas in a different sequence, ask the patient to remember previously made pairs and correlate the image with the aroma from memory ; give out 5 boards with different pasted textures and 5 numbered aromas, ask the patient to compare the aromas that best match the texture and remember the pairs of aromas with texture, after 10 minutes they give the patient the same boards and aromas in a different sequence, ask the patient to remember the earlier pairs and match the texture with the aroma from memory.