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What should be the rehabilitation of the smell after having had coronavirus


This February 27 is the International Day of Anosmia. What treatments can be performed (Shutterstock.com)

Smelling provides a set of sensations, emotions, pleasures that result in a state of well-being. We smell, we smell and we emit odors. And these smells are present in daily life, in love relationships, in health, at work, in industry, in transportation, in religious rituals. Smells are present everywhere, they are part of our interaction in the social sphere.

You can talk about three types of odors:

-The bodily.

-The manufactured or manufactured.

-The symbolic.

Olfaction is the action of smelling and it is a physiological immediacy, which has its response in the brain, after anatomical participation, where the meeting of two protagonists occurs: odors (chemicals) and the anatomical structure of the sense of smell.

In the hierarchy of the senses, smell has an absent vocabulary: it is much easier to talk or discuss about music, where the sense of hearing is involved, or about visual aspects (both are physical stimuli). The sense of smell has always been discredited, since ancient times. It was never taken into account (even by health professionals) and the truth is that little was known about it.

The first thing patients wonder is if the lack of smell can be treated, if it will return and if they will regain this sense (Shutterstock)
The first thing patients wonder is if the lack of smell can be treated, if it will return and if they will regain this sense (Shutterstock)

But nowadays, the coronavirus took hold of this sense: until 2019, the World Health Organization (WHO) estimated that 5% of the world’s population was anosmic. With the SARS-CoV-2 pandemic, this number increased dramatically.

East February 27 is International Anosmia Day, and it is an excellent opportunity to learn about the treatments available for these patients.

The first thing patients ask is If the lack of smell can be treated, if it will return and if they will regain this sense. The good news is that the answer is yes: lack of smell (called anosmia) has medical treatment and, in addition, smell you can train again and usually recover after days or weeks or even months, it always depends on the moment in which it is consulted.

Until 2019, the World Health Organization (WHO) estimated that 5% of the world's population was anosmic.  With the SARS-CoV-2 pandemic, this number increased dramatically (Shutterstock.com)
Until 2019, the World Health Organization (WHO) estimated that 5% of the world’s population was anosmic. With the SARS-CoV-2 pandemic, this number increased dramatically (Shutterstock.com)

For more than a decade, there has been clear evidence that olfactory training with odoriferous substances can restore smell. In 2009, a group of German researchers led by specialist Thomas Hummel described this wonderful possibility of retraining smell thanks to brain plasticity.

For this, an individualized protocol is designed, according to the priorities of each case and the damage that this abolition is causing in the person. There is no magic wand, but the guide in the therapeutic process is personalized, according to the case of each patient.

The training, as mentioned, It is individualized and consists, according to each case, of repeated exposure to different smells of the patient’s choice for as long as necessary, one at a time. The basis of the training is for the patient to associate the smell with his memory (evoking memories with that substance). The exercise should be performed for 5 seconds to 5-10 minutes, three or four times a day. Personally, and in my experience, I tell the patient not to go to a second smell until the first is not recognized. In addition, I request, in case the flavor is also abolished, let him try some candy. For example, if you smell mint, accompany the exercise with a mint, eucalyptus or menthol candy.

An individualized protocol is designed, according to the priorities of each case and the damage that this abolition is causing in the person (Shutterstock)
An individualized protocol is designed, according to the priorities of each case and the damage that this abolition is causing in the person (Shutterstock)

I do not suggest mixing the smells or smelling several at the same time, because the signals sent to the brain could be confused and affect identification and odor discrimination, which may not be accurate.

Olfactory training based on repeated stimulation is an experience that improves olfactory skills. It is a beneficial therapy for patients with post-viral, post-infectious loss of smell and also in losses due to head injuries or idiopathic (those whose causes are unknown).

In these retraining therapies improvements are observed and, for the moment, together with medical treatment is what can be offered to the patient.

* Stella Maris Cuevas (MN: 81701) is an ENT Doctor – Smell Expert – Allergist. Former President of the Association of Otolaryngology of the City of Buenos Aires (AOCBA)

I KEEP READING:

Everything that is known so far about the loss of smell and taste due to COVID-19
The aftermath of COVID-19: what life is like without smell
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