Page 28 - Olfaction regained_Flipbook-subtitles

technique during the odour test, this can be used as a starting point giving some instructions for change. If the patient experiences difficulty carrying out some movements, and there are no clear anatomic causes for this, specific exercises for those isolated movements may be used. Some examples of these types of exercises are described in Chapter 4, which also contains directions for treatment of patients with anatomical constraints. When the isolated movements can be carried out correctly, they can be combined with the other movements of the polite yawning technique. As soon as the patient is capable of carrying out the polite yawning technique correctly, it should be practiced and optimised with the use of a manometer, as described in the next section. Manometer as training aid A manometer is an indispensable device for olfactory rehabilitation, both for the patient as well as the SLP. The figures in this manual and the video clips on the accompanying CD-rom show a special manometer, made of Plexiglas tubes. Suggestions for a simpler homemade version of this instrument are given in the file (How to make a manometer) on the CD-rom. A manometer enables easy judgment of the generation of a nasal airflow in relation to the movement that the patient is carrying out. The amount and direction of movement of the fluids in the manometer give direct visual feedback. It also helps in providing insight into possible causes of an incorrect performance of the polite yawning technique. Before use, fill the manometer with water, approximately to the lowest indicator. Figure 10. Manometer filled with fluid. 27